| Objective:To observe the short-term clinical efficacy of Sacubitril/Valsartan in treating patients with dilated cardiomyopathy and ischemic heart failure after 3 months.Methods:50 patients with dilated cardiomyopathy(DCM)heart failure were selected from the second hospital of shanxi medical university from january 2019 to september 2019[DCM group,mean age(63.6±9.699),of which 30 were male and 20 were female]and 50 were ischemic cardiomyopathy [ICM group,mean age(65.49±8.38),of which 35 were male and 15 were female].The selected patients were eligible for NYHA grade II-IV.Patients in both groups were treated with salkurazide combined with conventional heart failure drugs(aldosterone receptor antagonist,β-receptor antagonist,diuretic,etc.)for 3 months.50 mg of salkubatan was given twice a day for 2 weeks.If there were no severe hypotension,vascular and neurological edema,elevated serum potassium and damage of liver and kidney function,the dose was doubled once every two weeks.Until the target dose of 200 mg is taken orally twice a day or the maximum dose that can be tolerated by the patient and maintained.The general clinical indexes and adverse reactions of the two groups were recorded in detail.NYHA cardiac function grade,6min walking test(6MWT),serum level of N-terminal pro-brain natriuretic peptide(NT-pro BNP),left ventricular end-diastolic diameter((LVEDd))and left ventricular ejection fraction((LVEF))were compared between the two groups before and after treatment.Results:1.The systolic blood pressure and diastolic blood pressure of the two groups were lower than those before treatment,but there was no notable discrepancy between the two groups(P>0.05).2.There was no notable discrepancy in serum potassium(K +)and creatinine(Cr)between the two groups before and after treatment,(P > 0.05).After 3 months of medication,the level of serum NT-pro BNP in both groups was lower than that before medication,and the decrease of serum NT-pro BNP level in DCM group was not as good as that in DCM group{DCM group(1442.85 ±295.067 ng/L)vs ICM group(1049.17±238.669ng/L),P<0.001}.3.After 3 months of treatment,the results of 6MWT in both groups were higher than those before treatment,and the results of DCM group were not as good as those of ICM group{DCM group(396.62 ±55.205m)vs ICM group(419.24 ±52.336m),P <0.05}.4.There was no obvious discrepancy in the classification of cardiac function before treatment in ICM group(P > 0.05).After treatment,the cardiac function of the two groups was better than that before treatment,and the improvement of cardiac function in the DCM group was lower than that in the ICM group(II 26% vs 48%,III 54% vs 38%,IV 20% vs 14%,P<0.05,the difference was statistically significant).5.After 3 months of treatment,the level of LVEF in both groups was higher than that before treatment,and the improvement of LVEF results in DCM group was less than that in ICM group{ DCM group(44.6 ±2.8%)vs ICM group(48.2 ±2.5%),P <0.001}.The LVEDd of patients in both groups decreased after medication,and there was no notable discrepancy in LVEDd between the two groups after treatment {DCM group(56.9 ±3.1 mm)vs ICM group(56.4 ±3.7mm),P>0.05}.6.During the 3-month treatment,there was no notable discrepancy in adverse reactions between the two groups(P > 0.05).There were no cases of termination of treatment due to hypotension,uncorrectable hyperkalemia and angioedema in both groups.During the 3-month follow-up,there were no adverse cardiovascular events in both groups,and there were no re-hospitalized patients in both groups because of heart failure.Conclusion:Sacubitril/Valsartan improves cardiac function in both DCM and ICM patients with heart failure and is more effective in ICM patients;the drug is safe and well tolerated;but has similar effects on cardiac remodeling in both groups. |
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