Hajahmadi Marjan, Zeinali Elahe, Joghataie Pegah, Pazoki Mahboubeh
Department of Cardiology, School of Medicine, Health Management and Economics Research Center, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran.
J Prev Med Hyg. 2024 Oct 31;65(3):E395-E402. doi: 10.15167/2421-4248/jpmh2024.65.3.3305. eCollection 2024 Sep.
There is evidence supporting the efficacy of Sacubitril /Valsartan for improving left heart failure, but few studies have examined its effects on right ventricular (RV) dysfunction. The current study aimed to investigate the effects of Sacubitril /Valsartan on RV dysfunction in patients with right heart failure.
The current study was a randomized and parallel clinical trial study. Patients over 18 years with any degree of right heart failure regardless of Left ventricular ejection fraction (LVEF) were included. The included patients were assigned randomly to three study arms using simple random allocation, i.e. the intervention group (Sacubitril Valsartan recipients) and the control groups (Losartan and Captopril recipients). The SPSS software version 19 was used for data analysis.
The changes in LVEF, RV FAC, RV diameter, DOE grade, and TAPSE in the Sacubitril/Valsartan group were significantly higher than the other two groups. The severity of RV dysfunction, as well as TR (Tricuspid Regurgitation) severity, decreased significantly three months after the intervention compared to the beginning of the intervention in all groups especially in the Sacubitril/Valsartan group (p: 0.006). The mortality rate in the Sacubitril/Valsartan, Losartan, and Captopril groups, were 2 (6.7%), 2 (11.2%), and 1 (7.7%) respectively (p: 0.83). Also, 27.6, 62.5, and 7.7% of cases in the Sacubitril/Valsartan, Losartan, and Captopril reached to optimum dose (p: 0.006).
Considering the results, it seems that Sacubitril/Valsartan has a positive effect on improving RV dysfunction in patients with right heart disorders.
有证据支持沙库巴曲缬沙坦对改善左心衰竭有效，但很少有研究考察其对右心室（RV）功能障碍的影响。本研究旨在探讨沙库巴曲缬沙坦对右心衰竭患者RV功能障碍的影响。
本研究为随机平行临床试验研究。纳入18岁以上任何程度右心衰竭的患者，无论左心室射血分数（LVEF）如何。采用简单随机分配将纳入的患者随机分为三个研究组，即干预组（接受沙库巴曲缬沙坦）和对照组（接受氯沙坦和卡托普利）。使用SPSS 19版软件进行数据分析。
沙库巴曲缬沙坦组的LVEF、RV FAC、RV直径、呼吸困难分级和三尖瓣环平面收缩期位移（TAPSE）的变化显著高于其他两组。与干预开始时相比，所有组尤其是沙库巴曲缬沙坦组干预三个月后RV功能障碍的严重程度以及三尖瓣反流（TR）的严重程度均显著降低（p：0.006）。沙库巴曲缬沙坦组、氯沙坦组和卡托普利组的死亡率分别为2例（6.7%）、2例（11.2%）和1例（7.7%）（p：0.83）。此外，沙库巴曲缬沙坦组、氯沙坦组和卡托普利组分别有27.6%、62.5%和7.7%的病例达到最佳剂量（p：0.006）。
考虑到研究结果，沙库巴曲缬沙坦似乎对改善右心疾病患者的RV功能障碍有积极作用。
