| Heart valve disease is a common disease in our country, seriously affecting the patient’s ability to work, shorten life expectancy. According to statistics from the Chinese cardiac surgery database, said China each year there are about 100,000 patients underwent heart valve replacement surgery, but patients need surgery or surgical indications of much higher data. Heart valve replacement surgery due to improved cardiac hemodynamic instability, which to some extent, laid the foundation for the improvement of cardiac function. But our country undergoing heart valve replacement surgery, most patients are in their timing of surgery was carried out under circumstances occur cardiac decompensation, that heart failure patients with different severity have occurred prior to surgery. Plenty of evidence based medicine also reveals, in the event of failure will show irreversible trend. So after heart valve replacement is still impossible to eliminate the underlying heart failure, heart failure and may even still have progress of. Therefore, we should patients after cardiac valve replacement heart function reply attention.β- blockers inhibit the adrenergic receptor, heart rate, decreased myocardial contractility, lower blood pressure, reduce myocardial oxygen consumption, to prevent damage to the heart of catecholamines, remodeling and improvement of left ventricular function and blood vessels. Existing studies have shown the benefits ofβ- blocker treatment of heart failure are: to improve symptoms, reduce morbidity,mortality and improve quality of life and the need for hospitalization. β- blockers can prevent and reverse left ventricular remodeling and reduce the risk of fatal arrhythmias and sudden cardiac death. Serious adverse reactions β- blockers hypotension, heart block, bradycardia, and fluid retention. The large part of the data to show a beneficial effect of β- blockers for treatment of heart failure, heart disease,many scholars as the standard treatment of heart failure. However, a large number of domestic and foreign applications neuroendocrine inhibitor treatment of chronic systolic heart failure of long-term clinical trials, all with coronary heart disease,hypertension based, without the inclusion of valvular heart disease, including heart failure.Before the study by comparing preoperative and postoperative patients in the conventional diuretics, vasodilators application on the basis of the drug, plus metoprolol tartrate tartrate improvement after cardiac function analysis of the efficacy of the drug in the experimental group, the application for clinicians metoprolol tartrate improve cardiac function in patients with valvular surgery provide reference to improve the quality of life of patients after surgery.ObjectiveObserve the application of metoprolol tartrate for heart valve replacement surgery cardiac function.Methods96 patients in accordance with the principles of randomized, controlled divided into experimental and control groups. Differences between the two groups in age,gender, heart function was not statistically significant(P> 0.05), the two groups were comparable. The control group received digitalis preparations, diuretics and other drugs conventional treatment, the experimental group was treated with metoprolol tartrate tablets on the basis of conventional therapy, dose adjustment based on cardiac function. The clinical signs and symptoms, laboratory tests, after three months echocardiography to measure left ventricular end systolic diameter(LVES), left ventricular end-diastolic diameter(LVED), left ventricular ejection fraction(LVEF), E/ A ratio. Feature event at any time determined by monitoring therapeutic effect between the two groups of patients after three months. All data were statistically analyzed.ResultsObserved three months after the experimental group were markedly effective in15 cases, effective 29 cases, 4 cases, the total efficiency was 91.7%;In the control group were markedly effective in 6 cases, effective 28 cases, 14 cases ineffective, the total efficiency 70.8%; the experimental treatment group than the control group(P<0.05). When the two groups before surgery and three months left ventricular diastolic function parameters compared with the improvement of the indicators in the experimental group was significantly higher(P <0. 05). Compared with preoperative cardiac function after surgery all patients have improved, to improve significantly after three months, cardiac function NYHA I reached level 19 cases(19.8%), NYHA II class were 65 cases(67.7%), NYHA III level in 12 cases(12.5%), suggesting that the majority of patients in cardiac function after three months have improved, but the distance we have significantly improved the quality of life of patients with the requirements are still gaps, further follow-up of long-term performance remains to be seen.ConclusionCompared with conventional therapy methods, plus metoprolol tartrate can effectively improve heart function in patients with significantly reduced due to worsening heart failure readmission rates, reduce the burden on patients and improve quality of life.Heart valve replacement surgery solves the mechanical heart valve damage, but can not improve myocardial damage itself, can not fully prevent the development of heart failure. Therefore, prior to the surgery the patient had recurrent heart failure, our experience is that the valve replacement surgery, you can use an extended period β- receptor blockers, diuretics, digoxin use small doses of merger patients with rapid atrial fibrillation, β- blockers also control heart rate, reduce myocardial damage for patients with atrial fibrillation, delaying further development of heart failure. |
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