AIM To investigate the therapeutic effect of sacubitril-valsartan combined with rosuvastatin on atrial fibrillation (AF) complicated with heart failure with preserved ejection fraction (HFpEP).
METHODS A total of 114 patients with AF combined with HFpEP in our hospital from October 2019 to October 2020 were selected and grouped by random number table, with 57 cases in each group. The control group received oral rosuvastatin and the study group was given oral sacubitril and valsartan based on the treatment of the control group. Both were treated for 1 month. Clinical efficacy, adverse reactions and effective rate of maintaining sinus rhythm were observed. Comparison between the two groups were made in ventricular remodeling indexes before and one month after treatment left atrial volume index (LAVI), left ventricular mass index (LVMI), left ventricular end-diastole Inner diameter (LVEDD), left ventricular ejection fraction (LVEF), ECG indicators (QRS wave duration, QTc interval, planar QRS-T angle), chitinase 3-like protein 1 (CH1L1), N-terminal type B Pre-brain natriuretic peptide (NT-proBNP) and Apelin levels. Spearman correlation analysis was performed to determine the correlation between clinical efficacy and ventricular remodeling indicators.
RESULTS One month after treatment, the total effective rate of treatment in the study group higher than that in the control group (P<0.05). Compared with those in the control group, the LVEF in the study group was bigger, the time limit of LVEDD, LAVI, LVMI, QRS wave and the QTc interval and the plane QRS-T angle were smaller (P<0.01), the serum NT-proBNP and CH1L1 levels were lower, and the Apelin level was higher (P<0.01). There was no statistically significant difference in the incidence of adverse reactions such as hypotension, headache and pharyngitis between the two groups . Three months after treatment, there was no loss to follow-up in the two groups. There was no statistically significant difference in the effective rate of maintaining sinus rhythm between the two groups . Spearman correlation analysis showed that the clinical efficacy of patients with AF combined with HFpEP was positively correlated with LVEF, and negatively correlated with LVEDD, LAVI, and LVMI (P<0.05).
CONCLUSION Sacubitril-valsartan combined with rosuvastatin is effective in the treatment of AF complicated with HFpEP, and the treatment effect is closely related to the improvement of ventricular remodeling-related indicators.
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