中国药房2024，Vol.35Issue(11)：1374-1379,6.DOI:10.6039/j.issn.1001-0408.2024.11.16
维立西呱对急性失代偿心衰的疗效及对不同LVDd患者LVEF的影响
Clinical efficacy of vericiguat in the treatment of acute decompensated heart failure and its effects on LVEF of patients with different LVDd
摘要
Abstract
OBJECTIVE To observe the efficacy of vericiguat in the treatment of acute decompensated heart failure(HF)and its effect on left ventricular ejection fraction(LVEF)in patients with different left ventricular end-diastolic internal diameters(LVDd).METHODS A total of 52 patients with acute decompensated HF who were hospitalized in Anqing Municipal Hospital from September 2022 to May 2023 and were stabilized by intravenous injection of diuretics or vasodilators and then given vericiguat orally were selected.Clinical baseline data were collected,and blood creatinine(Scr),estimated glomerular filtration rate(eGFR),N-terminal pro-B-type natriuretic peptide(NT-proBNP),echocardiographic indexes(LVEF,LVDd),and Kansas City cardiomyopathy questionnaire(KCCQ)scores and so on were recorded and analyzed at 1 and 6 months after treatment.The patients were divided into two subgroups according to whether they had dilated cardiomyopathy or not,the baseline data were compared between the two subgroups,and the changes in the above follow-up indexes for the entire population and two subgroups of patients were analyzed by using mixed effect model.RESULTS Patients in the dilated cardiomyopathy group were significantly younger than those in the nondilated cardiomyopathy group,while the former had a lower proportion of patients with combined coronary artery disease,longer LVDd,lower LVEF levels,and more HF patients with reduced ejection fraction(P＜0.05).Compared with baseline values,KCCQ scores were significantly higher in patients in the whole population,non-dilated cardiomyopathy group and dilated cardiomyopathy group at 1 month after treatment(P＜0.001).The difference between the whole population in terms of elevated KCCQ scores and decreased lg(NT-proBNP)levels was statistically significant at 6 months after treatment(P＜0.05);the levels of lg(NT-proBNP)of two subgroups were significantly decreased and KCCQ scores were significantly increased(P＜0.05),but the difference was not statistically significant(P＞0.05);LVEF levels of the patients in both subgroups were significantly elevated(P＜0.05)and the difference between the subgroups amounted to 7.52%(P=0.030).Mixed effect model result showed that whether patients had coronary artery disease and different baseline levels of LVDd were likely to affect follow-up LVEF levels,with coronary artery disease contributing to follow-up LVEF elevation(P=0.043),but the coronary artery disease subgroup×time interaction was not significant(P＞0.05);compared with patients with baseline LVDd≥62 mm,patients with baseline LVDd≤61 mm had a faster LVEF improvement(P＜0.05).CONCLUSIONS Vericiguat is able to improve cardiac function and quality of life in patients with acute decompensated HF without negatively affecting their renal function.The drug is able to significantly improve LVEF levels in patients with baseline LVDd≤61 mm.关键词
维立西呱/心力衰竭/急性失代偿/扩张型心肌病/冠心病/左室射血分数/左室舒张末期内径Key words
vericiguat/heart failure/acute decompensation/dilated cardiomyopathy/coronary heart disease/left vericiguat ejection fraction/left ventricular end-diastolic internal diameter分类
医药卫生引用本文复制引用
章礼玲,顾崇怀,乔锐,项学军..维立西呱对急性失代偿心衰的疗效及对不同LVDd患者LVEF的影响[J].中国药房,2024,35(11):1374-1379,6.基金项目
安庆市科技计划项目(No.2020Z2001) （No.2020Z2001）
