Department of Nephrology, Osaka Medical and Pharmaceutical University, Osaka, Japan;
Department of Nephrology, Osaka Medical and Pharmaceutical University, Osaka, Japan.
In Vivo. 2024 May-Jun;38(3):1266-1270. doi: 10.21873/invivo.13564.
BACKGROUND/AIM: Sacubitril/valsartan (SV), a novel pharmacological class of angiotensin receptor neprilysin inhibitors, is effective in treating heart failure (HF) by inhibiting the degradation of natriuretic peptides and the renin-angiotensin-aldosterone system. However, no studies have observed the long-term effects of SV on patients with HF and preserved left ventricular ejection fraction (LVEF) undergoing hemodialysis (HD) over a long period.
This single-center retrospective study of 21 months duration involved consecutive patients with HF and preserved LVEF undergoing HD, who received 50-200 mg/day. All patients were followed up regularly, and clinical, biochemical, and echocardiographic parameters were recorded at baseline and during follow-up. The efficacy and safety of SV were also analyzed.
This longitudinal study included nine patients, with a median age of 76 years. The median HD duration was 7 years. At baseline, the mean brain natriuretic peptide (BNP) was 133±73.6 pg/ml and that of LVEF was 66%±9%. After SV therapy, the systolic blood pressure, diastolic blood pressure, and heart rate decreased, albeit without statistical significance. BNP levels, LVEF, left atrial anteroposterior dimension, and left ventricular mass index did not change, compared to baseline values. No adverse effects were observed in any of the patients.
SV tended to decrease blood pressure and heart rate in patients with HF and preserved LVEF undergoing HD but did not alter cardiac function assessments, such as BNP or echocardiography.
背景/目的：沙库比曲缬沙坦（SV）是一种新型的血管紧张素受体脑啡肽酶抑制剂，通过抑制利钠肽和肾素-血管紧张素-醛固酮系统的降解，对心力衰竭（HF）有效。然而，尚无研究观察 SV 对长期接受血液透析（HD）的 HF 合并保留左心室射血分数（LVEF）患者的长期影响。
本单中心回顾性研究持续 21 个月，纳入了 21 名接受 50-200mg/天 SV 治疗的 HF 合并保留 LVEF 且正在接受 HD 的连续患者。所有患者均定期随访，并在基线和随访期间记录临床、生化和超声心动图参数。还分析了 SV 的疗效和安全性。
这项纵向研究包括 9 名患者，中位年龄为 76 岁。中位 HD 持续时间为 7 年。基线时，平均脑钠肽（BNP）为 133±73.6pg/ml，LVEF 为 66%±9%。SV 治疗后，收缩压、舒张压和心率降低，但无统计学意义。与基线值相比，BNP 水平、LVEF、左心房前后径和左心室质量指数均无变化。未观察到任何患者出现不良反应。
SV 倾向于降低 HF 合并保留 LVEF 且正在接受 HD 的患者的血压和心率，但未改变 BNP 或超声心动图等心脏功能评估。
