Crossover Matched Study About The Effects Of Trimetazidine On Autonomic Nervous Function In Chronic Heart Failure Patients

Objective: To comprehend the effects of trimetazidine on the heart rate variability(HRV) and illuminate whether trimetazidine could improve the injured function of autonomic nerves, as well as to establish new treatment methods based on the level of myocardial metabolism in patients with chronic heart failure. Methods: It was randomized, matched, crossover and single-blinded in the methods of clinic study. The diagnostic criteria was accorded to one of Framingham's Heart Failure. The major matched conditions were age, sex, pattern of heart failure, Class II III IV of New York Heart Association Cardiac Function Classification, primary heart disease (coronary artery disease, pulmonary heart disease, primary hypertension and cardiomyopathy) etc, and excluded the patients with Type II diabetes, severe liver and renal failure or cancer. First, according to the pairing conditions, a part of matched patients were assigned to group A randomly, the other were assigned to group B. The patients in group A were treated with trimetazidine in the routine therapy, while the patients in group B were received the routine therapy without trimetazidine. Following two-weeks of treatment and one-week of washout period, the treatment of pairing patients were intersected each other. None of the patients knew the difference in their treatment. 24h electrocardiogram monitoring examination was taken at the beginning, after two-weeks of treatment and five-weeks of treatment. The design of study can be saved the amount of samples, at the same time it can be controlled the difference of the deviation of phases and individuality. The parameters of HRV include SDNN (standard deviation of all normal sinus R-R intervals over 24 hours), SDANN (standard deviation of the averaged normal sinus R-R intervals for all 5-minute segments over 24 hours), rMSSD (root mean square of the successive normal sinus R-R intervals difference over 24 hours), HRVTI (heart rate variability triangular index).At the same time, the parameters of cardiac function were observed, including LVEF(left ventricular ejection fraction), LVEDD(left ventricular end-diastolic diameter), LADD(left artrial diastolic diameter). All the data were analyzed by Software Packaged by Social Science ver 12.0 and ANOVA for the crossover experiment was used to compare with the treatment difference of the two groups. The difference was statistically significant(P<0.05). Results: The parameters of HRV were significantly increased and there was significant statistical difference after treatment with trimetazidine (PSDNN<0.01, PSDANN<0.01, PrMSSD<0.05, PHRVTI<0.05). Simutaneously, the parameters...