Clinical effect of diltiazem in patients with diastolic heart failure

  AIM   To investigate the clinical effect of diltiazem in heart failure with preserved ejection fraction (HFpEF) patients.

  METHODS   One hundred and eighty-six patients were randomly divided into the diltiazem group and the control group and the basic clinical data of the patients were recorded. The control group was given traditional drug treatment and the treatment group was given traditional Chinese medicine combined with diltiazem hydrochloride. The patients were followed up for 12 months and their 6-minute walk test distance, diastolic functions, readmission rate due to acute-heart-failure (AHF) attack, incidence of cardiac death and the incidence rate for all-cause mortality before and after treatment were compared.

  RESULT   A total of 186 subjects were included, including 93 in the control group and 93 in the diltiazem group. There was no statistical significance in gender, age, hypertensive heart disease, hypertrophic cardiomyopathy, hyperlipidemia or smoking history between the patients of the two groups (P<0.05). The proportion of coronary heart disease in the diltiazem group was higher than that in the control group (P<0.05), which was statistically significant. Before treatment, there was no significant difference in 6 min walking distance between the two groups. After treatment, the 6 min walking distance in the deltiazem group was better than that in the control group (P<0.01). Before treatment, there was no difference in diastolic functions between the two groups. UCG results (E peak, A peak, E/A value) in the diltiazem group were better than those in the control group (P<0.05) and NT-proBNP diltiazem group decreased significantly compared with the control group (P<0.01). The 12-month follow-up found no statistical significance in the incidence of cardiac death or all-cause death between the diltiazem group and the control group, but the rate of readmission due to AHF in the diltiazem group was lower than that in the control group (P<0.05).

  CONCLUSION   Diltiazem combined with basic drugs has remarkable clinical effect in HFpEF patients, which significantly improves the diastolic functions and reduce the readmission due to acute heart failure in HFpEF patients.