Clinical effect of sacubitril/valsartan for heart failure with mid-range ejection fraction in left ventricle

doi:10.3969/j.issn.1004-583X.2021.05.006

Abstract

Abstract:

Objective To investigate the clinical effect of sacubitril/valsartan for heart failure with mid-range ejection fraction(HFmrEF) in left ventricle. Methods Ninety-eight patients with HFmrEF in left ventricle who were recruited from August 2019 to August 2020 were randomly divided into observation group and control group with 49 cases in each group. On the basis of conventional anti-heart failure treatment, the observation group was treated with sacubitril/valsartan sodium, while the control group was treated with enalapril. All the medicines were taken orally for six months by patients in two groups, respectively. The related cardiac indexes were monitored and analyzed before and after the test, such as N-terminal pro-B-type natriuretic peptides(NT-proBNP), soluble growth stimulation expressed gene 2(sST2), C-reactive protein(CRP), left ventricular ejection fraction(LVEF), interventricular septal thickness(IVST), left ventricular end diastolic diameter(LVEDD), left ventricular posterior wall thickness(LVPWT), left atrial diameter(LAD), NYHA classification, 6-minute walk test(6MWT), systolic blood pressure(SBP), as well as the adverse events in two groups after treatment. Results After treatment, NT-proBNP, sST-2, and CRP in the two groups were all lower than those before treatment, and the observation group significantly decreased(P<0.05).LVEF showed an upward trend in the two groups after treatment, while IVST, LVEDD, LVPWT and LAD showed a downward trend in the two groups after treatment; the changes in the observation group were greater than those in the control group (P<0.05). The improvements of 6MWT, SBP and classification of NYHA heart function in the observation group were significantly better than those in the control group (P<0.05), and sacubitril/valsartan could significantly reduce the readmission rate of heart failure. Conclusion Sacubitril/valsartan for patients with HFmrEF in left ventricle can effectively improve cardiac function.

Key words: heart failure, heart function tests, stroke volume, angiotensin converting enzyme inhibitors

CLC Number:

R541.6

Xu Dongrui, Zhao Qinhui, Liu Tongxiang. Clinical effect of sacubitril/valsartan for heart failure with mid-range ejection fraction in left ventricle[J]. Clinical Focus, 2021, 36(5): 416-420.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.05.006

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I5/416

Figures/Tables 6

References 19

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项目	观察组 (n=49)	对照组 (n=49)	统计值	P值
年龄(岁)	66.6±13.6	69.4±12.8	t=1.065	0.290
男性[例(%)]	32(65.3)	27(55.1)	χ²=1.065	0.302
病程(年)	2.6±2.3	2.7±2.4	t=0.049	0.961
既往病史[例(%)]
冠心病	29(59.2)	26(53.1)	χ²=0.373	0.541
高血压	30(61.2)	27(55.1)	χ²=0.377	0.539
房颤	4(8.2)	6(12.2)	χ²=0.445	0.505
心肌病	12(24.5)	13(26.5)	χ²=0.054	0.817
糖尿病	11(22.4)	15(30.6)	χ²=0.838	0.360
吸烟[例(%)]	8(16.3)	11(22.4)	χ²=0.588	0.443
用药情况[例(%)]
硝酸酯类	16(32.7)	15(30.6)	χ²=0.047	0.828
利尿剂	19(38.8)	18(36.7)	χ²=0.043	0.835
β受体阻滞剂	22(44.9)	25(51.0)	χ²=0.368	0.544
洋地黄类	5(10.2)	3(6.1)	χ²=0.136	0.712
调脂药物	31(63.3)	27(55.1)	χ²=0.676	0.411
抗血小板药物	32(65.3)	27(55.1)	χ²=1.065	0.302
ARB类	5(10.2)	6(12.2)	χ²=0.102	0.749

项目	观察组 (n=49)	对照组 (n=49)	统计值	P值
年龄(岁)	66.6±13.6	69.4±12.8	t=1.065	0.290
男性[例(%)]	32(65.3)	27(55.1)	χ²=1.065	0.302
病程(年)	2.6±2.3	2.7±2.4	t=0.049	0.961
既往病史[例(%)]
冠心病	29(59.2)	26(53.1)	χ²=0.373	0.541
高血压	30(61.2)	27(55.1)	χ²=0.377	0.539
房颤	4(8.2)	6(12.2)	χ²=0.445	0.505
心肌病	12(24.5)	13(26.5)	χ²=0.054	0.817
糖尿病	11(22.4)	15(30.6)	χ²=0.838	0.360
吸烟[例(%)]	8(16.3)	11(22.4)	χ²=0.588	0.443
用药情况[例(%)]
硝酸酯类	16(32.7)	15(30.6)	χ²=0.047	0.828
利尿剂	19(38.8)	18(36.7)	χ²=0.043	0.835
β受体阻滞剂	22(44.9)	25(51.0)	χ²=0.368	0.544
洋地黄类	5(10.2)	3(6.1)	χ²=0.136	0.712
调脂药物	31(63.3)	27(55.1)	χ²=0.676	0.411
抗血小板药物	32(65.3)	27(55.1)	χ²=1.065	0.302
ARB类	5(10.2)	6(12.2)	χ²=0.102	0.749

