| With a high and increasing incidence of heart failure,the mortality of heart failure is similar to malignant tumors,which has become one of the most important cardiovascular diseases.Therefore,it is of great significance to explore an effective treatment for heart failure.The 2018 Chinese guidelines for heart failure have detailed recommendations for the treatment of patients with ejective fraction reduction heart failure,and recently established a treatment regimen in which ACEI/ARB is replaced by ACEI/ARB with Sacubitril/valsartan in a specific population with a combination of beta blockers and aldosterone receptor antagonists(I,B).However,for the patients with heart failure whose ejection fraction is ≥40%,the guidelines only put forward clear diagnostic criteria,and the treatment is mainly to take comprehensive treatment for the existing symptoms and risk factors of cardiovascular disease of the patients,without giving a clear and effective treatment plan.Therefore,it is still necessary to further explore the effective treatment plan for heart failure patients with ejection fraction ≥40%.Objective: The purpose of this study was to further evaluate the clinical efficacy of Sacubitril/valsartan in treating HFmrEF and HFpEF patients from the aspects of cardiac structure and function,blood biochemical indicators,and quality of life assessment.Methods: 100 patients with heart failure with left ventricular ejection fraction ≥40% who were admitted to the People’s Hospital of Shaanxi from June 2018 to May 2019 were selected.According to the treatment plan,48 cases were randomly divided into the control group and 52 cases were randomly divided into the observation group.The control group was given the standard antiheart failure treatment regimen,and the observation group was replaced with the ACEI/ARB in the standard antiheart failure treatment regimen with Sacubitril/valsartan.After 6 months of continuous treatment,cardiac systolic function indicators,cardiac diastolic function indicators,biomarker levels,and renal work ion indicators were collected.At the same time,cardiac adverse events and heart failure rehospitalization were observed in both groups,and the occurrence of drug-related adversereactions during treatment was recorded.T-test,rank sum test and chi-square test were used for statistical inference.Results:1.There was no statistically significant difference between the two groups in the proportion of basic diseases,heart rate,QTc,QRS duration,plasma BNP,renal work ion level,cardiac systolic function index,cardiac diastolic function index,and overall summary score of Kansas cardiomyopathy questionnaire(KCCQ-OS-15)before treatment(P > 0.05).2.After 6 months of treatment,kCCQ-15-OSS,LVEF,LVEDD,LVESD and E/ E ’in the observation group were significantly improved compared with the control group,and the difference was statistically significant(P<0.05).3.At the end of treatment for 6 months,compared with ACEI/ARB,Sacubitril/valsartan significantly reduced the heart rate and QTc interval of the patients,and the difference was statistically significant(P<0.05).4.At 6 months of treatment,the plasma BNP level in the observation group was significantly lower(P=0.04),and there was no significant change in the level of renal work ion between the two groups after treatment,with no statistically significant difference(P>0.05).5.There was no statistically significant difference in the occurrence of adverse events and rehospitalization of heart failure between the two groups during treatment(P>0.05).Conclusions:Compared with ACEI/ARB,shakuba trivalsartan can significantly reduce BNP level,improve cardiac diastolic function and remodeling indicators,and improve patients’ quality of life,and the treatment safety is comparable to ACEI/ARB. |
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