Therapeutic Effect And Safety Of Sacubitril/valsartan On Acute Heart Failure

Objective:To observe the efficacy and safety of sacubitril/valsartan in patients with acute heart failure after hemodynamic stabilization.Methods:patients with acute heart failure of the First Hospital of Shanxi Medical University from July 2018 to October 2019 were randomly divided into the observational group(sacubitril/valsartan)and the control group(enalapril).On the basis of standardized treatment of heart failure,patients in the control group were given enalapril,while patients in observational group received corresponding doses of sacubitril/valsartan for 3 months according to the blood pressure.To observe the improvement of cardiac function and monitor the changes of blood pressure,N-terminal pro-B-type natriuretie peptide(NT-proBNP),blood potassium,liver and kidney function during medication,and evaluate LVEF,LVDD,LAD,PASP,Minnesota quality of life questionnaire(MLWHFQ)before and after treatment.And to observe the occurrence of adverse events such as cardiovascular death,re-hospitalization and adverse reactions such as symptomatic hypotension,deterioration of renal function,hyperkalemia and vascular edema in the two groups.Results:1.A total of 139 patients were divided into the control group(n=69)and the observational group(n=70).2.After treatment,the cardiac function was significantly improved.compared with the control group,the effective rate of observation group was more significantly improved(P<0.05).3.After treatment,NT-proBNP was significantly improved and compared with the control group,the index of observation group was more significantly improved(P<0.05).the proportion of patients with abnormal liver and kidney function decreased after treatment,but there were no statistical differences in the rate of decline between the two groups(P>0.05).4.After treatment,LVEF,LVDD and quality of life were significantly improved.compared with the control group,the above indexes in the observation group were more significantly improved(P<0.05).There were no significant difference in LAD and PASP after treatment in the control group(P>0.05)and LAD in the observation group(P>0.05).PASP in the observation group was improved(P<0.05).5.no vascular edema is in both groups.during treatment,there were no statistical differences in the occurrence of symptomatic hypotension,hyperkalemia and deterioration of renal function in the two group(P>0.05).6.No cardiovascular death occurred in all patients.compared with the control group,there was a significant decrease in re-hospitalization due to the deterioration of heart failure in the observation group.Conclusion:compared with enalapril,early usage of Sacubitril/valsartan can effectively improve cardiac function,improve ventricular remodeling as early as possible,reduce the risk of re-admission and improve prognosis.