| Background: The Rho-kinase inhibitor has been widely used in many disease such as Coronary artery disease,Angina,Cerealvascular disease et al. However, there is no study has investigated agreement among HFPEF patients. We hypothesized that the Rho-kinase inhibition as a novelty therapy target that is effective and will improve the quality of life in HFPEF patients.Objective: To discuss the short-term effectiveness of Rho-kinase inhibitor (fasudil) in HFPEF; Observing the impact of their serum BNP, echocardiography (UCG) indicators: time constant of left ventricular pressure fall (T), the maximum rate of left ventricular pressure drop (-dp/dtMax) left ventricular diastolic function parameters, and combined with clinical observation and follow-up, fasudil group compared with the conventional drugs group of these patients and then assess the effect of diastolic function and prognosis ; and then identify the safety and effectiveness of the fasudil used in these patients.Methods: The study involved 80 subjects diagnosed with HFPEF(heart failure with preserved ejection fraction, standard LVEF>45%),age arrange from 45 to 65 years. Divided into two group; 37 subjects assigned into group A, as control group receive traditional optimal medical therapy, such as (ACEI / ARB drugs, digitalis, diuretics, nitrate lipids,β-blockers, etc.), (22 males, 15 females), aged(52±5.3 years); 43 subjects (25 males and 18 females) aged(54±2.5years)assigned into group B, as experimental group not only receive traditional optimal medical therapy but also Fasudil; (30mg / time, twice a day intravenously). Take age compose and gender ratio into account, there is no statistically significant difference obtained from patients between two groups. All serum BNP values of patients test in 24 hours, 2 weeks after admission, respectively. Echocardiography parameters such as left ventricular the maximum rate of pressure drop (-dp/dtMax), and calculate the time constant of left ventricular pressure fall (T) of all patients, all data were measured in 48 hours, 2 weeks after admission, respectively. Two groups data before and after drug administration compared with paired t test, comparison between groups using independent sample t test. All the experimental data state with xUse the statistical software of SPSS16.0 to analyse. Differences in the standard test is p<0.05(bilateral).Result: 1. NYHA classification show:two groups of patients on admission for NYHA classification grade III ~ IV, after the intervention of 2 weeks after treatment, patients in control group and heart function tests significant improvement, (χ2 = 7.318a, p = 0.026), most patients NYHA functional class decreased to I ~ II in short term, but there is still a small number of patients with cardiac function still remains in the class III, but was discharged 4 weeks follow-up visible results in the control group, experimental group had improved on the basis of the experimental group were further improved NYHA classification, (χ2 = 6.036a, p = 0.014); but followed up for 6 weeks, although both groups cardiac function improved ,However, compared between the control group and experimental group,(χ2 = 0.409a, p = 0.522), no significant difference obtained. 2. Simple traditional drug treatment control group (group A) serum BNP value is compared between admission and 2 weeks later,[483.78±69.53(pg/ml) vs 283.41±34.69(pg/ml), p<0.05)], and the difference have the statistically significant; Meanwhile, experimental group add with fasudil (group B) that BNP concentration in serum arrange from [464.26±64.32 (pg / ml) fell to 263.65±49.11 (pg/ml), p<0.05], the difference have the statistically significant; Serum BNP value testing on admission of two groups of patients is compared between two groups ,[483.78±69.53(pg/ml) vs 464.26±64.32(pg/ml), p=0.199], therefore no statistically significant difference obtained; However, Serum BNP concentrations is measured after 2 weeks again, comparison in the same way between groups [283.41±34.69(pg/ml) vs 263.65±49.11(pg/ml), p=0.039], showed statistical difference. 3. The maximum rate of decrease of left ventricular pressure (-dp/dtMax)show: group A at admission was [(1210.40±194.95mmHg/s), (1259.50±198.31mmHg/s) ]was the value obtained after 2 weeks traditional drug treatment, compared before and after treatment with paired t test, p <0.05, statistical difference obtained; With similar condition, the value of -dp/dtMax at admission of group B was (1190.30±207.38mmHg/s), 2 weeks after the fasudil intervention (1341.20±178.79mmHg/s), groups paired comparison obtained, p <0.05, significantly statistical difference obtained too; At the same time, the -dp/dtMax value was compared between two groups of patients within 48 hours of admission, that is[(1210.40±194.95mmHg/s) vs (1190.30±207.38 mmHg/s), p>0.05], therefore no significant difference obtained; However, data comparison between the groups after 2 weeks treatment, that is [(1259.50±198.31 mmHg/s) vs (1341.20±178.79mmHg/s),p=0.056], therefore there are no statistically significant differences between the two groups. 4. Left ventricular pressure decline time constant (T)show: the value of group A at admission (58.54±10.23ms), (55.16±8.99ms) after treatment 2 weeks, p<0.05, difference have the statistically significant; the value of group B at admission was (57.95±11.08ms), after fasudil intervention 2 weeks (47.47±7.27ms), p<0.05, difference have the statistically significant. T value testing on admission of two groups of patients is compared between groups, that is [ ( 58.54±10.23ms ) vs (57.95±11.08ms),p=0.807],there is no statistically difference detect. With similar condition, T values of patients was compared between groups after admission 2 weeks,[(55.16±8.99 ms)vs(47.47±7.27ms),p<0.05], difference have the statistically significant.Conclusion: Rho-kinase inhibitor-fasudil, can further improve the short-term symptoms and cardiac diastolic function indices of patients with HFPEF with few major adverse cardiac events.
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