Gao Yang, Xing Changtai, Hao Wenjun, Zhao Hongwei, Wang Lili, Luan Bo, Hou Aijie
Department of Cardiology, The People's Hospital of Liaoning Province.
Department of Cardiology, The Center Hospital Affiliated to Shenyang Medical College.
Int Heart J. 2020 Jan 31;61(1):1-6. doi: 10.1536/ihj.19-231. Epub 2019 Dec 26.
Chronic heart failure (CHF) seriously affects the quality of patients' lives. Sacrubitril/valsartan is a combination angiotensin receptor-neprilysin inhibitor, a new therapeutic drugs to treat CHF.This study aims to observe the impact of sacrubitril/valsartan on clinical treatment and high-sensitivity cardiac troponin T (hs-cTnT), N-terminal pro-brain natriuretic peptide (NT-ProBNP) serum levels, the improvement of the left atrial diameter (LAD) and left ventricular end diastolic dimension (LVEDD), and the left ventricular ejection fraction (LVEF) in patients with CHF.120 patients were randomly divided into a sacrubitil/valsartan group and a valsantan group, with 60 cases in each. Patients in the sacrubitil/valsartan group were administered sacrubitril/valsartan; while in the valsantan group, they were administered valsartan. The clinical effects, adverse reactions, and rehospitalization were observed eight weeks later, and hs-cTnT and NT-ProBNP serum levels and LAD, LVEDD, and LVEF were assayed.There were 53 cases of positive effect in the sacrubitil/valsartan group and 42 in the valsartan group (P < 0.05). Eight participants demonstrated adverse reactions in the sacrubitil/valsartan group, while 17 in the control group (P < 0.05). Hs-cTnT and NT-ProBNP serum levels, the measurements of LAD, LVEDD, and LVEF in the sacrubitil/valsartan group before the treatments were (24.47 ± 7.54) pg/mL, (10,356.94 ± 5,447.68) pg/mL, (49.41 ± 5.22) mm, (68.06 ± 6.20) mm and (31.12 ±6.65) %; in the valsartan group were (29.752 ± 10.03) pg/mL, (9,518.17 ± 5,905.17) pg/mL, (49.65 ± 4.91) mm, (67.06 ± 3.97) mm, and (30.41 ± 6.11) % (P > 0.05), while in the sacrubitil/valsartan group, the values decreased after the treatments to (17.92 ± 4.74) pg/mL, (3,881.59 ± 2,087.79) pg/mL, (42.18 ± 4.87) mm, (60.35 ± 7.12) mm and (45.35 ± 4.49) %; in the valsartan group to (25.81 ± 7.36) pg/mL, (6,278.35 ± 2,643.11) pg/mL, (46.53 ± 4.80) mm, (64.51 ± 4.34) mm, and (36.47 ± 5.21) % (P < 0.05). There were significant differences within the same group, before and after treatments (P < 0.05).Sacrubitril/valsartan treatment of patients with CHF improves their symptoms and is deserving of clinical application. This is also evident from significantly improved levels of serum hs-cTnT and NT-ProBNP and the left ventricular function.
慢性心力衰竭(CHF)严重影响患者生活质量。沙库巴曲缬沙坦是一种血管紧张素受体脑啡肽酶抑制剂复方制剂,是治疗CHF的新型治疗药物。本研究旨在观察沙库巴曲缬沙坦对CHF患者临床治疗效果、高敏心肌肌钙蛋白T(hs-cTnT)、N末端脑钠肽前体(NT-ProBNP)血清水平、左心房内径(LAD)及左心室舒张末期内径(LVEDD)改善情况以及左心室射血分数(LVEF)的影响。将120例患者随机分为沙库巴曲缬沙坦组和缬沙坦组,每组60例。沙库巴曲缬沙坦组患者给予沙库巴曲缬沙坦治疗;缬沙坦组患者给予缬沙坦治疗。8周后观察临床疗效、不良反应及再住院情况,并检测hs-cTnT和NT-ProBNP血清水平以及LAD、LVEDD和LVEF。沙库巴曲缬沙坦组显效53例,缬沙坦组显效42例(P<0.05)。沙库巴曲缬沙坦组有8例出现不良反应,对照组有17例(P<0.05)。治疗前,沙库巴曲缬沙坦组hs-cTnT和NT-ProBNP血清水平、LAD、LVEDD及LVEF测量值分别为(24.47±7.54)pg/mL、(10356.94±5447.68)pg/mL、(49.41±5.22)mm、(68.06±6.20)mm和(31.12±6.65)%;缬沙坦组分别为(29.752±10.03)pg/mL、(9518.17±5905.17)pg/mL、(49.65±4.91)mm、(67.06±3.97)mm和(30.41±6.11)%(P>0.05);治疗后,沙库巴曲缬沙坦组上述指标分别降至(17.92±4.74)pg/mL、(3881.59±2087.79)pg/mL、(42.18±4.87)mm、(60.35±7.12)mm和(45.35±4.49)%;缬沙坦组分别为(25.81±7.36)pg/mL、(6278.35±2643.11)pg/mL、(46.53±4.80)mm、(64.51±4.34)mm和(36.47±5.21)%(P<0.05)。同一组治疗前后比较差异有统计学意义(P<0.05)。沙库巴曲缬沙坦治疗CHF患者可改善症状,值得临床应用。血清hs-cTnT和NT-ProBNP水平及左心室功能的显著改善也证实了这一点。