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沙库巴曲缬沙坦治疗后射血分数降低的老年心力衰竭患者的超声心动图变化

Echocardiographic changes in elderly patients with heart failure with reduced ejection fraction after sacubitril-valsartan treatment.

作者信息

Gu Wei, Xu Chuangye, Li Zhao, Li Zhi-Zhong

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.

School of Medicine, Southern University of Science and Technology, Shenzhen, China.

出版信息

Cardiovasc Diagn Ther. 2021 Oct;11(5):1093-1100. doi: 10.21037/cdt-21-355.

Abstract

BACKGROUND

To observe the changes of cardiac structure and function in elderly patients with heart failure with reduced ejection fraction (HFrEF) after taking Sacubitril-Valsartan for 6 months.

METHODS

Elderly patients with HFrEF hospitalized in Beijing Anzhen Hospital from May 2019 to May 2020 were enrolled continuously in the single-center, retrospective, cohort study. Patients' Echocardiographs were examined for the evaluation of their cardiac condition. The primary outcomes were changes in cardiac function and structure at the sixth month after discharge, including left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left atrial diameter (LAD), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT) and left ventricular mass index (LVMI).

RESULTS

A total of 336 elderly patients with HFrEF were enrolled in this study, with an average age of 69.8 years, including 268 males (79.8%). Compared to the admission levels, the LVEF after taking Sacubitril-Valsartan for 6 months was markedly improved (48.49% 39.07%, P<0.01), while the LVEDD (54.70 59.97 mm, P<0.01), LVESD (40.59 47.59 mm, P<0.01), LAD (48.59 52.45 mm, P<0.01) and LVMI (105.16 125.20 g/m, P<0.01) decreased. Similar results were obtained in the subgroups of patients who were diagnosed with HFrEF on admission. In men, NHYA II and NHYA III subgroups, cardiac function improved significantly.

CONCLUSIONS

Sacubitril-Valsartan can improve the cardiac function and structure of elderly patients with HFrEF.

摘要

背景

观察射血分数降低的老年心力衰竭(HFrEF)患者服用沙库巴曲缬沙坦6个月后心脏结构和功能的变化。

方法

连续纳入2019年5月至2020年5月在北京安贞医院住院的老年HFrEF患者进行单中心、回顾性队列研究。检查患者的超声心动图以评估其心脏状况。主要结局为出院后第6个月心脏功能和结构的变化,包括左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心房内径(LAD)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)和左心室质量指数(LVMI)。

结果

本研究共纳入336例老年HFrEF患者,平均年龄69.8岁,其中男性268例(79.8%)。与入院时相比,服用沙库巴曲缬沙坦6个月后的LVEF显著改善(48.49%对39.07%,P<0.01),而LVEDD(54.70对59.97mm,P<0.01)、LVESD(40.59对47.59mm,P<0.01)、LAD(48.59对52.45mm,P<0.01)和LVMI(105.16对125.20g/m,P<0.01)均降低。入院时诊断为HFrEF的患者亚组也得到了类似结果。在男性、NYHA II和NYHA III亚组中,心脏功能显著改善。

结论

沙库巴曲缬沙坦可改善老年HFrEF患者的心脏功能和结构。

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