| Objective:Objective To investigate the effect of Sacubitril/valsartan combined with compound Danshen dripping pills in the treatment of chronic heart failure with paroxysmal atrial fibrillation.Methods:A total of 476 patients with chronic heart failure complicated with paroxysmal atrial fibrillation admitted to the Department of Cardiovascular Medicine of the First Affiliated Hospital of Gannan Medical University from December 2020 to December 2022 were selected as retrospective studies.After strict implementation of the inclusion criteria and exclusion criteria,a total of 95 patients meeting the study object were finally selected.According to the treatment plan,they were divided into experimental group(43 cases)and control group(52cases).Both groups of patients received conventional anti-heart failure therapy and anticoagulation therapy for atrial fibrillation.On this basis,the control group received Sacubitril/valsartan,and the experimental group received Sacubitril/valsartan + compound Danshen dripping pills,both of which were treated for 6 months.Compared the echocardiogram index,P wave variance(Δ P),amino terminal brain natriuretic peptide precursor(NT-pro BNP),liver and kidney function level of the two groups before and after treatment,and statistically analyzed the sinus rhythm maintenance rate and the occurrence of adverse events of the two groups.To evaluate the therapeutic effect of Sacubitril/valsartan combined with compound Danshen dripping pills on chronic heart failure complicated with paroxysmal atrial fibrillation.Results:1.Baseline data of the experimental group and the control group: there were no significant differences in gender,age,BMI,NYNA cardiac function grade,history of hypertension,diabetes,coronary heart disease,stroke,blood pressure and other general clinical data between the two groups(P > 0.05).Before treatment,there were no significant differences in left ventricular ejection fraction(LVEF),left atrial anterior and posterior diameter(LAD),left ventricular anterior and posterior diameter(LVEDD),left ventricular posterior wall thickness(LVPWD),NT-pro BNP level,ΔP,liver function(ALT,AST)and renal function(Scr)between2 groups(P > 0.05).2.LVEF of the two groups after treatment was higher than that before treatment(P<0.05),and LVEF of the experimental group(52.23±7.72)% was higher than that of thecontrol group(47.69±7.38)%,the difference was statistically significant(P<0.05).The LAD in both groups after treatment was lower than that before treatment(P<0.05),and the LAD in the experimental group(44.63±5.57)mm was lower than that in the control group(46.79±6.12)mm,the differencewas statistically significant(P< 0.05).The LVEDD of the two groups after treatment was lower than that before treatment(P<0.05),including the experimental group(58.86±9.15 vs 55.09±6.31,P<0.05)and the control group(60.19±9.31 vs 57.29±8.58,P<0.05).There was statistically significant difference in intragroup comparison,but no statistically significant difference in LVEDD between the two groups after treatment(P=0.069).There was no significant difference in LVPWD between the two groups after treatment(9.12±1.95 vs 9.03±1.36,P> 0.05).3.After treatment,the NT-pro BNP of the two groups were lower than before treatment(P<0.05),and the experimental group NT-pro BNP(1430.81±530.69)pg/m L lower than the control group(2933.27±678.59)pg/m L,thedifference was statistically significant(P<0.05).4.After treatment,the ΔP of both groups is lower than before treatment(P<0.05),among which the experimental group ΔP(43.23±2.44 vs 40.53±1.00,P<0.05)and the control group(42.87±2.25 vs 40.23±1.42,P<0.05),the difference is statistically significant.After treatment,there was no significant differencein ΔPbetween the two groups(P=0.582).5.There were no significant differences in liver and renal function between the two groups beforeandaftertreatment(P > 0.05).6.Compared with the prognosis of the two groups,the readmission rate of heart failure in the experimental group was lower than that inthe control group within 6 months after treatment(9.3% vs 26.9%,P=0.029),and the difference was statistically significant.There were no significant differences in sinus rhythm maintenance rate,thromboembolic events and malignant arrhythmia events betweenthe twogroups(P> 0.05).Conclusion:1.In thetreatment of patients withchronic heartfailure complicated with paroxysmal atrial fibrillation,Sacubitril/valsartan combined with compound Danshen dripping pills can significantlyimprove NT-pro BNP,LVEF and LAD,reduce the rehospitalization rate of heart failure and improve heartfunction,and theefficacyis superior to Sacubitril/valsartanalone.2.Sacubitril/valsartancombinedwith compound Danshen dripping pills can reduce the P wavedispersion inpatientswith chronic heart failure complicated withparoxysmal atrial fibrillation,andmay reduce the recurrence of paroxysmal atrial fibrillation.3.Sacubitril/valsartancombinedwith compound Danshen dripping pills is safe andreliable for patients with chronicheart failure complicated with paroxysmal atrial fibrillation,anddoes not increasethe riskof liverand kidneyfunction damage. |
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