The Role Of ARNI In Heart Failure With Preserved Ejection Fraction In Peritoneal Dialysis Patients

Objective:To explore the changes of blood pressure,heart rate,cardiac function and cardiac structure indexes in patients of heart failure with preserved ejection fraction after treatment with ARNI on regular peritoneal dialysis.Methods:(1)Study subjects: A total of 25 patients of Heart Failure With Preserved Ejection Fraction who were performed PD from January 2018 to March 2023 in the First Hospital of Jilin University,and of who were regularly followed up and took ARNI for ≥3months,with complete clinical data were included in the study.(2)Data recording: The results of general data of patients,changes in cardiac structure indicators,laboratory data and improvement of clinical symptoms were collected before and after ARNI treatment.(3)Dose titration: On the basis of conventional treatment,all patients were given ARNI from 25 mg twice daily,and adjusted the dose every 3 weeks according to blood pressure and blood potassium level to the maximum oral dose of 200 mg twice daily or blood pressure <140/90 mm Hg.(4)Data analysis: Compare the changes of clinical indicators and symptoms before and after treatment with ARNI.Results:(1)After ARNI treatment,the blood pressure and heart rate of patients were decreased compared with the baseline level(P< 0.05).(2)There was no significant difference in cardiac structure indexes and cardiac function grades after ARNI treatment(P> 0.05).(3)There were no significant differences in serum creatinine,residual kidney Ccr,blood potassium,sodium and calcium after ARNI treatment compared with baseline values(P> 0.05).(4)No obvious adverse reactions occurred during the treatment of ARNI,which was well tolerated by all patients.Conclusion:(1)ARNI can significantly improve the blood pressure and heart rate in patients of heart failure with preserved ejection fraction after treatment with ARNI on regular peritoneal dialysis,but the therapeutic effect of reverse cardiac remodeling still needs long-term observation.(2)ARNI has no significant effect on serum creatinine,residual kidney Ccr,serum potassium,sodium,calcium and phosphorus in peritoneal dialysis patients,and its application in this population is safe.(3)ARNI was well tolerated in patients of heart failure with preserved ejection fraction without obvious adverse reactions on regular peritoneal dialysis.