Efficacy of sacubitril/valsartan combined with sodium nitroprusside for acute heart failure in elderly patients / 中华老年心脑血管病杂志

ABSTRACT

Objective To investigate the efficacy of sacubitril/valsartan combined with sodium ni-troprusside in treatment of acute heart failure(AHF)in elderly patients.Methods A total of 280 elderly AHF patients admitted in our hospital from June 2020 to June 2021 were enrolled and ran-domly divided into control group(143 cases,sodium nitroprusside treatment)and observation group(137 cases,sodium nitroprusside+sacubitril/valsartan).Their indicators in hemodynamics,cardiac function and vascular endothelial function,neurohormone factors and clinical total effec-tive rate were compared between 2 groups.Results After treatment,the observation group ob-tained significantly lower central venous pressure,mean arterial pressure,pulmonary vascular re-sistance,peripheral vascular resistance,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular end systolic volume,and levels of endothelin 1,N-terminal-type B natriuretic peptide precursor and noradrenaline,but higher LVEF and NO levels than the con-trol group(P＜0.01).The total effective rate was statistically higher(97.08％vs 86.71％,P=0.002),but the incidence of adverse reactions was notably lower(11.68％vs 20.98％,P=0.036)in the observation group than the control group.Conclusion The combined treatment reduces he-modynamic indicators and neurohormone factors,and regulates the cardiac function and vascular endothelial function in elderly AHF patients.It is superior to sodium nitroprusside monotherapy with better total effectiveness but lower incidence of adverse reactions.