Abstract:Objective To evaluate the therapeutic effect and safety of low-dose Sacubitril Valsartan in treatment of heart failure with reduced ejection fraction (HFrEF) in the elderly patients. Methods A total of 82 elderly patients with HFrEF (age≥60 years old) treated in Department of Cardiology of Shanghai East Hospital Ji′an Hospital from April 2019 to March 2021 were selected as research objects. They were divided into study group (n=42) and control group(n=40) according to coin toss method. The control group was treated with routine anti chronic heart failare method, the study group treated with Sacubitril Valsarta after stopping using angiotensin converting enzyme inhibitor (ACEI) in routine treatment. The 6 minutes walking test (6-MWT), plasma N-terminal pro-B-type natriuretic peptide (NTproBNP) and cardiac ultrasound were determined before and after 6 months of treatment to detect the patients′ cardiac function. The changes of cardiac function grade indexes in the two groups were evaluated, and the treatment effect and drug safety of the two groups were analyzed. Results There were no statistically significances in plasma NT-proBNP,left ventricle ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), left atrial diameter (LA),systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), 6-MWT levels between two groups before treatment (P>0.05). After 6 months of treatment, plasma NT-proBNP, LVEDD, LA, SBP, DBP, HR in study group were lower than those in control group, while the levels of LVEF and 6-MWT in study group were higher than those in control group, the differences were statistically significant (P<0.05). The total effective rate of the study group was higher than that of the control group, the difference was statistically significant (P<0.05). While there was no significant difference in total incidence of adverse reactions between the two groups (P>0.05). Conclusion Low-dose Sacubitril Valsartan can effectively inhibit the ventricular remodeling of elderly HFrEF patients, as well improve clinical symptoms and exercise endurance in elderly HFrEF patients with good safety.
刘远胜;周华;刘中文;廖斌;刘玲娟;欧军萍. 低剂量沙库巴曲缬沙坦治疗老年射血分数降低型慢性心力衰竭的效果及安全性[J]. 中国当代医药, 2022, 29(16): 20-24.
LIU Yuansheng;ZHOU Hua ;LIU Zhongwen; LIAO Bin; LIU Lingjuan; OU Junping▲. Efficacy and safety of low-dose Sacubitril Valsartan in treatment of heart failure with reduced ejection fraction in the elderly. 中国当代医药, 2022, 29(16): 20-24.
ZhangY,Zhang J,Butle J,et al.Contemporary Epidemiology,Management and Outcomes of Patients hospitalized for heart failure in china:Results From the China Heart Failure(China-HF)Registy[J].J Card Fail,2017,23(12):868-875.
Beltrán P,Palau P,Domíneguez E,et al.Sacubitril/valsartan and shorterm changes in the 6-minute walk test:A pilot study[J].Int J Cardiol,2018,252:136-139.
McDonagh TA,Metra M,Adamo M,et al.2021 ESC Guidelines for the diagnosis and treatment of acut and chronic heart failure[J].Eur Heart J,2021,42(36):3599-3726.
[7]
Desai AS,Solomon SD,Shah AM,et al.Effect of Sacubitril-Valsartan vs Enalapril on Aortic Stiffness in Patients With Heart Failure and Reduced Ejection Fraction:A Randomized Clinical Trial[J].JAMA,2019,322(11):1077-1084.
[10]
Linssen GCM,Jaarsma T,Hillege HL,et al.A comparison of the prognostic value of BNP versus NT-proBNP after hospitalization for heart failure[J].Neth Heart J,2018,26(10):486-492.
Bodnar RJ.Endogenous opiates and behavior:2019[J].Peptides,2021,114:170547.
[17]
Pilozzi A,Carro C,Huang X.Roles of β-Endorphin in Stress,Behavior,Neuroinflammation,and Brain En ergy Metabolism[J].Int J Mol Sci,2020,22(1):338.
[18]
Maslov MY,Foianini S,Orlov MV,et al.A Novel Paradigm for Sacubitril/Valsartan:Beta-Endorphin Elevation as a Contributor to Exercise Tolerance Improvement in Rats With Preexisting Heart Failure Induced by Pressure Overload[J].J Card Fail,2018,24(11):773-782.
[19]
Greene SJ,Fonarow GC,Vaduganathan M,et al.The vulnerable phase after hospitalization for heart failure[J].Nat Rev Cardiol,2015,12(4):220-229.
Logeart D,Isnard R,Resche-Rigon M,et al.Heart Failure of the French Society of Cardiology. Current aspect of the spectrum of acute heart failure syndrome in a real-life setting:the OFICA study[J].Eur J Heart Fail,2013,15(4):465-476.