Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P. R. China.
Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Xinquan Road 29, 350001, Fuzhou, Fujian, P. R. China.
J Cardiothorac Surg. 2023 Apr 11;18(1):138. doi: 10.1186/s13019-023-02252-y.
To evaluate the efficacy of sacubitril/valsartan for the treatment of patients with chronic heart failure (CHF) after cardiac valve surgery (CVS).
Data were collected from 259 patients who underwent CVS due to valvular heart disease and were admitted to the hospital with CHF from January 2018 to December 2020. The patients were divided into Group A (treatment with sacubitril/valsartan) and Group B (treatment without sacubitril/valsartan). The duration of treatment and follow-up was 6 months. The two groups' prior and clinical characteristics, post-treatment data, mortality, and follow-up data were analysed.
The effective rate of Group A was higher than that of Group B (82.56% versus 65.52%, P < 0.05). The left ventricular ejection fraction (LVEF, %) was improved in both groups. The final value minus the initial value was (11.14 ± 10.16 versus 7.15 ± 11.18, P = 0.004). The left ventricular end-diastolic/-systolic diameter (LVEDD/LVESD, mm) in Group A decreased more than in Group B. The final value minus the initial value was (-3.58 ± 9.21 versus - 0.27 ± 14.44, P = 0.026; -4.21 ± 8.15 versus - 1.14 ± 12.12, P = 0.016, respectively). Both groups decreased the N-terminal prohormone of B-type natriuretic peptide (NT-proBNP, pg/ml). The final value minus initial value was [-902.0(-2226.0, -269.5) versus - 535.0(-1738, -7.0), P = 0.029]. The systolic and diastolic blood pressure (SBP/DBP, mmHg) in Group A decreased more than in Group B. The final value minus the initial value was (-13.13 ± 23.98 versus - 1.81 ± 10.89, P < 0.001; -8.28 ± 17.79 versus - 2.37 ± 11.41, P = 0.005, respectively). Liver and renal insufficiency, hyperkalaemia, symptomatic hypotension, angioedema, and acute heart failure had no statistical differences between the two groups.
Sacubitril/valsartan can effectively improve the cardiac function of patients with CHF after CVS by increasing LVEF and reducing LVEDD, LVESD, NT-proBNP, and BP, with good safety.
评估沙库巴曲缬沙坦治疗心脏瓣膜手术后（CVS）慢性心力衰竭（CHF）患者的疗效。
收集了 2018 年 1 月至 2020 年 12 月因瓣膜性心脏病接受 CVS 并因 CHF 入院的 259 例患者的数据。患者分为 A 组（接受沙库巴曲缬沙坦治疗）和 B 组（未接受沙库巴曲缬沙坦治疗）。治疗和随访时间为 6 个月。分析两组患者的基线和临床特征、治疗后数据、死亡率和随访数据。
A 组的有效率高于 B 组（82.56%比 65.52%，P<0.05）。两组左心室射血分数（LVEF，%）均有所改善。终值减去初始值分别为（11.14±10.16 比 7.15±11.18，P=0.004）。A 组的左心室舒张末期/收缩末期直径（LVEDD/LVESD，mm）较 B 组减小更多。终值减去初始值分别为（-3.58±9.21 比-0.27±14.44，P=0.026；-4.21±8.15 比-1.14±12.12，P=0.016）。两组患者的 N 末端脑利钠肽前体（NT-proBNP，pg/ml）均降低。终值减去初始值分别为[-902.0（-2226.0，-269.5）比-535.0（-1738.0，-7.0），P=0.029]。A 组的收缩压/舒张压（SBP/DBP，mmHg）较 B 组下降更多。终值减去初始值分别为（-13.13±23.98 比-1.81±10.89，P<0.001；-8.28±17.79 比-2.37±11.41，P=0.005）。两组患者的肝肾功能不全、高钾血症、症状性低血压、血管性水肿和急性心力衰竭发生率无统计学差异。
沙库巴曲缬沙坦可通过增加 LVEF、降低 LVEDD、LVESD、NT-proBNP 和 BP，有效改善心脏瓣膜手术后 CHF 患者的心功能，安全性良好。
