Effect Of Sacubitril Valsartan On Cardiac Function And Cardiac Load In Patients With Heart Failure After Acute Myocardial Infarction

Objective: The purpose of this study was to investigate the effects on cardiac function.cardiac load and safety of Sacubitril Valsartan in patients with heart failure after acute myocardial infarction(AMI).Methods: Forty-four patients with heart failure after AMI who were admitted to the fifth department of the second hospital of Hebei medical university from October 2019 to January 2020 were selected as the study subjects.The study subjects were divided into A group and B group by random number table method,with 22 cases in each group.The A group was treated with benazepril hydrochloride 10 mg orally once daily on the basis of conventional treatment.After the stopping 36 hours of ACEI preparation or 24 hours of ARB preparation,the B group was changed to Sacubitril Valsartan on the basis of conventional treatment.The initial dose was 25 mg orally twice a day,and the dose was doubled once every two weeks until the target dose was 200 mg orally twice a day or the blood pressure was less than 90/60 mm Hg.At 1 day before and 1 month after treatment,the resting state hemodynamic parameters were monitored by Noninvasive cardiac output measurement system instrument monitors in the two groups.The changes of cardiac function and cardiac load were evaluated by monitoring the non-invasive hemodynamic parameters at rest.At the same time,levels of N-terminal brain natriuretic peptide precursor(NT-Pro BNP)in serum was detected to evaluate cardiac function and prognosis.Clinical adverse reactions and adverse events occurred during the 1-month follow-up period were compared to assess the safety of the drug.The changes of cardiac function and cardiac load indexes and safety assessment before and after treatment were analyzed statistically.Results: 1.After 1 month of treatment,the cardiac pump function parameters including CO,CI,SV,SVI and EF in both groups patients were significantly improved compared with the baseline levels,and the changes in the B group were improved much more than those in the A group(P?0.05);The myocardial contraction function parameters including LCWi,CTI and VET in both groups patients were significantly improved compared with the baseline levels,and the changes in the B group were improved much more than those in the A group(P?0.05);The levels of NT-pro BNP in both groups were significantly improved compared with the baseline data and the changes in the B group were improved much more than those in the A group(P?0.05);The parameters Systolic arterial blood pressure,Diastolic arterial blood pressure and Mean arterial blood pressure in both groups patients were significantly improved compared with the baseline levels,and the changes in the B group were improved much more than those in the A group(P?0.05);The total efficiency of B group was higher than that of A group(P?0.05).2.During the 1-month follow-up,there were no significant differences in the incidence of clinical adverse reactions and adverse events between the two groups(P?0.05).Conclusions:1.Sacubitril Valsartan is effective in the treatment of heart failure after acute myocardial infarction and can improve cardiac function and cardiac load.2.No significant clinical adverse reactions or adverse events were observed in the treatment of heart failure after acute myocardial infarction with Sacubitril Valsartan.