Short-term Clinical Observation Of Sacubitril/valsartan On Treatment Of Dilated Cardiomyopathy Patients With Heart Failure

BackgroundDilated cardiomyopathy(DCM)is a kind of primary cardiomyopathy,whose character is that there is no abnormal pressure or fluid overload or coronary artery disease,but left ventricle appear progressive enlargement and progressive dysfunction,which is one of common causes of heart failure.Clinically,drug therapy is the cornerstone of treatment of dilated cardiomyopathy.Current medications include beta-blockers aimed to sympathetic nervous system,angiotensin converting enzyme inhibitors(ACEI)or angiotensin receptor blockers(ARB)or mineralocorticoid receptor antagonists(MRAs)aimed to renin-angiotensin-aldosterone system(RASS).A large number of randomized controlled trials have shown that these drugs can reduce myocardial injury in patients with DCM and delay the disease development,and significantly improve the prognosis of patients with DCM heart failure.However,the clinical prognosis of patients with DCM is still bad.Sacubitril/valsartan is new drug which is used to treat heart failure.PARADIGM-HF trial has shown Sacubitril/valsartan compared with enalaprilat can further reduce the risk of cardiovascular death or heart failure hospitalization in patients with heart failure and it is safer and tolerable to patients.Based on this evidence the latest domestic guideline for diagnosis and treatment of dilated cardiomyopathy recommends Sacubitril/valsartan to treat the patients with DCM.However most Sacubitril/valsartan clinical drug trials from abroad,the effect of Sacubitril/valsartan in dilated cardiomyopathy with heart failure in our country has very few studies.This study on the short-term clinical observation of Sacubitril/valsartan and compared with benazepril to treat dilated cardiomyopathy in patients with heart failure.ObjectiveTo study the short-term efficacy of Sacubitril/valsartan on treatment of dilated cardiomyopathy patients with heart failure.MethodsCollected 70 cases of DCM patients with heart failure in the first affiliated hospital of Zhengzhou university from December 2017 to October 2018.Among these cases according to the different treatment the patients will be divided into Sacubitril/valsartan group and the benazepril group.The difference of other drugs to treat heart failure is no statistical different.After continuous application three months we observe the effect,echocardiographic indexes change,NT-proBNP change,renal function change,6-MWT results,adverse events and adverse reactions,and we compare with the two groups.ResultsThe clinical efficacy of Sacubitril/valsartan group is superior to the benazepril group(P<0.05).After 3 months of treatment,Sacubitril/valsartan group can improve the LVEF values,improve LVEDV and LVEDD and RVEDD,make the NT-proBNP down(P<0.05),but there is no statistical difference between two groups(P> 0.05).After 3 months of treatment renal function of the two groups is no difference(P>0.05).The 6-MWT results of the two group are improved,and the Sacubitril/valsartan group is superior to the benazepril group(P<0.05).In the short term heart failure hospitalization rates between the two groups and the incidence of adverse reactions are no statistical difference(P>0.05).Conclusions:1.In short term Sacubitril/valsartan to treat DCM with heart failure can improve heart function and curative effect affirmation and it is safe.2.Sacubitril/valsartan to treat DCM with heart failure is no less than the benazepril;we can convert ACEI or ARB into Sacubitril/valsartan to treat the DCM patients.