Study Of The Effect Of Dagliflozin On The RAAS System During Treatment In Patients Without Diabetic Heart Failure

Objective:To study the changes of plasma concentrations of PRC,ANG-II and ALD in patients with non-diabetic heart failure(HFr EF)after treatment with dapagliflozin,and to investigate the effect of dapagliflozin on the RAAS system in patients without diabetic heart failure.Method:A total of 102 patients with non-diabetic heart failure were admitted to the Department of Cardiology of the First Affiliated Hospital of Dali University from July 2021 to October 2022,and 44 patients with conventional therapy were included in the control group,and 58 patients who received oral dagliflozin based on conventional therapy were included in the experimental group.The general condition was recorded,and the general laboratory indicators(blood uric acid,blood glucose,creatinine,total cholesterol,triglyceride,uric acid,serum potassium,serum sodium,low density lipoprotein cholesterol),BNP value,RAAS system(PRC,ANG-II,ALD),left ventricular ejection fraction(LVEF),and cardiac function grade were measured before and on the 7 days after the administration.The two groups recorded and compared the basic data and the changes in heart failure symptoms,cardiac and renal function,and the RAAS system.Results:1.The cardiac function grade of NYHA in the experimental group was increased from 1(1.72%)to 12(20.68%)after treatment.Grade II cardiac function was significantly higher from 5 cases(8.62%)to 45 cases(77.59%).Grade III cardiac function decreased significantly from 40 cases(68.89%)to 0 cases(0.00%),and grade IV cardiac function decreased from12 cases(20.68%)to 1 case(1.72%).There were significant differences in the distribution of cardiac function before and after treatment(P<0.05).The total effective rate of the experimental group was 96.55%,which was higher than that of the control group after cardiac function treatment,and the difference between the experimental group was statistically significant(P<0.05).2.Dapagliflozin significantly reduced the levels of UA and Glu,and the difference before and after treatment was statistically significant(P<0.05).There were no significant changes in Cr,TC,TG,LDL-C,K+,Na+(P>0.05)before and after taking dapagliflozin.Before and after treatment,the patients in the experimental group were re-examined for vital signs,Glu,TC,TG,Cr,UA,K~+,and Na~+,and there were no obvious abnormalities and no adverse events,indicating that dapagliflozin was safe for heart failure.3.After treatment,the BNP value in the experimental group was(434.55±418.40)pg/ml,and the control group was(619.33±453.37)pg/ml,which was lower than that in the control group,and the difference between the groups was statistically significant(P<0.05).The average decrease in BNP was(869.12±1143.25)pg/ml in the experimental group and(276.79±740.19)pg/ml in the control group,and the difference between the groups was statistically significant(P<0.05).The results showed that the overall BNP value of the two groups decreased significantly(P<0.05).4.The average PRC value in the experimental group before treatment was(13.13±4.02)pg/ml,which was not significantly different from(11.65±4.19)pg/ml in the control group(P>0.05).After treatment,the PRC value of the experimental group decreased significantly to(11.58±4.77)pg/ml,and the difference was statistically significant(P<0.05).The PRC value in the control group increased significantly,and the difference was statistically significant(P<0.05).Comparing the post-treatment differences between the two groups,the results showed that the experimental group was significantly lower than the control group(P<0.05).Before treatment,the average ALD value of the experimental group was(84.53±13.54)pg/ml,which was not significantly different from that of the control group(82.04±12.32)pg/ml(P>0.05),and after treatment,the ALD value of the experimental group decreased significantly to(65.47±12.01)pg/ml,the difference was statistically significant(P<0.05),and the mean ALD value of the control group decreased,but the difference was not statistically significant(P>0.05).Comparing the difference before and after treatment between the two groups,ALD(pg/ml)(19.05±20.16)and the control group(2.29±16.07)showed that the experimental group was significantly higher than the control group(P<0.05).The plasma Ang II.(35.41±5.61)pg/ml before treatment was not significantly different from the control group(33.21±7.47)pg/ml(P>0.05);after treatment,the experimental group and the control group decreased significantly,and the difference before and after treatment was statistically significant(P<0.05).Comparing the difference between patients before and after treatment,Ang II(pg/ml)(14.49±5.87)and the control group(10.16±6.46)showed that the experimental group was significantly higher than the control group(P<0.05).5.There was no significant difference in PRC,Ang-II and ALD concentrations between men and women before and after the experiment(P>0.05).Conclusion:1.Dapagliflozin can significantly reduce the grade of cardiac function and BNP value,and the safety profile is good,suggesting that dapagliflozin can improve cardiac function in patients.2.Dapagliflozin significantly reduces PRC,Ang-II,and ALD concentrations,and the therapeutic effect is not affected by gender and other drugs.Hint that dapagliflozin may have an inhibitory effect on the RASS system.