Effects of metoprolol combined with trimetazidine on cardiac function and matrix metalloproteinase-9 levels in patients with coronary heart disease complicated with chronic heart failure

Abstract

Objective To observe the effect of metoprolol combined with trimetazidine on coronary heart disease with chronic congestive heart failure, and its effects on myocardial structure, plasma brain natriuretic peptide (BNP) and matrix metalloproteinase-9 (MMP-9). Methods From January 2016 to November 2017, 160 coronary heart disease patients with chronic congestive heart failure in the First People's Hospital of Wenling were randomly divided into treatment group (78 cases)and control group (77 cases)through random number table method.The control group was given conventional anti-heart failure treatment.The treatment group was treated with metoprolol and trimetazidine.After 3 months of treatment, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume(LVESV), LVEF, BNP and changes in MMP-9 were compared. Results The total effective rate of the treatment group was 90.36%, which was significantly higher than 77.92% of the control group (χ2=5.024, P 0.05), the LVEF of the treatment group was increased[(41.38±9.26)% vs.(46.31±10.8)%] (t=-3.15, P=0.001). After treatment, the LVESV between the treatment group and control group had statistically significant difference[(124.54±16.57)mL vs.(106.36±16.44)mL](t=7.16, P<0.05). The BNP level was decreased in the treatment group after treatment[(4 036.39±696.24)ng/L vs.(3 621.78±732.57)ng/L] (t=3.73, P<0.05), while the BNP level had no statistically significant change in the control group (t=1.47, P=0.07). the MMP-9 level in the treatment group was lower than that before treatment[(396.21±97.56)ng/mL vs.(345.11±86.25)ng/mL](t=3.57, P<0.05), while the MMP-9 level in the control group had no statistically significant change (t=1.06, P=0.15). The MMP-9 and BNP levels decreased more significantly in the treatment group than those in the control group (t=3.73, 3.57, all P<0.05). Conclusion Metoprolol combined with trimetazidine in the treatment of patients with chronic heart failure can significantly alleviate clinical symptoms, reduce the expression level of MMP-9, and is safe for clinical use.Therefore, it is recommended use in clinical. Key words: Congestive heart-failure; Matrix metalloproteinase-9; Ultrasonic cardiogram; Brain natriuretic peptide