| Objective:Echocardiography will be used to compare the changes of cardiac structure and function in patients with chronic heart failure before and after treatment with sacubitril/valsartan in order to provide reference for cardiac ultrasound workers and clinical evaluation of patients’prognosis.Methods:Patients diagnosed with chronic heart failure with reduced ejection fraction(HFr EF)were selected from the First Hospital of Jilin University between December 2019 and December2020.Transthoracic echocardiography and laboratory examinations were performed before,1month and 3 months after medication.The administration of Echocardiographic and laboratory parameters were as follows:Left ventricular end-diastolic diameter(LVEDd),left atrial anterior-posterior diameter(LAAPd),left ventricular septum diameter(IVSd),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),1eft ventricular ejection fraction LVEF,E/e’,global longitudinal strain(GLS),global constructive work(GCW),global work efficiency(GWE),global work index(GWI),global wasted work(GWW),peak strain time dispersion(PSD),N-terminal pro-brain natriuretic peptide(NTpro-BNP),6 minutes walk test,New York Heart Association Functional Classification(NYHA).To investigate the effect of on left ventricular function in patients with HFr EF by comparing the changes of related indexes.Results:(1)General information of patientsA total of 40 patients with male 24 cases(60.00%),female 16 cases(40.00%),average age 47.79±14.84,6 cases of hypertension patients(15.00%),3 patients with DCM(7.50%),merging AF patients were 2 cases(5.00%)and 29 cases of no related medical history(72.50%).Cardiac functionⅡlevel 6 cases(15.00%),cardiac functionⅢlevel 34 cases(85.00%).Average height was(1.71±0.77)m,the mean weight was(73.07±11.77)kg,the average BMI was(24.93±3.64)kg/m~2,the average systolic blood pressure was(119.86±11.41)mm Hg,average diastolic blood pressure was(78.87±7.41)mm Hg.(2)The levels of LVEDd、LAAPd、LVEDV、LVESV、IVSd、LVEF、E/e′、GLS、GCW、GWE、GWI、GWW、PSD、NTpro-BNP、6-minute walk test and clinical efficacy were compared after 1 month and 3 months of treatment with sacubitril valsartan.Before medication,1 month and 3 months after medication,LVEDd,LAAPd,LVEDV and LVESV gradually decreased,LVEF gradually increased,E/e′gradually decreased,and the absolute value of GLS gradually increased,PSD gradually decreases,GWI,GCW and GWE were increased and GWW was decreased compared with that before medication,and the differences in each index before and after medication were statistically significant(P<0.001).There was no significant difference in IVSd before medication,one month after medication and three months after medication(P>0.05).(3)Comparison of NTpro-BNP before and after medicationThe plasma NTpro-BNP concentration gradually decreased after medication,and the difference was statistically significant(P<0.001).(4)Comparison of 6-minute walk test The comparison of walking test data before and 6minutes after medication showed that the walking distance increased gradually after medication,and the difference was statistically significant(P<0.001).(5)Comparison of effective rates before and after medication The effective rates of 1month and 3 months after medication were 47.50%and 80.00%,respectively.The effective rate at 3 months after medication was higher than that at 1 month after medication,and the difference was statistically significant(P<0.05).Conclusions:The cardiac structure and function of HFREF patients were significantly improved after treatment with sacubitril/valsartan,and the improvement effect was most significant at 3months after medication. |
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