对心力衰竭伴射血分数降低(HFrEF)患者血管紧张素受体和溶血素抑制(ARNI)的评价——一项现实世界研究

IF 0.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
M. Hafizullah, W. Aman, Hisar Afridi
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引用次数: 0

摘要

目的:这是一项真实世界的前瞻性研究,旨在评估使用苏比里尔/缬沙坦进行Neprlysin Inhibition (ARNI)治疗心力衰竭伴射血分数降低(HFrEF)患者的效果。方法:这是一项门诊研究,研究对象为HFrEF (EF<40%)且血压稳定的患者,经知情同意后。连续入组患者,并在6周和12周进行随访。所有就诊均进行了详细的临床和超声心动图检查。在基线和随访时对24例患者进行了ProBNP、肾谱、HbA1C和电解质的生化评估。结果:入组患者80例,可随访63例。平均年龄53.54±13.32岁,男性占55%。治疗12周后,66%的NYHA功能评分改善,31%的NYHA功能评分改善1级以上(p<0.01)。Pro-BNP从基线时的3552.71±1804.74降至第二次FU时的723±930 (p<0.002)。33%的患者结构改善。左室舒张末期内径(EDD)减少3.49 mm,左室收缩末期内径(ESD)减少3.97 mm (p<0.014)。分数缩短(FS)增加2.07%,EF增加3.52 (p<0.01)。患者对该药耐受性良好,但大多数患者无法耐受更高的推荐剂量。肾脏状态、电解质和HbA1C没有明显改变。结论:在指导药物治疗(GDMT)的基础上加用苏比利/缬沙坦治疗可显著降低ProBNP,显著改善功能等级,增强心脏泵活动,降低LVEDD和LVESD,改善FS和EF。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evaluation of Angiotensin Receptor and Neprlysin Inhibition (ARNI) in Patients of Heart Failure with Reduced Ejection Fraction (HFrEF) - a real-world study
Objectives: This is a real world prospective study to evaluate the effects of Neprlysin Inhibition (ARNI) using sacubitril/valsartan in patients with heart failure with reduced ejection fraction (HFrEF). Methodology: This was an outpatient study on patients of HFrEF (EF<40%) and stable blood pressure after obtaining informed consent. Consecutive patients were enrolled and followed at 6 and 12 weeks. Detailed clinical and echocardiographic examinations were performed on all visits. Biochemistry evaluating ProBNP, renal profile, HbA1C and electrolytes were performed in 24 patients at baseline and follow-up. Results: We enrolled 80 patients, but 63 patients could be followed. Mean age was 53.54±13.32 years and 55% were males. After 12 weeks treatment improvement in NYHA functional class was seen in 66% and improvement by more than one grade in 31% (p<0.01). Pro-BNP reduced from 3552.71±1804.74 at the baseline to 723±930 on the second FU visit (p<0.002).  Structural improvement was seen in 33% of patients. Left ventricular (LV) end-diastolic diameter (EDD) reduced by 3.49 mm and LV end systolic diameter (ESD) by 3.97 mm (p<0.014). Fractional shortening (FS) increased by 2.07% and EF by 3.52 (p<0.01). Patients tolerated the drug well, but most could not tolerate the higher recommended dosage. Renal status, electrolytes, and HbA1C did not alter significantly. Conclusion: Treatment with sacubitril/valsartan in addition to the guideline directed medical therapy (GDMT) resulted in marked reduction in ProBNP, significant improvement in functional class and enhancement of cardiac pumping activity with reduction in LVEDD and LVESD and improvement in FS and EF.
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来源期刊
Pakistan Heart Journal
Pakistan Heart Journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
0.20
自引率
0.00%
发文量
64
审稿时长
6 weeks
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