Clinical Observation Of Enkephalinase Inhibitor On Ventricular Remodeling In Patients With Dilated Cardiomyopathy And Heart Failure

Objective: To observe and compare the effects of sacurbatrovalsartan,spironolactone,valsartan and enalapril tablets on ventricular remodeling in patients with dilated cardiomyopathy and heart failure.Methods: 180 patients with dilated cardiomyopathy and heart failure who were admitted to our hospital from December 2018 to December 2019 were selected as the subjects of this study.All patients were evenly divided into the sacurbactra valsartan group(n = 60),the valsartan group(n = 60),and the enalapril group(n = 60)according to the different treatment drugs.Treatment,including cardiotonics,diuretics,nitrates,spironolactones,and beta-blockers.Based on this,patients with sacurbatrovalsartan take 50 mg / dose orally twice a day,then gradually Increase the dose to the target dose of 200 mg / times,2 times / d;patients in the valsartan group take 80 mg of the corresponding oral drug once / d and patients in the enalapril group start with 10 mg to 20 mg of oral corresponding drug,once / d.The maintenance dose is 20 mg daily.The above doses are initial doses and need to be adjusted according to the patient’s condition.Patients were compared before and after treatment with echocardiography,6-minute walking test,NTproBNP level,treatment effect,and incidence of adverse reactions.Result:(1)Three groups of patients received left ventricular posterior wall thickness(LVPWT),left ventricular end systolic diameter(LVESd),left ventricular end diastolic diameter(LVEDd),diastolic ventricular septal thickness(IVST),left atrium after treatment The inner diameter(LA)decreased significantly,P <0.05.There was no significant comparison between the sacurbactra valsartan group and the other two groups,P> 0.05;(2)The left ventricular ejection fraction(EF)and short-axis shortening rate(FS)of the three groups of patients were significantly increased compared with those before and after treatment,and the comparison was statistically significant,P <0.05,and the EF of the sacurbavar valsartan group And FS were significantly higher than the other two groups,P <0.05.(3)The 6-minute walking test results of the three groups were significantly improved after treatment,P <0.05.The improvement was most pronounced in the patients in the sacurbavar valsartan group,which was significantly higher than those in the other three groups P <0.05.(4)The levels of NT-proBNP in the three groups were significantly decreased after treatment,P <0.05.Among them,NT-proBNP level in the shakuba trvalsartan group was significant compared with the other three groups,P <0.05.(5)The total effective rate of patients in the sacurbactrazartan group was 91%,the valsartan group was 78%,and the enalapril group was 76%.In the other two groups,the comparison is significant,P <0.05.(6)The adverse reactions this time were mainly hypotension,dry cough,renal failure,and angioedema.The incidence of adverse reactions in the sacurbatrovalsartan group was 10%,and the incidence of adverse reactions in the valsartan group was 6.0%.The incidence of adverse reactions in the enalapril group was 13.3%.The incidence of adverse reactions in the three groups was not significant,P> 0.05.Conclusions:(1)Sakuba trvalsartan can significantly improve left ventricular systolic function in patients with dilated cardiomyopathy and achieve the purpose of reversing ventricular remodeling;(2)Shakubatrivalsartan can improve the cardiac function of patients,and its effect is higher than valsartan and enalapril tablets,without serious adverse reactions,and has higher safety.