小剂量沙库巴曲缬沙坦与培哚普利治疗老年HFrEF患者的效果及对血流动力学心脏重构的影响

doi:10.3969/j.issn.1006-6233.2023.08.031

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Abstract Objective: To explore the effect of low-dose sacubitril/valsartan and perindopril in the treatment of elderly patients with heart failure with reduced ejection fraction (HFrEF) and the influence on hemodynamics and cardiac remodeling. Methods: The clinical data of 133 elderly patients with HFrEF admitted to the hospital from January 2020 to October 2022 were retrospectively analyzed, and the patients were divided into observation group (conventional treatment+low-dose sacubitril/valsartan, n=69) and control group (conventional treatment+perindopril, n=64) according to the treatment methods. Cardiac function grading, cardiac remodeling indicators, hemodynamic indicators and serum cardiac function indicators were compared between the two groups before treatment and at 3 months of treatment. Adverse drug reactions were recorded in the two groups. Results: The NYHA cardiac function grading in observation group was significantly better than that in control group at 3 months of treatment (Z=2.112, P=0.035). At 3 months of treatment, the LVEF in the two groups was higher than that before treatment (P<0.05) while the LVEDd and LVESD were lower than those before treatment (P<0.05), and the differences before and after treatment in the two groups showed statistical significance (P<0.05). The HR in observation group at 3 months of treatment was lower than that before treatment (P<0.05) while the CO and CI were higher than those before treatment (P<0.05), and the differences before and after treatment revealed statistical significance in the two groups (P<0.05). The levels of serum NT-proBNP, hs-CRP and cTnT in observation group at 3 months of treatment were lower than those before treatment (P<0.05), and the differences before and after treatment in the two groups revealed statistical significance (P<0.05). There were no statistically significant differences in the incidence rates of adverse reactions such as hypotension, dry cough and dizziness between the two groups (P>0.05). Conclusion: Low-dose sacubitril/valsartan and perindopril are safe and effective in the treatment of HFrEF. The former one is more effective in improving the cardiac function and cardiac remodeling and stabilizing the hemodynamics.

Key words： Heart failure with reduced ejection fraction Elderly Sacubitril/valsartan Perindopril Cardiac function

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2023.08.031 OR http://www.hbyxzzs.cn/EN/Y2023/V29/I8/1388

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