Therapeutic effect of trimetazidine,dopamine combined with furosemide in elderly patients with rheu-matic heart disease and chronic heart failure and its effect on Metrnl,sTREM-1 and syndecan-1 lev-els
10.3969/j.issn.1008-0074.2025.05.14
- VernacularTitle:曲美他嗪、多巴胺联合呋塞米治疗老年风湿性心脏病合并慢性心力衰竭患者的疗效及对Metrnl、sTREM—1、syndecan—1水平的影响
- Author:
Fang YU
1
;
Yong WU
;
Yu-hua MIN
Author Information
1. 咸阳市第一人民医院药剂科,陕西咸阳 712000
- Publication Type:Journal Article
- Keywords:
Rheumatic heart disease;
Heart failure;
Trimetazidine;
Dopamine;
Furosemide
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2025;34(5):669-675
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of trimetazidine,dopamine combined with furosemide in eld-erly patients with rheumatic heart disease(RHD)and chronic heart failure(CHF)and its effect on the levels of me-teorin-like protein(Metrnl),soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and syndecan-1.Methods:This randomized controlled study enrolled 106 elderly patients with RHD and CHF who were hospi-talized in the First People's Hospital of Xianyang between March 2022 and December 2023.Patients were divided in-to control group(n=53,routine treatment)and intervention group(n=53,additional trimetazidine,dopamine and furosemide combined treatment),and treated for 1 week.The clinical efficacy,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),6-min walking distance(6MWD),Minnesota living with heart failure questionnaire(MLHFQ)score,serum levels of B-type natriuretic peptide(BNP),Metrnl,sTREM-1 and syndecan-1,and incidence of adverse reactions during treatment were compared between the two groups.Binary Logistic regression was used to analyze the association be-tween influencing factors and therapeutic effect.Results:The total effective rate of intervention group was signifi-cantly higher than that of control group(96.23％vs.83.02％,P=0.026).Compared to patients in the control group after treatment,those in the intervention group had significantly lower LVEDd[(45.27±5.95)mm vs.(50.11±4.47)mm],LVESd[(34.85±4.19)mm vs.(40.93±4.77)mm],MLHFQ score[(34.51±4.47)points vs.(45.62±5.08)points],levels of BNP[(95.29±8.31)pg/ml vs.(145.39±25.71)pg/ml],sTREM-1](43.59±4.21)pg/ml vs.(50.61±5.48)pg/ml]and syndecan-1[(7.01±1.88)μg/L vs.(11.02±2.36)μg/L],and significantly higher LVEF[(58.14±4.02)％vs.(50.61±6.15)％],6MWD[(433.48±45.74)m vs.(386.51±31.25)m]and Metrnl level[(205.08±27.45)ng/L vs.(188.52±22.37)ng/L](P＜0.001 all).Bi-nary Logistic regression analysis showed that the combination of trimetazidine,dopamine and furosemide was an in-dependent protective factor for the efficacy of elderly patients with RHD and CHF(OR=0.096,95％CI:0.011～0.837,P=0.034).There was no significant difference in the total incidence of adverse reactions between interven-tion group and control group(13.20％vs.11.32％,P=0.767).Conclusion:The combination of trimetazidine,do-pamine and furosemide could significantly improve cardiac function and exercise tolerance,reduce serum sTREM-1 and syndecan-1 levels,and increase Metrnl level with good safety in elderly patients with RHD and CHF.
