Short-term Efficacy Observation Of Sacubitril/valsartan And ACEI/ARB In Patients With Dilated Cardiomyopathy And Heart Failure

Objective: The aim of this study is to determine the efficacy of sacubitril/valsartan in the treatment of dilated cardiomyopathy(DCM)heart failure compared with ACEI/ARB.To explore the mechanism of Sacubitril/valsartan in patients with dilated cardiomyopathy and heart failure,and to provide evidence for its clinical diagnosis and treatment.Methods: We respectively collected the data of patients who visited the Fourth Hospital of Hebei Medical University from January 2018 to October 2019.A total of 56 patients who met the inclusion criteria were divided into sacubitril/valsartan group and ACEI/ARB group.Sacubitril/valsartan group: sacubitril/valsartan + other heart failure drugs,a total of 25 cases,21 men,4 women;ACEI/ARB group: ACEI/ARB + other heart failure drugs,a total of 31 cases,25 men,women 6 cases.ACEI/ARB group: ACEI/ARB maximum tolerated dose;sacubitril/valsartan group: sacubitril/valsartan,starting dose 25 mg bid,and then gradually increase to the maximum tolerated dose.Other treatments for heart failure,including rest,salt and water restriction,diuretics,?-receptor antagonists and other treatments are the same.Continuous treatment for 3 months.Cardiac function grading,Kansas city cardiomyopathy questionnaire(KCCQ)score,echocardiography,electrolytes,and renal function were measured before and after treatment in the two groups.Results: After 3 months of treatment,the clinical effectiveness and KCCQ scores of the sacubitril/valsartan group were higher than those of ACEI/ARB group(P<0.05).The left ventricular ejection fraction(LVE F)of sacubitril/valsartan group was higher than that before treatment,and the left ventricular end-diastolic dimension(LVEDD)was smaller than that before treatment.But there was no statistical significance between the two groups(P>0.05).Right ventricular end-diastolic diameter(RVEDD)and left atrial diameter(LAD)were smaller than those before treatm ent(P<0.05).The rate of rehospitalization in the sacubitril/valsartan group was reduced(P<0.05).There were 6 cases of hypotension in the sacub itril/valsartan group,with statistical significance(P<0.05).Conclusions: Compared with ACEI/ARB,sacubitril/valsartan can sig nificantly improve the quality of life in patients with DCM heart failure.It has a good effect in improving ventricular remodeling.However,the risk of hypokalemia of sacubitril/valsartan is higher.It is necessary to pay close attention to the patient's capacity status,and optimize the use of diuretics to maximize the benefits of sacurbactra valsartan.