Therapeutic effect and mechanism of individualized treatment for hypertension patients with coronary heart disease under non-invasive cardiac output measurement
- VernacularTitle:高血压伴冠心病患者无创心输出量测量下个体化方案治疗的效果及机制
- Author:
Haifen HUANG
1
;
Qingyong CHEN
;
Fang HE
;
Ren LI
Author Information
- Keywords: hypertension; coronary heart disease; non-invasive cardiac output measure-ment; individualized treatment regimen; blood pressure; heart rate variability; myocardial injury; major adverse cardiovascular events
- From: Journal of Clinical Medicine in Practice 2025;29(5):70-75,81
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the efficacy and mechanism of individualized treatment for hypertension patients with coronary heart disease under non-invasive cardiac output measurement.Methods A total of 94 hypertension patients with coronary heart disease in the hospital from January 2020 to August 2022 were selected and randomly divided into two groups,with 47 cases in each group.Control group was treated with conventional treatment,while observation group was treated with individualized treatment under non-invasive cardiac output measurement,and both group were continuously treated for 3 months.Clinical efficacy,the blood pressure control[diastolic blood pres-sure(DBP),systolic blood pressure(SBP)],cardiac ultrasound parameters[left ventricular end-systolic diameter(LVESD),left ventricular mass index(LVMI),interventricular septal thickness(IVS),left ventricular end-diastolic diameter(LVEDD)],heart rate variability[the standard devia-tion of the average RR interval(SDANN),the standard deviation of the RR interval of all sinus beats(SDNN),and the proportion of adjacent NN＞50 ms in the number of sinus beats(PNN50)],indi-cators of myocardial injury[α-hydroxybutyrate dehydrogenase(α-HBDH),lactate dehydrogenase(LDH),creatine kinase(CK)],transforming growth factor-β1(TGF-β1)/pancreatic cancer-deficiency factor(Smads)signaling pathway,and incidence of major adverse cardiovascular events(MACE)were compared between the two groups.Results The total effective rate of the observation group was 95.74％,which showed no significant difference compared with 85.11％of the control group(P＞0.05).After 1 and 3 months of treatment,the levels of DBP and SBP in both groups were de-creased significantly compared with those before treatment(P＜0.05),and the LVMI,IVS,LVEDD and LVESD in the observation group were significantly lower than those in the control group(P＜0.05).After 3 months of treatment,the SDANN,PNN50 and SDNN in observation group were significantly higher than those in control group(P＜0.05),while CK,α-HBDH and LDH as well as the expression levels of TGF-β1R Ⅰ,TGF-β1R Ⅱ,Smad1 and Smad2 were significantly lower than those in the control group(P＜0.05).After 3 months of follow-up,the incidence rate of MACE in observation group was 6.38％,which showed no significant difference compared with 14.89％in control group(P＞0.05).Conclusion Compared with conventional treatment regi-men,individualized treatment regimen with non-invasive cardiac output measurement can signifi-cantly alleviate myocardial injury,reverse ventricular hypertrophy and improve heart rate variability,and its mechanism may be related to the inhibition of the TGF-β1/Smads signaling pathway.
