AboutenalaprilandmetoprololontheimpactofchroniccongestiveheartfailurepatientoutcomesandQTdispersion[Keywords:]inaccordancewithenalaprilmetoprololinheartfailureQTdispersionChroniccongestiveheartfailureisthefinaldestinationofthemajorityofcardiovasculardisease,isthemaincauseofdeath.1985years,CampbellandDay,firstproposedtheconceptofQTdispersion(QTd)reflectsventricularrepolarizationtimeandspacethatQTdheterogeneityfollowedbyalargenumberofexperimentalandclinicalstudieshavereportedthetheQTdphysiologicalsignificanceandclinicalvalue,astheveryheterogeneityofanon-invasiveindicatorsreflecttheventricularcomplex,widelyusedintheheartofavarietyofpathologicalconditionsandtreatmentevaluation.alargenumberofThestudyresultsshowedthatlongQTsyndrome,coronaryheartdisease,heartfailure,cardiachypertrophy,valvulardiseaseandotherpathologicalconditionscanQTdincrease,manyscholarsfromtheQTdreflectsventricularrepolarizationheterogeneitydeparture,asforecasttheoccurrenceof1heartdiseaseindicatorsofmalignantventriculararrhythmiasandpoorprognosisinclinicaldiseasepopulationstodetectcontrast,indeedsuggestingahighpopulationofmalignantarrhythmiasandsuddendeathtendencyQTdwassignificantlygreaterthanthenormalgroup[1]inpatientswithchroniccongestiveheartfailureventricularhypertrophyorexpansion,ventricularremodeling,resultinginECGrepolarizationchangesQTdincrease,maypromotetheoccurrenceoffatalarrhythmias.thisstudywastoevaluatetheenalaprilandmetoprololinpatientswithchroniccongestiveheartfailureQTdimpact,inordertodetermineitsclinicalefficacy.1MaterialsandMethods1.1Theobjectofstudy1.1.1groupofheartfailure:standardheartfunctionI~IIIlevelchroniccongestiveheartfailurepatientswith70cases,42malesand28females,age(53.4+-5.7)years(36to72years)selectedcasesmeetthefollowingcriteria:(1)nottakingACEIandβ-blockersinpatientswith(2)thereisacleardiagnosisofstructuralheartdisease,inlinewithcardiacfunctionⅠ~Ⅲlevelofheartfailure2symptoms,signs③excludetheapplicationofACEIandβ-blockercontraindications.1.1.2Thecontrolgroup:38cases,22malesand16females,healthy,ageandheartfailuregroupmatch.1.2ResearchMethods1.2.1ofQTddetermination:thestandard12-leadECG,paperspeed25mm/s,gainof10mm/mV.MeasurementoftheQTintervalmeasuredfromthebeginningpartofeachQRScomplextotheendoftheTwaveendoftheTwave[2]:TPfortheequipotentialline,1T-wavedeclinetosupportthemoststeepattherelevantpointofthetangentwiththebaseline,②WhentheTwavedownthebranchthanthestraight,taketheTwavereturnedtobaseline,(3)significantUwaves,takingthetroughbetweentheTwaveandUwave,④WhenthepartialfusionoftheUwaveandTwavefortheT-wavedeclinesupporttoextendtheline,totaketoextendthelineandtheintersectionofthebaseline.EachleadcontinuousmeasurementofthethreeQTinterval,RRinterval,themeanvalue.QTdispersion(QTd)isdefinedastheQTmaximum(QTmax)andthedifferencebetweenthe3minimum(QTmin),thecorrectedheartrate,Bazzet’sformulaofQTc=QT/R-RcalculatedbythecorrectionoftheQTdispersion(QTcdin)toavoidbeingaffectedbymeasuringthenumberofleadthesizeofthesquarerootleadsinadditiontoQTcdleadcorrectionQTcdin(leadadjusted)[3],andmeasurablelead>=9.1.2.2treatmentandefficacyevaluationcriteria:patientswithchroniccongestiveheartfailuretobeinaccordancewithenalapril,metoprolol,thestartingdoseinaccordancewithenalapril2.5mgtwicedaily,metoprolol6.25mg2timesaday,accordingtothepatient’sbloodpressure,heartrateisadjustedtothemaximumtoleratedd...