维立西呱联合“新四联”疗法可改善心力衰竭患者的心功能和生活质量：一项单中心前瞻性研究。

Vericiguat combined with "new quadruple" therapy enhances cardiac function and life quality in patients with heart failure: a single-center prospective study.

作者信息

Zhao Di, Zhang Yanjuan, Yong Yonghong, Wang Liansheng, Liu Jiabao

机构信息

Department of Cardiology, The First Afﬁliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Front Cardiovasc Med. 2024 Oct 11;11:1476976. doi: 10.3389/fcvm.2024.1476976. eCollection 2024.

DOI:10.3389/fcvm.2024.1476976

PMID:39465136

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11502340/

Abstract

OBJECTIVE

To investigate the therapeutic effect of Vericiguat combined with "new quadruple" drugs on patients with heart failure (HF).

METHODS

From December 1, 2022 to February 1, 2024, 103 patients with heart failure were consecutively enrolled from the cardiology clinic or ward of the First Affiliated Hospital of Nanjing Medical University. Before enrollment, the patients' left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDD), N-terminal pro-B-type natriuretic peptide (NT-proBNP), liver and kidney function electrolytes, and Minnesota Living with Heart Failure Questionnaire (MLHFQ) and other indicators were measured. Patients diagnosed with reduced ejection fraction (HFrEF) and with heart failure with mildly reduced ejection fraction (HFmrEF) were treated with Vericiguat combined with "ARNI, BB, MRA, SGLT2i" therapy. Patients diagnosed with preserved ejection fraction (HFpEF) were treated with Vericiguat combined with "ARNI, BB, SGLT2i" therapy. The above indicators were rechecked after 1 month of treatment.

RESULTS

For all patients, comparison after treatment: LVEF (38.1 ± 8.5% vs. 43.1 ± 8.5%, < 0.01), LVEDD (60.5 ± 8.1 vs. 58.2 ± 7.3 mm, < 0.01), NT-proBNP (4,567.8 ± 5,163.9 vs. 1,895.6 ± 2,702.1 ng/L, < 0.01), MLHFQ (45.72 ± 11.09 vs. 32.29 ± 9.41, < 0.01). Further subgroup analysis showed that Vericiguat combined with "ARNI, BB, SGLT2i or MRA" improved the LVEF and reduced NT-proBNP levels in patients with HFrEF, HFmrEF or HFpEF. and improved patients' quality of life scores. The intergroup comparison showed the therapeutic effect of the combination was equivalent in HF caused by myocardial Infarction (MI), dilated cardiomyopathy (DCM) or Valvular Heart Disease (VHD).

CONCLUSION

Vericiguat combined with the "new quadruple" therapy has a significant therapeutic effect on patients with heart failure caused by MI, DCM or VHD.

摘要

目的

探讨维立西呱联合“新四联”药物治疗心力衰竭（HF）患者的疗效。

方法

2022年12月1日至2024年2月1日，从南京医科大学第一附属医院心内科门诊或病房连续纳入103例心力衰竭患者。入组前，测量患者的左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、N末端B型利钠肽原（NT-proBNP）、肝肾功能电解质以及明尼苏达心力衰竭生活质量问卷（MLHFQ）等指标。诊断为射血分数降低（HFrEF）和射血分数轻度降低的心力衰竭（HFmrEF）患者采用维立西呱联合“ARNI、BB、MRA、SGLT2i”治疗。诊断为射血分数保留（HFpEF）的患者采用维立西呱联合“ARNI、BB、SGLT2i”治疗。治疗1个月后复查上述指标。

结果

所有患者治疗后比较：LVEF（38.1±8.5%对43.1±8.5%，<0.01），LVEDD（60.5±8.1对58.2±7.3mm，<0.01），NT-proBNP（4567.8±5163.9对1895.6±2702.1ng/L，<0.01），MLHFQ（45.72±11.09对32.29±9.41，<0.01）。进一步亚组分析显示，维立西呱联合“ARNI、BB、SGLT2i或MRA”可改善HFrEF、HFmrEF或HFpEF患者的LVEF，降低NT-proBNP水平，并提高患者的生活质量评分。组间比较显示，该联合治疗在心肌梗死（MI）、扩张型心肌病（DCM）或心脏瓣膜病（VHD）所致HF中的治疗效果相当。