Premature Ventricular Contraction
Conditions
Brief summary
Objective: investigators investigated the effects of metoprolol tartrate plus Tongmai Yangxin Pill on premature ventricular complexes and cardiac function in patients with premature ventricular complex. Methods: In total, 584 participants with premature ventricular complex will be randomly assigned (at a 1:1 ratio) into two groups: study group (metoprolol tartrate \[25 mg twice per day, orally\] plus Tongmai Yangxin Pill \[40 pills twice per day, orally\]) and control group (metoprolol tartrate \[25 mg twice per day, orally\] plus placebo \[40 simulated pills twice per day, orally\]). The total treatment period is 8 weeks. Efficacy endpoints and safety assessment: Primary efficacy endpoints are as follows: change in 24-h number of PVCs after treatment and effective rate of 24-h number of PVCs after treatment. Secondary efficacy endpoints are as follows: change in New York Heart Association classification; total effective rate of comprehensive effect; change in high-sensitivity C-reactive protein level; and change in echocardiography parameters (i.e., left ventricular ejection fraction, left ventricular end diastolic dimension, E/A, cardiac index, cardiac output, and stroke volume).
Interventions
DRUGTongmai Yangxin Pill (TMYXP)
TMYXP is a Chinese patent medicine developed by many years of clinical practice experience. The ingredients of TMYXP are Radix Rehmanniae, Caulis Spatholobi, Polygonum Multiflorum, Colla Corii Asini, Ophiopogonis, Tortoise Shell (vinegar), Radix Codonopsis, Cassia Twig, Jujube, Schisandra Fruit, and Licorice Root. It has the effect of invigorating Qi, nourishing Yin, dredging the pulse, and relieving pain. It is used in treatment of Qi and Yin deficiency syndromes caused by coronary heart disease, angina pectoris, and arrhythmia. Metoprolol tartrate (a heart-selective β-blocker) is a class II antiarrhythmic medication that decreases the ventricular rate of supraventricular tachyarrhythmias by inhibition of atrioventricular conduction.
metoprolol tartrate (a heart-selective β-blocker) is a class II antiarrhythmic medication that decreases the ventricular rate of supraventricular tachyarrhythmias by inhibition of atrioventricular conduction.
DRUGplacebo
simulated pills
Sponsors
Tianjin Lerentang factory
Xuanwu Hospital, Beijing
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Masking description
Prior to the start of the study, the sponsor (or contract research organization) and statistician will make masking of the research drugs. The statistician in this study used statistical software to generate random coding table according to the method of stratified block randomization. Personnel who have no involvement in this study will paste the corresponding drug number on the drug packaging according to the random coding.
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Lown PVC grade, II-IVA; * in patients with coronary heart disease and comorbid PVC or non-organic heart disease, the PVC frequency was 3000-30000 times/24 h; * New York Heart Association grade, I or II; * ejection fraction, ≥45%; * written informed consent to participate in the trial.
Exclusion criteria
* presence of bradyarrhythmia (\<50 beats/min), including sinus syndrome and atrioventricular block (second or third degree atrioventricular block); * presence of persistent ventricular tachycardia, non-persistent ventricular tachycardia, and/or persistent atrial fibrillation; * presence of severe PVC requiring treatment with other antiarrhythmic drugs; -presence of drug-induced, electrolyte-induced, or acid-base-induced arrhythmia; * presence of uncontrolled or severe hypertension (e.g., grade ≥3 hypertension); * presence of uncontrolled diabetes; presence of alanine aminotransferase or aspartate aminotransferase level ≥1.5-fold above the upper limit of normal, urea nitrogen level ≥1.2-fold above the upper limit of normal, and/or blood creatinine above the upper limit of normal; * presence of severe respiratory dysfunction or asthma; * presence of primary hematopoietic diseases, other systemic diseases (e.g., hyperthyroidism), poor peripheral circulation perfusion, severe peripheral vascular diseases, and/or PVC with unknown etiology; * presence of allergic constitution, mental disorder, alcoholism, and/or smoking habit; * pregnancy or lactation; * ongoing β-blocker treatment or contraindications to β-blocker treatment; -participation in other clinical trials within the prior 3 months; * and other reasons for lack of suitability to participate in this study, as determined by the investigators.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in 24-h number of PVCs after 8-week treatment | 8 weeks | — |
| Effective rate of 24-h number of PVCs after 8-week treatment. | 8 weeks | the definition of effective is, premature ventricular complex decreased by 50%-70% compared with baseline in the Holter result. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| change in high-sensitivity C-reactive protein level | 8 weeks | — |
| change in echocardiography parameter left ventricular ejection fraction | 8 weeks | — |
| change in echocardiography parameter left ventricular end diastolic dimension | 8 weeks | — |
| change in New York Heart Association (NYHA) classification | 8 weeks | Marked effective NYHA improvement was defined as reduction of NYHA grade by ≥2; effective NYHA improvement was defined as reduction of NYHA grade by 1; non-effective NYHA improvement was defined as no change or elevation of NYHA grade. |
| change in echocardiography parameter cardiac index | 8 weeks | — |
| change in echocardiography parameter cardiac output | 8 weeks | — |
| change in echocardiography parameter stroke volume | 8 weeks | — |
| change in echocardiography parameter E/A | 8 weeks | — |
| total effective rate of comprehensive effect | 8 weeks | Total effective rate of comprehensive effect was defined as total symptom score; clinical recovery was defined as significant improvement of clinical symptoms and reduction of symptom score by ≥90%. |
Outcome results
None listed