| Purpose To evaluate the clinical efficacy and safety of the treatment of Sacubitril Valsartan in patients with heart failure with preserved ejection fraction(HFpEF)and hypertension.,and to analyze its impact on serum inflammatory factors,providing a basis for its wider clinical application.Method A simple randomization method was used to divide 89 cases of LVEF ≥50% of patients with heart failure and hypertension admitted to the Department of Cardiology of the Fifth Affiliated Hospital of Guangzhou Medical University from June 2021 to June 2022 into a control group(enalapril/ACEI group)and an observation group(sacubitril valsartan/ARNI),and other basic medications are the same(spironolactone,β recepter antagonist and Dagliflozin).Both groups of patients were randomly divided into two groups based on the optimal drug treatment.After 3months of continuous treatment,the clinical effects of each group before and after treatment,as well as between the two groups,were observed,including blood pressure,NYHA grading,renal function,NT-pro BNP levels,6MWT,Kansas City Cardiomyopathy Questionnaire Score(KCCQ-CSS),changes in cardiac function ultrasound indicators(LVEDD,IVST,LVPWT)and their impact on serum inflammatory factor expression: TNF-α、IL-6、IL-1 β and adverse reactions of drugs.Results(1)There was no significant difference in the general baseline data between the two groups(P>0.05).(2)Compared with before treatment,there was a significant decrease in systolic blood pressure(SBP)and diastolic blood pressure(DBP)in both groups after treatment,with statistical significance(P<0.05);After treatment,compared between the two groups,the blood pressure in the sacubitril valsartan group decreased more significantly,and the results were statistically significant(P<0.05).(3)Compared with before treatment,the LVEDD of both groups improved after treatment,with statistically significant results(P<0.05).However,there was no significant change in IVST and LVPWT,and the difference was not statistically significant(P>0.05);And there was no statistically significant difference in the comparison results between the two groups after treatment(P>0.05).(4)Compared with before treatment,the NT pro BNP of both groups decreased significantly after treatment,while the 6MWT increased significantly,with a statistically significant difference(P<0.05);After treatment,compared between the two groups,the ARNI group showed a lower decrease in NT pro BNP levels and a higher increase in 6MWT levels,with statistically significant differences(P<0.05)(5)After treatment,the NYHA cardiac function levels of both groups of patients improved compared to before treatment,and the ARNI group showed more significant improvement,with a statistically significant difference(P<0.05).(6)Compared with before treatment,the TNF of the two groups after treatment-α、IL-6 、 IL-1 β The expression levels were significantly reduced,with statistically significant differences(P<0.05);And after treatment,TNF was compared between the two groups-α、 IL-6、IL-1 β,The decrease in ARNI group was greater,and the difference was statistically significant(P<0.05).Conclusion Sacubitril valsartan can effectively treat hypertensive patients with HFpEF,control blood pressure more effectively,lower serum levels of inflammatory factors,and alleviate inflammatory reactions better than enalapril;At the same time,it can effectively improve ventricular remodeling and heart function,improve patients’ quality of life,and still have significant advantages compared to traditional ACEI,although some indicators are not statistically significant.This also provides a solid practical foundation for us to better apply ARNI in clinical work in the future. |
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