The Effects To The Heart Rate Variability After Using Metoprolol Associated Digoxin Treating The Dilated Cardiomyopathy

Objective: Through analyzing the patients' diversify of heart rate variability, to approach the relation between heart rate variability and prognosis after using metoprolol associated digoxin treating the dilated cardiomyopathy.Methods: 120 patients with dilated cardiomyopathy were randomly divided into four groups: The first treatment group was 30 patients using metoprolol associated digoxin treatment going with the conventional anti-heart failure therapies such as diuretic and vasodilating agent. The second treatment group was 30 patients using metoprolol treatment going with the conventional anti-heart failure therapies such as diuretic and vasodilating agent. The third treatment group was 30 patients using digoxin treatment going with the conventional anti-heart failure therapies such as diuretic and vasodilating agent. The control group was 30 patients using the conventional anti-heart failure therapies such as diuretic and vasodilating agent. These four groups were given 24 hours dynamic electrocardiogram examination before treatment, 3 and 6 months after treating. Using 24 hours dynamic electrocardiogram, which applied the American Centry 2000 Holter recording and analizing system, The main outcome measures: 1. SDNN: the standard deviation of consecutive cardiac cycles of 24 hours recordings, unit: ms. reflecting the autonomic nerve's (including the sympathetic and pneumogastric nerve) total magnitude of tone, uses for appraise total HRV. The value of SDNN more bigger expressed the HRV more bigger, vice versa. 2. SDANN: the consecutive cardiac cycles of 24 hours recordings which is divided into sequential time section according to five minutes, first calculate the mean value of NN of every five minutes, and then calculate the standard deviation of the total mean values, unit: ms. That is standard deviation of the average R-R intervals calculated every five minutes for 24 h. It is applied for evaluating the slow change composition of HRV, reflecting the magnitude of sympathetic tone. 3. SDNNindex: it is the mean average of the standard deviation of consecutive cardiac cycles of 24 hours recordings every five minutes, unit: ms. The index, which is calculated the diversity of heart rate variability in five minutes, reflects the comparatively slow composition of HRV, associating with low and extremely low frequency in frequency domain. 4. RMSSD: root mean square successive difference between adjacent normal R-R intervals of 24 hours recordings, unit: ms. chiefly reflects the fast change composition of HRV, videlicet, tension of pneumogastric nerve. Concurrently,we given the total patients UCG examination before treatment,afret 3-month and 6-month treatment, determined the EF(point of spouting the left ventride blood) and graded the heart function by the clinical manifestation of the patients, judged the effects of the heart rate variability to the heart function. Thus through analyzing the patients' diversify of heart rate variability, to approach the relation between heart rate variability and prognosis after using metoprolol associated digoxin treating the dilated cardiomyopathy.Results: (1) Compared with the other three groups, the index SDNN of the first treatment group: was significantly elevated. So the effects, which produced by the different treatment, has statistical significance.(2) Compared with the other three groups, the index SDANN of the first treatment group: was significantly elevated. So the effects, which produced by the different treatment, has statistical significance.(3). Compared with the other three groups, the index SDNN_index of the first treatment group: was significantly elevated. So the effects, which produced by the different treatment, has statistical significance.(4) Compared with the other three groups, the index RMSSD of the first treatment group: was significantly elevated. So the effects, which produced by the different treatment, has statistical significance.(5) Compared with the other three groups, the index EF of the first treatment group: was significantly elevated, the heart function of the first treatment group: was significantly ameliorated. So the effects, which produced by the different treatment, the heart function of the dilated cardiomyopathy has statistical significance.Conclusion: Using metoprolol associated digoxin treating the dilated cardiomyopathy could be able to a higher effectively raise the patients' heart rate variability, improve the autonomic nerve's equilibrium, strengthen pneumogastric nerve's activity, ameliorate the cardiac function, enhance the patients' quality of life, decrease the patients' hospitalization days and times, reduce the occurrence of malignant abnormalities of heart rate, lower sudden death rate and amend the prognosis.