Effects of rehabilitation exercise combined with Nicorandil on cardiac function,oxidative stress,and serum BNP levels in elderly patients with chronic heart failure
Objective To investigate the clinical efficacy of rehabilitation exercise combined with nicorandil in the treatment of elderly patients with chronic heart failure(CHF),and to provide evidence for the clinical treatment of elderly CHF patients.Methods A total of 82 elderly patients with CHF admitted to The First Affiliated Hospital of Air Force Medical University from December 2021 to December 2022 were selected and allocated to a study group(n=42)and a control group(n=40)following the treatment plan.The control group received conventional treatment combined with rehabilitation exercise,while the study group received nicorandil in addition to the treatment in the control group.The clinical efficacy,brain natriuretic peptide(BNP)levels,cardiac function indicators[left ventricular end-diastolic diameter(LVDED),left ventricular ejection fraction(LVEF),and left ventricular end-systolic diameter(LVSED)],6-minute walk test(6MWT)distance,oxidative stress indicators,vascular endothelial function,and occurrence of adverse reactions were compared between the two groups.Results The overall response rate of treatment in the study group was significantly higher than that in the control group[97.62％(41/42)vs.80.00％(32/40);x2=4.831,P=0.028].Before treatment,no significant difference was observed in serum BNP levels between the two groups(P＞0.05).After 1 month,3 months,and 6 months of treatment,the BNP levels in the study group were significantly lower than those in the control group at the same time points(P＜0.05).Before treatment,no significant differences were found in LVDED,LVEF,LVSED,and 6MWT distance between the two groups(P＞0.05).After treatment,the LVDED and LVSED in the study group were significantly smaller than those in the con-trol group,while LVEF and 6MWT distance were significantly larger than those in the control group(P＜0.05).Before treatment,no significant differences were noted in serum superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),catalase(CAT),and malondialdehyde(MDA)levels between the two groups(P＞0.05).After treatment,the serum SOD,GSH-Px,and CAT levels in the study group were significantly higher than those in the control group,while the ser-um MDA level was significantly lower than that in the control group(P＜0.05).Before treatment,no significant differ-ences were found in brachial artery diameter after congestion,brachial artery diameter change rate after reactive congestion,brachial artery blood flow,and serum nitric oxide(NO)and endothelin-1(ET-1)levels between the two groups(P＞0.05).After treatment,the brachial artery diameter after congestion,brachial artery diameter change rate after reactive congestion,brachial artery blood flow,and serum NO level in the study group were significantly higher than those in the control group,while the serum ET-1 level was significantly lower than that in the control group(P＜0.05).The incidence of adverse reactions in the study group and the control group was 4.76％(2/42)and 2.50％(1/40),respectively,with no significant difference(P＞0.05).Conclusion Rehabilitation exercise combined with nicorandil in the treatment of elderly patients with CHF can regulate oxidative stress levels,vascular endothelial function,and serum BNP levels and promote cardiac function,with a high safety profile,holding promise for a wider clinical application.
NicorandilElderly with chronic heart failureCardiac functionOxidative stressBrain natriuretic peptideRe-habilitation exercise
万方数据
维普
