Objective: To observe the efficacy of Shengmaisan and Guizhi Gancao Longgu Muli Tang on patients of rheumatic heart disease with persistent atrial fibrillation after rheumatic valve replacement

and its effect on the cardiac structure and inflammatory factors. Method: A total of 126 patients with rheumatic heart disease with persistent atrial fibrillation after rheumatic valve replacement were randomly divided into observation group and control group (63 cases in each group). In addition to the comprehensive treatment

the control group was also treated with amiodarone; and the observation group was also treated with Shengmaisan and Guizhi Gancao Longgu Muli Tang in addition to the therapy of control group. The course of treatment was 10 weeks. Left ventricular end diastolic diameter (LAD)

right atrial diameter (RAD)

right ventricular internal diameter (RVD)

left ventricular end diastolic diameter (LVEDD)

left ventricular ejection fraction (LVEF)

left ventricular ejection fraction and PLT counts and FIB levels were detected; and cell adhesion factor (S-ICAM-1

s-VCAM-1)

transforming growth factor-β1 (TGF-β1)

plasma matrix metalloproteinase(MMP)-2

MMP-9 and tissue inhibitor of metalloproteinase-2 (TIMP-2) were detected by enzyme-linked immunosorbent assay (ELISA). Result: The total effective rate was 88.9% in the observation group

which was significantly higher than that in the control group (73.0%

χ2 =5.147

P<0.05). The retention rate of sinus rhythm in the observation group was 73.7%

which was significantly higher than that in the control group (42.1%

χ2=5.644

P<0.05). After treatment

LAD

RAD

RVD

LVEDD and LVEF were significantly better in the observation group than those in the control group (P<0.05). The levels of PLT

FIB

s-ICAM-1 and s-VCAM-1 in the observation group were significantly lower than those before treatment and the control group (P<0.05). After treatment

the levels of TGF-β1

MMP-2 and MMP-9 in the observation group were significantly lower

the level of TIMP-2 was significantly higher than before treatment (P<0.05)

and the above indexes were significantly better than those of the control group after treatment (P<0.05). No serious adverse events were observed in the two groups during treatment. Conclusion: Shengmaisan and Guizhi Gancao Longgu Muli Tang can effectively maintain the conversion rate of patients of rheumatic heart disease with persistent atrial fibrillation after rheumatic valve replacement

and improve myocardial remodeling and cardiac function. Its mechanism may further improve myocardial remodeling by reducing the levels of inflammatory factors and cell adhesion factors and the myocardial fibrosis.