The Clinical Efficacy Of High-dose-?-blocker In The Treatment Of Dilated Cardiomyopathy

Objective : To investigate the clinical efficacy of high-dose ?-blocker metoprolol sustained-release tablets in the treatment of heart failure in patients with dilated cardiomyopathy.Methods : A retrospective analysis of 352 patients with dilated cardiomyopathy heart failure diagnosed and treated in our hospital for the past 10 years was conducted.In order to ensure the reliability and comparability of the study,91 patients with better data and good homogeneity were further screened,according to whether a ?-blockers were added on the basis of conventional treatment and the dose size of used.They were divided into 4 groups: control group(without beta-blockers),small dose treatment group(? 47.5mg),medium dose treatment group(47.5-95mg),high dose treatment group(142.5-190mg)groups,by comparative analysis of the symptoms,signs(mainly blood pressure,heart rate)and cardiac structural function(mainly cardiac ultrasound parameters)of each group after treat with six months,one year and two years,then evaluate the therapeutic effect and the high-dose-?-blocker.Results :1.Comparison of heart function changes between groups: With the passage of time,the treatment efficiency of the treatment groups were significantly higher than the control group(P<0.05),especially in the medium and large dose treatment group(P <0.05).2.Comparison of clinical observation indexes and cardiac ultrasound parameters: With the passage of treatment time,there shows no significant difference in LVDd?FS compared with the control group in the ?-blocker treatment group(P>0.05),No significant remission was found(P>0.05);while the LAD and EF do the contrast,they demonstrate a significantly improved in the ?-blocker treatment group compared with the control group(P<0.05),but the effect was similar in the different doses of the treatment group,so does in the groups comparison(P>0.05).clinical observation indicators of systolic blood pressure,diastolic blood pressure,heart rate in the ?-blocker treatment group was not significantly better than the control group(P>0.05),but a significant remission was found in each ?-blocker treatment group(P<0.05).Although there was no statistical difference in the comparison of multiple parameters,compared with other treatment groups,this study suggested that the high-dose treatment group gradually showed obvious therapeutic remission effects:(1)LAD,LVDd,: although the treatment group was not significantly different from the control group,but after 1 year of treatment,the treatment group Gradually shrinkage the heart cavity,and the high-dose group was more obvious than other treatment groups;(2)FS,EF: As time went by,there was no significant difference between the treatment group and the control group in the changes of the values and trends,but after six months of treatment,the treatment group appeared Ejection fraction was significantly increased,left ventricular diameter shortened,and the high-dose group was significantly more than other treatment groups;(3)systolic blood pressure,diastolic blood pressure,heart rate: Although the dose of beta-blockers during treatment has a certain effect on blood pressure,over time,the values of all groups tend to stabilize at the same level,There was no statistical difference between the groups.3.The incidence of adverse reactions among groups was similar,the difference was not statistically significant(P>0.05).Conclusion :This study shows that long-term use of ?-blocker in real clinical practice can effectively improve the symptoms of dilated cardiomyopathy patients with heart failure,elevate the ejection fraction,and improve cardiac function.Without drug contraindications,small doses began to gradually reach tolerated doses,and long-term high-dose ?-blocker maintained the benefits of treatment better,and over time,gradually reflect the delay or even reversal of ventricular remodeling.