Assessment On The Efficacy Of Trimetazidine In Elderly Heart Failure Through Hs-cTnT And NT-proBNP

Obictive:The plasma levels change of high sensitive troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide(NT-proBNP) were observed to approach the the correlation among hs-cTnT,NT-proBNP and NYHA,to explore the value of examination hs-cTnT for evaluating cardiac function in heart failure patients.And then the hs-cTnT was firstly used as an index to evaluate the therapeutic effect of Trimetazidine in elderly patients with chronic heart failure.Method:According to the NYHA cardiac functional grading method,61patients of heart failure were divided into three groups as follows:grade II,19cases;grade Ⅲ,28cases;grade Ⅳ,14cases.The healthy control group consisted of30normal subjects. All above test objects were extracted fasting blood to measure plasma hs-cTnT and NT-proBNP with electrochemiluminescence method in the first day.Then61patients with heart failure were randomly divided into2groups,that were therapy group and control group. All of them were given a standard treatment(including cardinatia、diuretics、(3-blocke、ACEI、aldosterone receptor antagonist and vasodilating agent), and on the basis of conventional treatment,31patients in therapy group were given20mg Po TID Trimetazidine,all61patients were followed for12weeks.In the12weeks after the intervention,patients in the two groups were extracted fasting blood to measure plasma hs-cTnT and NT-proBNP with electrochemiluminescence method again.For the first day and in the12weeks after the intervention, the value of LVEF and E/A were recorded by echocardiogram. The data was processed and analyzed through SPSS13.0statistical software.Result:Compared with healthy control group. the plasma hs-cTnT and NT-proBNP in all HF patients were increased obviously (P<0.01).With the NYHA cardiac functional grade increasing,the heart function became worse, and the plasma hs-cTnT and NT-proBNP were increased (P<0.05).The analysis displayed hs-cTnT was positively correlated with NYHA (P<0.05),NT-proBNP was positively correlated with NYHA (P<0.01).After12weeks of therapy,the plasma hs-cTnT and NT-proBNP in two group patients were decreased (P<0.05);and the LVEF was increased (P<0.05),however the efficacy of the therapy group was superiored than that of control group(P <0.05);but the E/A was changed slightly (P>0.05)Conclusion:1. Hs-cTnT was increased obviously in elderly patients with chronic heart failure,and the more worse of heart function,the more higher of its plasma concentration;2. With the condition of HF patients improved after treatment,the heart function became better, and the hs-cTnT was decreased gradually;3. The hs-cTnT could be an ideal index used to judge the severity of heart function and the effect of the treatment just as NT-proBNP;4.It is feasible to use hs-cTnT as an index to judge the therapeutic effect of Trimetazidine in elderly patients with chronic heart failure.