| Objective To investigate the effect of Sarcubatri Valsartan on cardiac function,quality of life and hospitalization events in patients with chronic heart failure after peritoneal dialysis.Methods Prospective patients with chronic heart failure who underwent regular peritoneal dialysis at the peritoneal dialysis center of the Department of Nephrology,Ningxia Medical University from December 1,2020 to December 31,2021 were included.On the basis of its original treatment plan for correcting heart failure,the standard titration dose of sarcubatri valsartan(SV)was given for intervention for 1 year.The end points of the study were as follows:(1)Quality of life: the patients’ physical health(including physical function,role limitation caused by physical health problems,physical pain,and overall health)and overall mental health(including emotional function,mental health,energy,and social function)before and after treatment were compared with the Concise Health Questionnaire(SF-36);(2)Cardiac structure and function: a.Comparison of New York Heart Function Rating(NYHA Rating)before and after SV intervention;B.Echocardiographic parameters before and after SV intervention: changes of left ventricular off-axis systolic rate,left ventricular ejection fraction,left atrial diameter,ventricular septal thickness,left ventricular posterior wall thickness,left ventricular end diastolic diameter and other indicators;C.Changes of left ventricular mass index before and after SV intervention.(3)Nutritional status: the nutritional status of the enrolled subjects before and after SV treatment was evaluated with the Modified Quantitative Subjective Overall Assessment(MQSGA)scale;(4)Hospitalization events: a.Number of hospitalizations: compare the number of hospitalizations within 6 months before SV intervention with the number of hospitalizations within 6 months after intervention;B.Reasons for hospitalization: compare the reasons for hospitalization before and after SV intervention;C.Medical expenditure: compare the medical expenditure during the hospitalization period of 6 months before the SV intervention with the medical expenditure during the hospitalization period of 6 months after the intervention.(5)Safety indicators:During the whole study period,the patients’ safety indicators and adverse drug reactions were followed up.Results(1)A total of 85 patients were included,including 45 males(52.9%),with an average age of 48 ± 13 years and a median dialysis age of 27(10,41)months.The main primary diseases included 51 cases of chronic glomerulonephritis(60.0%),10 cases of hypertension(22.4%)and 12 cases of diabetes(14.1%).84 cases(98.8%)were complicated with hypertension,17 cases(20.0%)with diabetes,and 70 cases(82.4%)with coronary heart disease.After a median follow-up of 13(12,14)months,a total of 77 patients were followed up.(2)Quality of life: After treatment,The patients’ overall physical health(including physical function,physical function,physical pain,and overall health)and overall mental health(including emotional function,mental health,energy,and social function)were significantly improved(P<0.01)(2)Cardiac function: After treatment,the proportion of NYHA III-IV patients with cardiac function decreased compared to before treatment.A total of 29 cases(34.12%)before treatment and 10 cases(12.99%)after treatment had z=-4.451,P<0.01.The left ventricular ejection fraction(LVEF)significantly increased after treatment compared to baseline.(57.77±9.67)% VS(61.56±8.35)%,t =-3.164,P<0.01;The left ventricular mass index decreased after treatment(135.79 ± 39.93)g/m2 compared to before treatment(138.08 ± 44.55)g/m2,P>0.05.After treatment,the left atrial diameter,interventricular septum thickness,left ventricular posterior wall thickness,and left ventricular end diastolic diameter had no significant difference compared with those before treatment(P>0.05);(3)Hospitalization events: The average annual hospitalization frequency(unit:times/person/year)of patients after treatment decreased from 1.082 to 0.588,P<0.05,;The number of hospitalizations for patients after treatment decreased from 0.257(0.156,4.447)(ten thousand yuan/month)to 0.136(0.091,2.256)(ten thousand yuan/month)during hospitalization,with a P<0.01 difference.The reasons for hospitalization before and after treatment vary,and the difference is statistically significant.In addition,it was also found that the proportion of central vascular events caused by hospitalization decreased after treatment(from 35.14% before treatment to 28.57%).(4)Nutritional status: After treatment,the MQSGA score improved compared to before,with a statistically significant difference of P<0.05 Safety indicators: During the SV intervention period,a total of 2(2.59%)cases of transient hyperkalemia occurred.There was no significant change in blood potassium and creatinine before and after treatment,and the difference was not statistically significant.(6)Hypotension: During the treatment period,there were no patients who stopped taking medication due to sustained low blood pressure,and 2(2.59%)patients had transient hypotension that could be tolerated by adjusting the medication dosage by the outpatient physician.After treatment,the systolic blood pressure decreased compared to before(145.0 ±18.9)mm Hg before treatment vs(139.9 ± 17.4)mm Hg after treatment,P<0.05,with a statistically significant difference.)The diastolic blood pressure decreased from(90.3 ± 15.4)mm Hg to(84.8 ± 13.8)mm Hg,P<0.05),and no serious adverse reactions occurred during the treatment period.Conclusion In a short period of time,sarcubatri valsartan can significantly improve the cardiac function,quality of life and nutritional status of patients with peritoneal dialysis complicated with heart failure,reduce the number of all-cause hospitalization and medical expenses,and have good safety. |
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