The Effects Of Sacubitril/valsartan On The Index Of Ventricular Remodeling And Cardiac Function In Patients With Chronic Heart Failure

ObjectiveTo study the effects of sacubitril/valsartan on the blood cyclophilin A(Cy PA),Galectin-3,MMP-2,MMP-9,NT-pro BNP levels in patients with chronic heart failure(CHF).Methods1.According to the criteria of 2018 Chinese Heart Failure Diagnosis and Treatment Guidelines,the patients with CHF who were hospitalized in the First Affiliated Hospital of Bengbu Medical College from January 2018 to June 2022 were selected.After admission,patients should improve routine examinations,echocardiography,electrocardiogram to determine the cause of heart failure.According to their application,they were divided into experimental group(sacubitril/valsartan)and control group(valsartan).According to the left ventricular ejection fraction(LVEF),cardiac functional classification and primary disease,the experimental group was divided into different LVEF subgroups,different cardiac functional classification subgroups and different primary disease subgroups.A total of 154 patients with CHF were included in this research project,including 50 cases in the control group and 104 cases in the experimental group.2.Collect the general clinical data and detect the levels of Cy PA,Galectin-3,MMP-2,MMP-9 and NT-Pro BNP in blood of all patients before and 3 months after the application of sacubitril/valsartan or valsartan,the 6MWT levels before and after treatment were also collected.3.SPSS25.0 statistical software was used to analyze the data,P<0.05 indicates that the difference is statistically significant.Results1.The levels of Cy PA,Galectin-3,MMP-2,MMP-9 and NT-pro BNP in CHF patients were significantly decreased and the 6MWT of CHF patients was significantly increased after the application of sacubitril/valsartan compared with the control group(all P < 0.05).2.The indexes of different LVEF groups decreased significantly after treatment compared with those of the same group before treatment,and the differences were statistically significant(all P<0.05).There were significant differences in the changes of6 MWT,NT-pro BNP,Galectin-3,and MMP-9 between different LVEF groups before and after treatment,and the changes in HFr EF group were significantly higher than those in HFmr EF group(all P<0.05).The changes of Cy PA and MMP-2 in different LVEF groups before and after treatment were not statistically different(all P>0.05).3.After treatment,there were significant differences in the levels of each index of different cardiac function classification groups compared with those in the same group before treatment(all P<0.05).The difference in the change values of 6MWT,NT-pro BNP,Galectin-3,MMP-2 and MMP-9 before and after treatment among the groups with different cardiac functional grades was statistically significant(all P<0.05).The change values of NT-pro BNP in the cardiac function class IV group were greater than those in the cardiac function class II and class III groups,and the change value of NT-Pro BNP in the cardiac function class III group was greater than that in the class II group.The change values of Galectin-3,MMP-2 and MMP-9 in the cardiac function class IV group were greater than those in the cardiac function class II and class III groups.There was no statistical difference between the two groups in the cardiac function class II and class III groups.The change value of 6MWT in the class III and class IV cardiac function groups before and after treatment was greater than that in the class II cardiac function group,and there was no statistical difference between the two groups in the class III and class IV cardiac function groups.There was no significant difference in the Cy PA values before and after treatment among the different cardiac function classification groups(P>0.05).4.The indexes of different etiological groups after treatment were statistically different from those before treatment(all P<0.05).There was no significant difference in the changes of blood Cy PA,Galectin-3,MMP-2,MMP-9,NT-pro BNP and the improvement of 6MWT between different etiological groups before and after treatment(all P>0.05).5.The level of blood NT-pro BNP in CHF patients was positively correlated with the levels of blood Cy PA,Galectin-3,MMP-2 and MMP-9(rs=0.625,0.470,0.523,0.499,all P<0.05).Conclusion1.Sacubitril/valsartan significantly improves cardiac function in patients with CHF.2.Sacubitril/valsartan may inhibit ventricular remodeling and improve cardiac function by reducing the levels of Cy PA,Galectin-3,MMP-2 and MMP-9 in patients with CHF.