Objective  To explore the effect of metoprolol combined with trimetazidine on serum angiotensin Ⅱ (Ang Ⅱ) and vascular endothelial function in patients with chronic heart failure (CHF).

  Methods  Totally 136 CHF patients were randomly divided into control group and experimental group, with 68 cases in each group. The control group was given basic therapeutic measures and metoprolol, while the experimental group was given trimetazidine on the basis of the control group. Left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVESD), N-terminal pro-B type natriuretic peptide (NT-ProBNP), 6-minute walking distance, the level of Ang Ⅱ, endothelial flow-mediated dilation (FMD) of brachial artery, the levels of plasma nitric oxide (NO) and endothelin-1 (ET-1), clinical efficacy and adverse reactions were compared between the two groups before and after treatment.

  Results  Two cases in both groups dropped out of the study. After treatment, LVEDd, LVESD and NT-ProBNP level of the experimental group were significantly lower than those of the control group, while the LVEF and 6-minute walking distance were significantly higher than those of the control group (P < 0.05). After treatment, Ang Ⅱ and ET-1 levels in the experimental group were significantly lower than those in the control group, while FMD and NO levels were significantly higher than those in the control group (P < 0.05). The total effective rate of the experimental group was 95.45%, which was significantly higher than 84.85% of the control group (P < 0.05). The incidence of adverse reactions was 10.61% in the experimental group, which showed no significant difference when compared to 6.06% in the control group (P>0.05).

  Conclusion  Metoprolol combined with trimetazidine is safe and effective in the treatment of CHF patients, which can improve the heart function and vascular endothelial function and enhance the therapeutic effect.