Department of Nephrology, Shaanxi Second Provincial People's Hospital, Xi'an, Shaanxi, China.
Department of Nephrology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
Med Sci Monit. 2024 Jul 12;30:e943529. doi: 10.12659/MSM.943529.
BACKGROUND Heart failure and end-stage renal disease often coexist, and management of heart failure can be challenging in patients during hemodialysis. Sacubitril-valsartan (SV) is the first drug to receive regulatory approval for use in patients with chronic heart failure with reduced ejection fraction (HFrEF) and New York Heart Association (NYHA) classification II, III, or IV. This study aimed to evaluate the efficacy and safety of SV for use in chronic heart failure patients on maintenance hemodialysis (MHD). MATERIAL AND METHODS From September 2021 to October 2022, 28 patients on MHD with chronic heart failure at the hemodialysis center of Shaanxi Second Provincial People's Hospital were regularly followed. During the 12-week follow-up period, all patients were administered SV at doses of 100-400 mg per day. Biochemical indicators, echocardiographic parameters, life quality scores, and adverse events were evaluated. RESULTS We enrolled 28 patients. Compared with the baseline levels, NYHA class III in these patients treated with SV was significantly decreased from 60.71% to 32.14% (P<0.05), left ventricular ejection fraction (LVEF) was significantly improved from 44.29±8.92% to 53.32±7.88% (P<0.001), the Physical Component Summary (PCS) score was significantly improved from 40.0±6.41 to 56.20±9.86 (P<0.001), and the Mental Component Summary (MCS) score was significantly improved from 39.99±6.14 to 52.59±11.0 (P<0.001). CONCLUSIONS We demonstrated that SV improved NYHA classification and LVEF values of patients on MHD with chronic heart failure and also improved their quality of life.
心力衰竭和终末期肾病常同时存在,血液透析患者的心力衰竭管理具有挑战性。沙库巴曲缬沙坦(SV)是首个获得监管部门批准用于射血分数降低的慢性心力衰竭(HFrEF)和纽约心脏协会(NYHA)分级 II、III 或 IV 患者的药物。本研究旨在评估 SV 在慢性心力衰竭维持性血液透析(MHD)患者中的疗效和安全性。
2021 年 9 月至 2022 年 10 月,陕西省第二人民医院血液透析中心对 28 例 MHD 合并慢性心力衰竭的患者进行定期随访。在 12 周的随访期间,所有患者每天服用 100-400mg 的 SV。评估生化指标、超声心动图参数、生活质量评分和不良事件。
共纳入 28 例患者。与基线水平相比,SV 治疗后 NYHA 分级 III 的患者比例从 60.71%显著下降至 32.14%(P<0.05),左心室射血分数(LVEF)从 44.29±8.92%显著提高至 53.32±7.88%(P<0.001),生理成分综合评分(PCS)从 40.0±6.41 显著提高至 56.20±9.86(P<0.001),心理成分综合评分(MCS)从 39.99±6.14 显著提高至 52.59±11.0(P<0.001)。
我们证实 SV 改善了 MHD 合并慢性心力衰竭患者的 NYHA 分级和 LVEF 值,同时提高了他们的生活质量。