Sacubitril valsartan improves heart functions in heart failure patients with reduced ejection fraction

  AIM  To observe the effect of sacubitril valsartan on heart functions and pulse wave velocity (PWV) in heart failure patients with reduced ejection fraction and to explore the relationship the between heart functions and PWV.

  METHODS  Eighty patients with chronic heart failure who were hospitalized in the Department of Cardiology, Xinjiang Military Region General Hospital from January 2017 to October 2019 were selected for this study and they were randomly divided into control group and treatment group, with 40 in each group. Control group was given conventional treatment and in treatment group, sacurabitril valsartan replaced ACEI/ARB in the conventional treatment regimen. Comparison between the two groups was made in the changes in cardiac functions, ventricular remodeling related indexes and PWV values before and after treatment.

  RESULTS  There was no statistically difference in baseline data between the two groups. After treatment, LVEDV and LVESV in both control group and treatment group were lower than those before treatment (P<0.05) and LVEF and 6MWD were higher and longer than those before treatment (P<0.05). LVEF and 6MWD in treatment group after treatment were better improved than those in control group (P<0.05). IVST, LVPWT and LVMI in both groups were reduced after treatment (P<0.05) and LVMI in treatment group after treatment was lower than that in control group (P<0.05). After treatment, NT-proBNP and sST2 in control group were lower than those before treatment (P<0.05) and NO levels were increased (P<0.05). After treatment, NT-proBNP and sST2 in treatment group were significantly lower than those before treatment (P<0.01) and NO levels increased more significantly (P<0.01). PWV in control group was lower than that before treatment (P<0.05) and PWV in treatment group was significantly lower than that before treatment (P<0.01), and lower than that in control group (P<0.05).

  CONCLUSION  Sacubitril valsartan is more effective in reducing myocardial fibrosis in heart failure patients with ejection fraction, reversing ventricular remodeling and improving cardiac functions, and thus enhancing the activity tolerance of patients with heart failure. Sacubitril valsartan synergistically improves arterial compliance, reduces heart afterload and further delays the development of heart failure.