Severe heart failure with rapid arrhythmia: Treatment with amiodarone and esmolol and its effect on TGF-β1, APN and PIIINP

Abstract

Rapid arrhythmia (RA) is a major complication of severe heart failure (SHF). Treatment with anti-arrhythmic drug amiodarone though improves the myocardial blood supply and suppress arrhthmia, its clinical application is unsatisfactory. Amiodarone combined with another class II antiarrhythmic drug, esmolol shows rapid onset and good efficacy. Here, we studied the effects of amiodarone and esmolol in severe heart failure (SHF) with rapid arrhythmia (RA) and its effect on TGF-β1, APN and PIIINP. A total of 180 SHF patients with RA treated at Zhejiang Provincial Hospital of Traditional Chinese Medicine were selected and divided into experimental group (n = 90) and control group (n = 90) according to the random number table method. The control group was given routine therapy + amiodarone therapy, and the experimental group was given routine therapy + amiodarone + esmolol therapy. Cardiac function measures including cardiac index (CI), mean arterial pressure (MAP) and ejection fraction (LVEF), diastolic blood pressure (DBP), systolic blood pressure (SBP) and heart rate (HR), serum TGF-β1, APN and PIIINP levels were observed in both groups before and 48 h after treatment. After treatment, the CI, MAP and LVEF of the experimental group were greater than those of the control group (P<0.05); DBP, SBP and HR were greater (or higher) in the experimental group than in the control group (P<0.05); serum TGF-β1 and PIIINP levels in experimental groups were all lower than in control group and serum APN levels were higher (P<0.05) than in control group. The total effective rate of the experimental group was less than that of the control group (P<0.05). There was no difference in the incidence of adverse effects between the two groups (P>0.05). The results indicate that treatment of severe heart failure (SHF) with rapid arrhythmia (RA) by amiodarone and esmolol may safely enhance cardiac function, blood pressure and heart rate, improve efficacy, inhibit the progression of myocardial fibrosis, and improve serum TGF-β1, APN and PIIINP levels.