| ObjectiveTo explore the value of two-dimensional speckle tracking imaging(2D-STI)in the evaluation of the therapeutic effect of sacubitrilvalsartan in patients with chronic heart failure(CHF).MethodAccording to the entry criteria(see text for details),a total of 70 chronic heart failure(CHF)patients who were treated in the cardiology department of our hospital from November 2018 to November 2019 were selected.According to the treatment plan,they were divided into two groups,namely,the control group and the experimental group,35 cases each.Both groups were treated with conventional anti-heart failure drug treatment(including digitalis,diuretics,nitrates,etc.).On this basis,the control group was given benazepril hydrochloride(lotingxin,beijing novartis pharmaceutical,specification 10mg),anti-heart failure treatment,oral according to the clinical required target maintenance,twice a day.The experimental group was treated with sakubatran valsartan(noxintol,Novartis Pharma Stein AG specification50 mg)for heart failure after withdrawal of angiotensin converting enzyme inhibitor(angiotensin-converting enzyme inhititors,ACEI)or angiotensin II receptor antagonist(angiotensin receptor blocker,ARB)for 36 hours.target dosage orally.The left ventricular ejection fraction(2DLVEF),left ventricular end-diastolic diameter(LVEDd)and left ventricular end-systolic diameter(LVEDs)were measured before,two weeks and four weeks after treatment.And 2D-STI were used to obtain the global longitudinal peak strain of apical two chamber(GLPS-2AC),global longitudinal peak strain of apical four chamber(GLPS-4AC),global longitudinal peak strain of apical long axis(GLPS-LAX),In order to obtain the average value of left ventricular longitudinal peak strain(GLPS-AVG).N terminal B natriuretic peptide(NT-pro BNP)levels were also recorded.The differences of the above parameters before and after treatment were compared between the experimental group and the control group.Results:1.Comparison of baseline data between the two groups: there was no significant difference in baseline data such as heart rate and blood pressure between the two groups(P > 0.05);there was no significant difference in LVEF、LVEDd、LVEDs、GLPS-2AC、GLPS-4AC、GLPS-LAX、GLPS、NT-pro BNP between the two groups before treatment(all P > 0.05).2.Comparison of the experimental group: GLPS、GLPS-LAX、GLPS-4AC and GLPS-2AC were all increased after two weeks of treatment,but there was no significant difference between GLPS-4AC and GLPS-2AC(P = 0.001、0.000、0.052、0.108),NT-pro BNP decreased(P= 0.000);LVEF、LVEDd、LVEDs、 GLPS-2AC、GLPS-4AC、GLPS-LAX、GLPS、NT-pro BNP were all improved at 4 weeks of treatment compared with before and 2 weeks of treatment,and the difference was statistically significant(all P < 0.05).3.Comparison of the control group: LVEF、LVEDd、LVEDs、GLPS-2AC、GLPS-4AC、GLPS-LAX、GLPS、NT-pro BNP were improved after four weeks of treatment,the difference was statistically significant(all P < 0.05).4.Comparison between the two groups:only the experimental group GLPS and GLPS-LAX increased when treated for 2 weeks(P = 0.000、0.000);LVEDd、LVEDs decreased significantly(P = 0.000、0.000)and LVEF、GLPS-2AC、GLPS-4AC、GLPS-LAX、GLPS increased significant(P = 0.009、0.000、0.000、0.000、0.000)compared with the control group at 4 weeks of treatment.Conclusion1.For patients with chronic heart failure,compared with ACEI,the treatment of sacubitrilvalsartan can improve the systolic function of heart rapidly and effectively.2.STI is more sensitive and early to assess the changes of left ventricular myocardial mechanics than the conventional cardiac function evaluation index.It has a unique application value in the follow-up evaluation of chronic heart failure.3.Two dimensional strain imaging technology provides a new method for the evaluation of the therapeutic effect of cardiovascular diseases such as chronic heart failure,which is worth popularizing. |
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