Clinical Efficacy of Sacubitril/valsartan in the Treatment of Maintenance Hemodialysis Patients with Heart Failure with Preserved Ejection Fraction / 医学研究杂志

ABSTRACT

Objective To explore the clinical efficacy of sacubitril/valsartan(SV)in the treatment of maintenance hemodialysis(MHD)with heart failure with preserved ejection fraction(HFpEF).Methods A total of 90 patients with MHD combined with HFpEF admitted to the Second People′s Hospital Affiliated of Hefei to Bengbu Medical College from January to December 2021,they were divided into control group and treatment group according to the random number method,with 45 cases in each group.Patients in the control group tookangiotensin-converting enzyme inhibitor/angiotensin Ⅱ receptor blocker(ACEI/ARB)conventional drugs orally;patients in the treatment group took ARNI orally,the initial dose was 50mg,twice a day,followed by an increase to 100mg twice a day,after 2 weeks.After 3 months of treatment,the relevant indicators of cardiac function,including left ventricular ejection fraction(LVEF),left ventricu-lar end-diastolic dimension(LVEDD),left ventricular end-systolic dimension(LVESD),pulmonary artery pressure(PAP),N-ter-minal pro-B-type natriuretic peptide(NT-pro BNP),6-minutes walk test(6MWT),blood pressure level,serum potassium and the incidence of adverse events before and after treatment were collected and compared.Results After 3months of treatment,there were no significant differences in the clinical data,cardiac function index,cardiac function grade,6MWT,blood pressure level and serum potassi-um between the control group and the treatment group before treatment(P<0.05);after 3months of treatment,the levels of LVEF,LVEDD,LVESD,PAP,NT-pro BNP,6MWT,and blood pressure were all improved significantly compared with the baseline in both groups(P<0.05),and there was no significant difference of serum potassium before and after treatment in the two groups(P>0.05);after treatment,LVEF and 6MWT in the treatment group were higher than those in the control group,the LVEDD,LVESD,PAP,NT-pro BNP and blood pressure were lower than in the control group(P<0.05).There were significant differences in LVEF,LVEDD,LVESD,NT-pro BNP,6MWT,systolic blood pressure and diastolic blood pressure between the two groups before and after treatment(P<0.05).Conclusion The clinical efficacy of SV in MHD patients with HFpEF is certain,and can significantly improve cardiac function,increase the NYHK grade,improve blood pressure levels and exercise tolerance,reduce rehospitalization rates.