组别	例数		NT-proBNP(ng/L)				sST-2(pg/ml)			CRP(μg/ml)			SCr(μg/L)
组别	例数		治疗前		治疗后		治疗前	治疗后		治疗前	治疗后		治疗前	治疗后
观察组	49		2762.8±557.9		851.2±323.1^b		75.1±8.5	62.8±7.1^b		9.6±7.8	3.1±2.3^b		86.9±32.2	92.2±27.7
对照组	49		2812.0±402.8		1580.8±333.9^b		73.3±7.0	66.7±10.4^b		9.6±8.1	4.5±3.7^b		86.9±34.7	104.0±28.2^a
t值			-0.500		-10.990		1.195	-2.165		-0.049	-2.302		-0.003	-2.096
P值			0.618		0.001		0.235	0.033		0.961	0.023		0.998	0.039
组别		例数		总蛋白(g/L)			总胆红素(μmol/L)			TC(mmol/L)			LDL-C(mmol/L)
组别		例数		治疗前		治疗后	治疗前		治疗后	治疗前		治疗后	治疗前		治疗后
观察组		49		65.6±8.1		65.0±8.8	23.2±13.6		23.0±14.6	3.8±1.0		3.7±1.0	2.3±0.5		2.4±0.7
对照组		49		65.3±7.4		64.2±6.0	23.3±15.3		23.4±15.7	3.9±1.0		3.8±0.9	2.3±0.8		2.3±0.9
t值				0.162		0.517	-0.057		-0.148	-0.421		-0.507	-0.335		0.212
P值				0.872		0.606	0.955		0.882	0.675		0.613	0.739		0.832

组别	例数		NT-proBNP(ng/L)				sST-2(pg/ml)			CRP(μg/ml)			SCr(μg/L)
组别	例数		治疗前		治疗后		治疗前	治疗后		治疗前	治疗后		治疗前	治疗后
观察组	49		2762.8±557.9		851.2±323.1^b		75.1±8.5	62.8±7.1^b		9.6±7.8	3.1±2.3^b		86.9±32.2	92.2±27.7
对照组	49		2812.0±402.8		1580.8±333.9^b		73.3±7.0	66.7±10.4^b		9.6±8.1	4.5±3.7^b		86.9±34.7	104.0±28.2^a
t值			-0.500		-10.990		1.195	-2.165		-0.049	-2.302		-0.003	-2.096
P值			0.618		0.001		0.235	0.033		0.961	0.023		0.998	0.039
组别		例数		总蛋白(g/L)			总胆红素(μmol/L)			TC(mmol/L)			LDL-C(mmol/L)
组别		例数		治疗前		治疗后	治疗前		治疗后	治疗前		治疗后	治疗前		治疗后
观察组		49		65.6±8.1		65.0±8.8	23.2±13.6		23.0±14.6	3.8±1.0		3.7±1.0	2.3±0.5		2.4±0.7
对照组		49		65.3±7.4		64.2±6.0	23.3±15.3		23.4±15.7	3.9±1.0		3.8±0.9	2.3±0.8		2.3±0.9
t值				0.162		0.517	-0.057		-0.148	-0.421		-0.507	-0.335		0.212
P值				0.872		0.606	0.955		0.882	0.675		0.613	0.739		0.832

组别	例数	LVEF(%)		LVEDD(mm)		IVST(mm)		LVPWT(mm)		LAD(mm)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	49	43.9±3.2	53.2±4.1^b	57.9±6.5	47.6±5.2^b	10.1±1.5	7.9±1.1^b	10.1±1.5	8.1±0.9^b	39.6±3.5	37.1±3.4^b
对照组	49	43.0±2.8	45.6±3.4^b	57.8±5.7	54.5±6.1^b	9.4±1.5	8.4±1.1^b	9.7±1.3	8.5±0.8^b	39.3±2.9	38.4±2.1^a
t值		1.364	9.924	0.088	-6.085	1.869	-2.193	1.583	-2.134	0.487	-2.332
P值		0.176	0.001	0.930	0.001	0.065	0.031	0.117	0.035	0.627	0.022