Study On The Clinical Efficacy Of Sacubitril Valsartan In The Treatment Of Heart Failure Patients With Reduced Ejection Fraction

Background: Heart failure is caused by impaired systolic and / or diastolic function,which makes it difficult for the venous return to the heart to fully discharge the heart,resulting in stagnation of blood in the venous system,insufficient blood perfusion,and corresponding heart circulation disorders.Heart failure is a common outcome in the late stages of different heart diseases,with a high mortality rate and becomes a global public health problem.The early symptoms of heart failure patients are not obvious,and most of the clinical manifestations are breathlessness and difficulty in normal life activities,which leads to a sharp decline in the quality of life of patients.The 5-year mortality rate of patients can reach 50.0%-60.0%.At present,the treatment of heart failure in clinic is mainly based on cardiac strength,vasodilation and diuresis.With the continuous development of medical technology,drugs are constantly being introduced.Sacubatrol valsartan is a new type of therapeutic drug that is widely used in adults with chronic heart failure with reduced ejection fraction,which helps reduce the risk of cardiovascular death and heart failure hospitalization.At the same time,sacubitril valsartan can also replace angiotensin-converting enzyme inhibitor(ACEI)or angiotensin II receptor antagonist(ARB)in combination with other drugs for patients with heart failure.Objective: To explore the clinical efficacy of sacubitril valsartan in patients with heart failure with reduced ejection fraction,and provide a basis and reference for the treatment of heart failure.Methods: Eighty patients with heart failure with reduced ejection fraction who were admitted to the Department of Cardiology and Geriatrics of Changle County People’s Hospital from May 2018 to December 2018 were selected as subjects and randomly divided into a control group(n = 40 cases)and observation Group(n = 40 cases).All patients completed relevant examinations after admission,including: general data survey(including:cardiac function classification,gender,basal heart rate,blood pressure),cardiac function level measurement,renal function,electrolytes and B-type natriuretic peptide precursor(NT-pro BNP)Wait.Patients in both groups were routinely given cardiotonic,diuretic,vasodilator,salt-limiting,β-blocker,and spironolactone treatments,and instructed patients to rest.The control group was supplemented with benazepril hydrochloride on the basis of conventional treatment,and the observation group was given sacubatril valsartan on the basis of conventional treatment.The effect of the patients was evaluated after 3 months of treatment,both groups were treated after treatment 6-month follow-up to compare the two groups’ recent efficacy rate,cardiac function and cardiac structure(including: left ventricular end-diastolic diameter(LVEDD),left ventricular posterior wall thickness(LVPW),left ventricular ejection fraction(LVEF),NT-pro BNP,Serum urea nitrogen(BUN),serum creatinine(Cr)levels,and calculate the estimated glomerular filtration rate(e GFR),the number of hospitalizations and the cumulative hospitalization time,inflammatory factor levels and drug safety Analyze and process relevant data.Results:(1)The curative effect rate of the observation group of sacubatril valsartan(80% of target dose)3 months after treatment was 97.50%,higher than the control group(78% of target dose)77.50%(P <0.05);(2)The LVEF level in the observation group 3 months after treatment was higher than the control group(P <0.05);the LVEDD,LVPW and NT-pro BNP levels in the observation group 3 months after treatment were all lower than the control group(P <0.05);(3)The levels of BUN and Cr in the observation group and the control group decreased3 months after treatment,and the e GFR level increased(P <0.05);the levels of BUN and Cr in the observation group 3 months after treatment were both lower than the control group(P<0.05);the e GFR level in the observation group 3 months after treatment was higher than that in the control group(P <0.05);(4)Both groups were reexamined 3 months and 6 months after treatment.The number of hospitalizations and cumulative hospitalization time of the observation group after treatment were less than that of the control group(P <0.05);(5)The levels of inflammatory factors in the observation group and the control group after 3 months of treatment were lower than before treatment(P <0.05);the serum levels of interleukin-6(IL-6)and granules of inflammatory factors in the observation group after 3months of treatment The levels of cell-phagocyte clone stimulating factor(CM-CSF),phagocyte adsorption protein(MCP-1),and tumor necrosis factor-a(TNF-a)were all lower than that of the control group(P <0.05);(6)The incidence of conjunctivitis,decreased concentration,painful cramps,gastrointestinal reactions and drowsiness and dizziness during the treatment of the observation group and the control group was not statistically significant(P> 0.05);(7)The incidence of severe arrhythmia,acute heart failure,cardiogenic death,myocardial infarction,and angina pectoris in the observation group were lower than those in the control group(P <0.05).Conclusions: Sacubatrol valsartan can be used in the treatment of patients with heart failure and reduced heart failure to obtain higher clinical efficacy,and it is worthy of popularization and application.