Effects Of Metoprolol Succinate On Heart Function And Motor Function In Patients With Chronic Heart Failure

Objective:A large number of studies have found that Resting Heart Rate(RHR)is an important risk factor for cardiovascular disease and all-cause death.Increased heart rate(HR)is related to poor prognosis of cardiovascular disease,and HR decreases It is possible to improve the clinical symptoms and prognosis of patients with cardiovascular disease.As we all know,?-blockers can improve the heart function of patients with chronic heart failure(CHF),improve the quality of life,and at the same time reduce the mortality rate,and these benefits are negative to ?-blockers.The role of sexual timing is closely related,that is,the important external manifestation of the role of ?-blockers is to reduce the patient's HR.Metoprolol succinate has a high selectivity for ?1 receptors,and studies have shown that it can improve left ventricular ejection fraction and quality of life in patients with heart failure(HF)when compared with placebo.Increased tolerance.At present,there are few studies on the effect of metoprolol succinate on the overall cardiac function and motor function of CHF patients after HR control.The purpose of this study is to observe the effect of metoprolol succinate on CHF patients after HR control.Of the overall heart function and motor function.Methods:This study was conducted from March 2018 to August 2019 in the Second Affiliated Hospital of Kunming Medical University.A total of 80 cases of CHF patients with HR greater than 80 bpm were collected,including 52 males and 28 females.Use the patient as a control.Collect all patients' gender,age,occupational status,smoking history,drinking history,past special medical history,family history and medication history.We used a slowly increasing dose of metoprolol succinate sustained-release tablets(Betaloc(?)ZOK,AstraZeneca,Sweden)on the basis of general heart failure treatment,and began to give 23.75 mg or 47.5 mg.Increase the dose by 23.75 mg over 7 days until the target HR level(60-70 bpm)is reached.The resting HR at 1,3,6 and 12 months after intervention was measured by electrocardiogram on the basis resting HR and metoprolol succinate sustained-release tablets.A sphygmomanometer is also used to simultaneously monitor Systolic Blood Pressure(SBP).Use echocardiography to assess cardiac function parameters,such as Cardiac Index(CI)and Ejection Fractions(EF).The main result is the assessment of cardiac function changes based on EF and CI.The standard 6-minute walk test(6MWT)and the Veteran Specific Activity Questionnaire(VSAQ questionnaire)were used to assess motor endurance and motor function.Metoprolol succinate was used to observe the changes of cardiac function and motor function in patients with CHF after reaching HR control under the therapeutic dose.SPSS 21.0 software was used for statistical processing.Data are described in counts,percentages,and mean ± standard deviation.One-way repeated measures analysis of variance was used to compare the data collected at four follow-up points at 1,3,6,and 12 months with baseline data.Pearson correlation analysis was performed to evaluate the correlation between HR and cardiac and motor functions after metoprolol succinate achieved HR control.P value<0.05 has statistical significance.Results:1.Basic characteristics of patient dataThis study included data from 80 patients with an average age of 66.39±7.38(54-78)years;males,n=52(65%);females,n=28(35%).Among the comorbidities,n=60(75.00%)patients with hypertension;n=51(63.75%)patients with diabetes;n=50(62.50%)patients with coronary heart disease;n=71(88.75%)patients with cavity infarction.At the same time,patients with a history of smoking n=58(72.50%);patients with a history of drinking n=45(56.25%);patients with a family history of heart disease n=28(35.00%).The average Glomerular Filtration Rate(GFR)was 73.9±26.8 ml/min/1.73 m2,and the Body Mass Index(BMI)was 23.85±3.62 kg/m2.In addition,most patients are New York Heart Function Class(NYHA)Class ?/?