Clinical Efficacy Of Low-dose Sacubitril/Valsartan In Treatment Of Patients With Chronic Heart Failure

Objective:To investigate the short-term effect of low-dose sacubitril/valsartan on chronic heart failure.Methods:A total of 55 patients with chronic heart failure diagnosed and treated in Bai qiuen Hospital affiliated to Shanxi Medical University from November 2017 to May 2019 were collected.Conventional heart failure drugs,such as ?-receptor blocker,aldosterone receptor antagonists,diuretics and digoxigenin,are given on the basis of the disease,with previous use of angiotensin converting enzyme inhibitors(ACEI)or angiotensin receptor blockers(ARB)in addition to conventional treatment;ACEI was eluted 36 hours later or ARB was eluted 24 hours later and converted to sacubitril/valsartan 50 mg 2/d;The dosage was adjusted according to the patients' systolic blood pressure,and the drug was administered continuously for 6 months.Laboratory test results,ecg parameters,echocardiography parameters and adverse reactions were collected at 1,3 and 6 months after treatment.Results:(1)According to the results of echocardiography,the Left ventricular ejection fraction and Left ventricular end diastolic dimension had statistical significance at different time points before and after treatment(F=26.268 and 38.006 respectively,P<0.001).Among them,the Left ventricular ejection fraction had no difference before treatment and 1 month after treatment,increased significantly 3 months after treatment,and reached the highest 6 months after treatment.There was no statistically significant difference between the left ventricular end diastolic dimension before treatment and 1 month after treatment.The Left ventricular end diastolic dimension decreased significantly 3 months after treatment and was the smallest 6 months after treatment.The total difference of Left atrial diameter at different time points before and after treatment was statistically significant(F= 42.009,P<0.001).(2)The concentration of NT-proBNP in plasma before treatment,1 month,3 months and 6 months after treatment showed a statistically significant difference(F=175.562,P<0.001),decreased 1 month after treatment,lower in 3 months and lowest in 6 months.(3)Electrocardiogram results showed that the overall difference between QTc interval and QRS interval at different time points before and after treatment was statistically significant(F=14.535 and 8.516 respectively,P<0.001 and P=0.001),and showed a continuous downward trend with time changes.(4)During the follow-up period of 6 months,7 cases of adverse reactions occurred,with the incidence rate of adverse events being 14.3%.Five patients were readmitted due to heart failure,with a readmission rate of 10.2%.There were no deaths.Conclusion:(1)Oral administration of low-dose of Sacubitril/valsartan to patients with chronic heart failure can delay the development of heart failure,improve cardiac function and improve prognosis.(2)Sacubitril/valsartan may have potential antiarrhythmic effect,but the specific mechanism is still unclear and needs further study.