| Objective To investigate the efficacy and safety of sacubitril/valsartan in treatment of patients with midrange ejection fraction（HFmr EF）.MethodsA total of 203 HFmr EF patients with chronic heart failure admitted to the Department of Cardiology of Fuyang People’s Hospital from March 2019 to September 2020 were selected as the research subjects,and randomly divided into control group（n=100）and experimental group（n=103）.The control group was given diuretic,vasodilator and other conventional treatment plus ACEI / ARB drugs.Patients in the experimental group were additively treated with angiotensin converting enzyme inhibitor（ACEI）or angiotensin II antagonist（ARB）to sacubitril/valsartan（ARNI）（25 mg to 200 mg,twice a day）,Compare the two groups after treatment in patients with 1 month,6 months and 1 year after the Kansas city cardiomyopathy patients quality of life table（KCCQ）score,N-terminal-pro BNP（NT-pro BNP）,left ventricular ejection fraction（LVEF）and left ventricular short axis reduced rate（LVFS）change and effectiveness,to hospitalization for heart failure and end and death from cardiovascular events,Adverse reactions of patients in the two groups were also analyzed.ResultsAfter treatment,KCCQ scores in the experimental group were significantly higher than those in the control group at 1 month,6 months and 1 year after treatment（P<0.05）,NT-pro BNP decreased gradually after treatment,and improved significantly（P<0.05）,while there was no significant difference between LVEF and LVFS after 1 month of treatment and the control group（P>0.05）,and increased gradually at 6 months and 1 year after treatment,and improved significantly compared with the control group（P<0.05）;After 1 year of treatment,the total response rate of clinical efficacy in the experimental group（97.09% vs 90.00%,P=0.039）was significantly higher than that in the control group.During the treatment period,a total of 50 patients in the experimental group and the control group were hospitalized for recurrence of heart failure symptoms,including 20 patients in the experimental group and 30 patients in the control group.The readmission rate for heart failure in the experimental group（19.42% vs.30.00%,P=0.0117）was significantly lower than that in the control group,and the incidence of adverse reactions in the experimental group was lower than the control group（14.56% vs.24%）,However,there was no significant difference（P=0.094）,and no cardiovascular death was found in both groups during the follow-up period.ConclusionSacubitril/valsartan can effectively improve cardiac function and clinical prognosis in patients with median ejection fraction heart failure with high safety. |
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