(n=75.93.75%).Previous medications were patients taking Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptor Blocker(ACEI/ARB)n=78(97.50%);patients taking diuretics n=75(93.75%);patients taking spironolactone n=75(93.75%);patients taking digoxin n=59(73.75%);patients taking anticoagulant n=76(95.00%).In addition,the patients had an average SBP of 126.83±13.76 mmHg,an average HR of 82.65±6.76 bpm,an average EF value of 37.58±5.90%,an average CI of 1.79±0.22 L/min*m2,an average 6MWT distance of 372.59±32.82 m,and an average VSAQ value of 6.63±1.15.2.Changes in HR and SBPThe average dose of metoprolol succinate sustained-release tablets to achieve the target HR was 99.75 mg(47.5-142.5 mg).At 1,3,6,and 12 months after treatment with metoprolol succinate sustained-release tablets,the average resting HR measured by resting electrocardiogram decreased significantly from a baseline value of 82.65±6.76 bpm to 69.23±2.96 bpm(P<0.01),67.46±2.49 bpm(P<0.01),65.75±3.27 bpm(P<0.01)and 64.86±3.21 bpm(P<0.01).Similarly,during the first month of follow-up,SBP also decreased significantly from the baseline value of 126.83±13.76mmHg to 123.38±12.26mmHg(P<0.01),and then slightly increased by 124.16±9.32mmHg(P<0.01)0.01),which was 124.81±5.42mmHg during the 6th month of follow-up(P<0.01).During the 12th month of follow-up,the SBP level reached a stable level of 123.31±6.70 mmHg(P<0.01),which was comparable to the level of metoprolol succinate sustained-release tablets 1 month after treatment.3.Cardiac function of metoprolol succinate sustained release tablets after treatmentAfter treatment with metoprolol succinate sustained-release tablets,during the first month of follow-up,the EF decreased from 37.58±5.90%of the baseline value to 36.18± 6.32%(P=0.15).During the third month of follow-up,EF is 35.91±5.50%(P=0.067).Afterwards,it started to pick up and rose steadily to 47.85±4.49%(P<0.01)and 50.24±3.63%(P<0.01)during the 6th and 12th month of follow-up.respectively.The CI decreased from the baseline value of 1.79±0.22L/min*m2 to 1.77±0.22 L/min*m2 during the first month of follow-up(P=0.643),then at the third month,the sixth month and the twelfth month During the month of follow-up,it increased significantly to 2.26±0.20 L/min*m2(P<0.01),2.600±0.18L/min*m2(P<0.01)and 2.72±0.18 L/min*m2(P<0.01)).4.Motor function of metoprolol succinate sustained-release tablets after treatmentAfter treatment with metoprolol succinate sustained-release tablets,during the first month of follow-up,the distance traveled during 6MWT decreased significantly from the baseline value of 372.59±32.82 m to 343.75±32.66 m(P<0.01),followed by a slight The increase was 351.23±32.92 m during the 3rd month follow-up(P<0.01),and further showed a significant stable increase,to 398.50±21.57 during the 6th and 12th month follow-up,respectively.m(P<0.01)and 416.44±15.93 m(P<0.01).During the follow-up in the first month and the third month,the VSAQ was reduced from the baseline value of 6.63 ± 1.15 to 4.87 ± 0.86(P<0.01)and 5.49 ±1.03(P<0.01).During the 12th month of follow-up,they increased to 7.85±1.04(P<0.01)and 8.26±0.84(P<0.01),respectively.5,Relativity of HR and clinical after HR control of metoprolol succinate sustained-release tabletsThrough statistical analysis,at the 12th month of follow-up,there was a negative correlation between HR and cardiac function parameters EF(r=-0.306;P<0.05)and CI(r=-0.359;P<0.05),namely heart rate Decreasing within a certain range will gradually improve EF and CI,thereby improving heart function.At the 12th month of follow-up,HR was positively correlated with 6MWT(r=0.347;P<0.05),indicating that heart rate control can improve patients' motor function.However,in the VSAQ questionnaire,there was no correlation between HR and VSAQ questionnaire(r=-0.162:P=0.151).Conclusion:1.After treatment with metoprolol succinate in CHF patients,HR has been clearly controlled,and the target heart rate can basically be achieved.2.The heart function and motor function of CHF patients after metoprolol succinate treatment have the same trend.Both of them have a short-term decline process at the beginning of the treatment,and then gradually recover and improve significantly.3.After treatment with metoprolol succinate to achieve heart rate control,CHF patients can improve the heart function and motor function of patients with left ventricular systolic function.