Department of Cardiology, Affiliated Huiyang Hospital of Southern Medical University, Huizhou, China.
Clin Hemorheol Microcirc. 2021;77(4):425-433. doi: 10.3233/CH-201032.
The aim of the present study was to observe the effect of sacubitril valsartan on cardiac function and vascular endothelial function in patients with chronic heart failure with reduced ejection fraction (HFrEF).
A total of 80 patients with HFrEF were randomly divided into an observation group and a control group, with 40 patients in each group. Sacubitril valsartan was added to the conventional treatment in the observation group, and perindopril was added to the conventional treatment in the control group. Both groups were treated continuously for 12 weeks. The left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), flow-mediated vasodilatory function (FMD) of the brachial artery, and levels of plasma Ang II, endothelin 1 (ET-1), and calcitonin gene-related peptide (CGRP), together with the serum nitric oxide (NO) and NO synthase (NOS) were compared before and after treatment in the groups.
Before the treatment, the levels of LVEF, LVEDD, FMD, Ang II, ET-1, CGRP, NO, and NOS in the observation group were not significantly different from those in the control group (P > 0.05). However, the levels of LVEF, FMD, CGRP, NO, and NOS in both groups were significantly higher after the treatment than those before the treatment (P < 0.05) and significantly higher in the observation group than those in the control group. The difference was statistically significant (P < 0.05). Meanwhile, the levels of LVEDD, Ang II, and ET-1 in both groups decreased significantly after the treatment (P < 0.05) and were significantly lower in the observation group than those in the control group. The difference was statistically significant (P < 0.05).
Sacubitril valsartan might improve endothelial function while increasing cardiac function in HFrEF patients.
本研究旨在观察沙库巴曲缬沙坦对射血分数降低的慢性心力衰竭（HFrEF）患者心功能和血管内皮功能的影响。
将 80 例 HFrEF 患者随机分为观察组和对照组，每组 40 例。观察组在常规治疗的基础上加用沙库巴曲缬沙坦，对照组在常规治疗的基础上加用培哚普利。两组均连续治疗 12 周。比较两组治疗前后左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、肱动脉血流介导的血管舒张功能（FMD）以及血浆血管紧张素Ⅱ（AngⅡ）、内皮素 1（ET-1）、降钙素基因相关肽（CGRP）水平，同时比较两组血清一氧化氮（NO）和一氧化氮合酶（NOS）水平。
治疗前，观察组 LVEF、LVEDD、FMD、AngⅡ、ET-1、CGRP、NO 和 NOS 水平与对照组比较差异均无统计学意义（P＞0.05）。治疗后两组 LVEF、FMD、CGRP、NO 和 NOS 水平均明显高于治疗前（P＜0.05），且观察组明显高于对照组，差异均有统计学意义（P＜0.05）。同时，两组 LVEDD、AngⅡ和 ET-1 水平治疗后均明显下降（P＜0.05），且观察组明显低于对照组，差异均有统计学意义（P＜0.05）。
沙库巴曲缬沙坦可能通过改善内皮功能，同时增加 HFrEF 患者的心功能。
