Fu Sha, Xu Zhenjian, Lin Baojuan, Chen Junzhe, Huang Qiuyan, Xu Yanchun, Xu Anping, Chen Yangxin, Tang Ying
Department of Nephrology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China.
Departments of Medicine & Therapeutics, Li Ka Shing Institute of Health Sciences, and Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Front Med (Lausanne). 2021 Jun 21;8:657067. doi: 10.3389/fmed.2021.657067. eCollection 2021.
The effect of the angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril-valsartan in patients with heart failure with preserved ejection fraction (HFpEF) remains unclear, and data on ARNI treatment in peritoneal dialysis (PD) patients are lacking. The present study was designed to assess the efficacy and safety of sacubitril-valsartan in patients with HFpEF undergoing peritoneal dialysis. End-stage kidney disease (ESKD) patients undergoing PD for 3 months with New York Heart Association (NYHA) class II-IV heart failure, ejection fraction of 50% or higher, and elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) were assigned to receive sacubitril-valsartan. Patients were followed up regularly after medication treatment. The alterations in clinical and biochemical parameters before and after taking sacubitril-valsartan (generally 50-100 mg b.i.d) were investigated, and safety was also assessed. Twenty-one patients were recruited in this study. Compared with baseline levels, NT-proBNP levels [9769.0 (3093.5-21941.0) vs. 3034.0 (1493.2-6503.0), = 0.002], and heart rate [80.0 (74.5-90.5) vs. 75.0 (70.3-87.0), = 0.031] were markedly decreased after treatment with sacubitril-valsartan. Signs and symptoms of heart failure (21/21 vs. 15/21, = 0.021) were obviously alleviated, NYHA classification and E/e' ratio showed a notable trend of improvement after 3-12 months of follow-up. None of the patients showed adverse drug reactions. The present data suggested that sacubitril-valsartan treatment in patients with HFpEF undergoing PD was effective and safe.
血管紧张素受体脑啡肽酶抑制剂（ARNI）沙库巴曲缬沙坦对射血分数保留的心力衰竭（HFpEF）患者的疗效尚不清楚，且缺乏关于腹膜透析（PD）患者使用ARNI治疗的数据。本研究旨在评估沙库巴曲缬沙坦对接受腹膜透析的HFpEF患者的疗效和安全性。将接受腹膜透析3个月、纽约心脏协会（NYHA）心功能II-IV级、射血分数50%或更高且N末端B型脑钠肽原（NT-proBNP）水平升高的终末期肾病（ESKD）患者分配接受沙库巴曲缬沙坦治疗。药物治疗后对患者进行定期随访。研究了服用沙库巴曲缬沙坦（一般为50-100mg，每日两次）前后临床和生化参数的变化，并评估了安全性。本研究共招募了21名患者。与基线水平相比，沙库巴曲缬沙坦治疗后NT-proBNP水平[9769.0（3093.5-21941.0）对3034.0（1493.2-6503.0），P=0.002]和心率[80.0（74.5-90.5）对75.0（70.3-87.0），P=0.031]明显降低。心力衰竭的体征和症状（21/21对15/21，P=0.021）明显减轻，随访3-12个月后NYHA分级和E/e'比值显示出显著的改善趋势。所有患者均未出现药物不良反应。目前的数据表明，沙库巴曲缬沙坦治疗接受腹膜透析的HFpEF患者是有效且安全的。
