| OBJECTIVE: To investigate the effects of sacubitril/valsartan on cardiac structure and function,quality of life scores,and adverse cardiovascular events in elderly patients with chronic heart failure.Methods: From February 2019 to October 2020,120 patients with chronic heart failure who attended the Department of Geriatrics and Cardiovascular Medicine of Yijishan Hospital,First Affiliated Hospital of Wannan Medical College were selected,including66 males and 54 females.According to the random number table method,they were divided into two groups,60 cases in the control group and 60 cases in the observation group.The control group was given angiotensin receptor blocker(ARB)valsartan 80 mg once a day on the basis of routine administration of β-receptor blockers and aldosterone receptor antagonists;The observation group was given the initial dose of sacubitril/valsartan sodium tablets 50 mg on the basis of routine use of β-receptor blockers and aldosterone receptor antagonists,twice a day,and the dose was increased to 100 mg after 2 weeks when the blood pressure remained stable.The treatment time is3 months.The related indicators of cardiac structure and function and the quality of life scores of the two groups of patients before treatment and after 3 months of treatment were observed.The re-admission rate and the incidence of cardiovascular adverse events were compared between the two groups in 3 months.Results: After 3 months of treatment in the control group,the New York Heart Association(NYHA)cardiac function classification,left ventricular ejection fraction(LVEF),and N-terminal pro-brain natriuretic peptide(N-terminal pro-brain natriuretic peptide,NT-pro BNP),Hypersensitive troponin T,the overall effective rate of treatment,and the Kansas City Cardiomyopathy Questionnaire(KCCQ)scores were improved compared with those before treatment,the difference was statistically significant(P<0.05).In the observation group,NYHA cardiac function classification,LEVF,6-minute walking distance(6MWD),NT-pro BNP,Hypersensitive troponin T,overall effective rate of treatment,and KCCQ score were improved after 3 months of treatment,and the difference was statistically significant(P<0.05).And the observation group’s NYHA heart function classification,LVEF,6MWD,NT-pro BNP,Hypersensitive troponin T,overall effective rate of treatment and KCCQ score improved more significantly than the control group,with statistical significance difference(P<0.05).The left ventricular end-diastolic dimension(LVEDD)of the two groups of patients improved after 3 months of treatment,but the difference was not statistically significant(P>0.05).No cardiovascular deaths occurred in the two groups of patients during treatment,and the hospital readmission rate in the observation group was lower than that in the control group,with statistical significance difference(P<0.05).No serious adverse drug reactions occurred in the two groups of patients.Conclusion: In elderly patients with chronic heart failure,the use of sacubitril/valsartan instead of angiotensin receptor antagonists can further improve the patient’s cardiac structure and function-related indicators,increase the overall effective rate of treatment and the patient’s quality of life,and reduce the patient’s readmission rate,without significant adverse drug events occurred. |
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