Observation Of The Therapeutic Effect Of Sacubitril/Valsartan On Dilated Cardiomyopathy With Moderate To Severe Valve Regurgitation

Objective:In patients with dilated cardiomyopathy(DCM)with moderate to severe valve regurgitation,the therapeutic effect of sarkubatrivalsartan on DCM was analyzed,and its effect on the prognosis of patients was analyzed,so as to provide a theoretical basis for the treatment of DCM.Materials and Methods:From April 2020 to April 2022,120 DCM patients in cardiology department of our hospital were collected as research objects.All DCM patients were diagnosed by echocardiography.The ratio of the area of the regurgitant bundle to the area of the left atrium was used to determine whether patients with DCM had moderate to severe valve regurgitation.120 patients with DCM were randomly divided into two groups:Noxital group and benazepril group,with 60 patients in each group.Collect the basic clinical information of patients after admission,including age,sex,disease history,concomitant medication and treatment.Before treatment and one month,three months and six months after treatment,NYHA cardiac function grading was used to evaluate the cardiac function grade of the subjects,and LVEF,LVEDD,LVFS and E/A ratio of the patients were detected by cardiac color Doppler ultrasound.At 1 month,3 months and 6 months after the treatment,the patients’ cardiopulmonary function was measured with 6-minute walking test step.Record whether the patient has adverse drug reactions,including hypotension,hypokalemia,renal function damage and angioneurotic edema.The patients were followed up within 12 months after receiving treatment,and the end point was the occurrence of adverse cardiac events.Adverse cardiac events refer to patients who need to be hospitalized again due to cardiac death or serious arrhythmia or obvious deterioration of cardiac insufficiency.The expression level of NT-pro BNP in serum was detected by ELISA.Results:Before the start of the study,there was no statistical difference between the two groups in terms of age,sex,disease history,NT-pro BNP and renal function indicators.Before the start of the study,there was no statistical difference between the two groups in NYHA grading and cardiac color Doppler ultrasound related indicators(LVEF,LVEDD,and E/A).After 1 and 3 months of treatment,the level of NT-pro BNP in serum of subjects in the Noxital group was lower than that in the benazepril group(P<0.05);After 6 months of treatment,the average level of NT-pro BNP in the serum of subjects in the Noxital group was lower than that in the benazepril group,but the difference between the two groups was not statistically significant.After 1 and 3 months of treatment,the proportion of subjects in the Noxital group with lower NYHA grade(Grade I+Grade II)was higher than that in the benazepril group.After 6 months of treatment,the proportion of subjects in the Noxital group with lower NYHA grade(Grade I+Grade II)was higher than that in the benazepril group,but there was no statistical difference.After 1,3 and 6 months of treatment,LVEF,LVFS and E/A ratio of subjects in the Noxital group were higher than those in the benazepril group,and LVEDD was lower than those in the benazepril group.After 1,3 and 6 months of treatment,the 6MWT of subjects in the Noxital group was greater than that in the benazepril group.The incidence of renal function injury in the Noxital group was lower than that in the benazepril group.There was no significant difference in the incidence of hypotension,hyperkalemia and angioneurotic edema between the two groups.The probability of adverse cardiac events in patients in the Noxital group was lower than that in the benazepril group.Noxital treatment is an independent protective factor for poor prognosis of patients.High age,history of coronary heart disease,high NYHA grade and high level of pro BNP1 are independent risk factors for poor prognosis of patients.Conclusion:In patients with moderate to severe valve regurgitation DCM,compared with traditional ACEI treatment,Noxital has increased the therapeutic effect,improved the quality of life and prognosis of patients,and reduced adverse drug reactions.