中国医学创新2025，Vol.22Issue(4)：24-30,7.DOI:10.3969/j.issn.1674-4985.2025.04.006
LCZ696对HFrEF及HFmrEF合并心房颤动患者心脏保护作用的临床研究
Clinical Study on Cardioprotective Effect of LCZ696 on HFrEF and HFmrEF Patients with Atrial Fibrillation/
摘要
Abstract
Objective:To investigate the cardioprotective effect of Sacubitril Valsartan(LCZ696)on heart failure with reduced ejection fraction(HFrEF)and heart failurewith mid-range ejection fraction(HFmrEF)combined with atrial fibrillation.Method:A total of 80 patients with HFrEF and HFmrEF combined with atrial fibrillation admitted to Zhanjiang Central People's Hospital from October 2021 to September 2022 were selected as the study objects,and were divided into control group and observation group according to random number table method.The observation group was divided into two subgroups according to the type of heart failure:HFrEF group and HFmrEF group.Patients were given diuretics,β-blockers,aldosterone receptor antagonists,Digoxin,Ivabradine Hydrochlorid,Warfarin or Rivaroxaban according to the specific conditions of patients follow the guidelines for heart failure and atrial fibrillation,the control group was given conventional ACEI or ARB,and the experimental group was given LCZ696 oral therapy on the basis of conventional treatment.The clinical efficacy and cardiac function[6 min walk test(6MWT),myocardial marker N-terminal pro brain natriuretic peptide(NT-proBNP),left atrial diameter(LAD),left atrial volume index(LAVI),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter(LVESD)]of the two groups and subgroups of observation group were compared,and the incidence of cardiovascular events were calculated.Result:Compared with the control group,the total effective rate of observation group was higher(95.00%vs 80.00%)(P<0.05),and there was no statistical significance in the total effective rate of HFrEF group and HFmrEF group(P>0.05).There were no significant differences in 6MWT,NT-proBNP,LAD,LAVI,LVEF,LVEDD and LVESD between the two groups before treatment(P>0.05).After treatment,6MWT and LVEF of two groups were increased,while NT-proBNP,LAD,LAVI,LVEDD and LVESD were decreased,the 6MWT and LVEF of the observation group were higher than those of the control group,and the NT-proBNP,LAD,LAVI,LVEDD and LVESD of the observation group were lower than those of the control group(P<0.05).After treatment,6MWT and LVEF in both subgroups of observation group were higher than those before treatment,NT-proBNP,LAD,LAVI,LVEDD and LVESD were lower than those before treatment,and the increase of 6MWT and LVEF in HFrEF group was higher than those in HFmrEF group,and the decrease of NT-proBNP was higher than that in HFmrEF group(P<0.05).There were no significant differences in the incidence of cardiovascular events between the two groups and subgroups of observation group(P>0.05).Conclusion:Patients with HFrEF and HFmrEF complicated with atrial fibrillation can obtain better results with LCZ696 treatment,protect heart function,and have fewer cardiovascular events.Among them,the main benefit group is HFrEF patients with atrial fibrillation,as for HFmrEF patients with atrial fibrillation,the application of LCZ696 treatment needs to be further standardized.关键词
心力衰竭/射血分数/沙库巴曲缬沙坦/心脏功能Key words
Heart failure/Ejection fraction/Sacubitril Valsartan/Cardiac function引用本文复制引用
陈旭松,简春燕,彭畅第,李山岳,吴一帆..LCZ696对HFrEF及HFmrEF合并心房颤动患者心脏保护作用的临床研究[J].中国医学创新,2025,22(4):24-30,7.基金项目
湛江市非资助科技攻关计划项目(2021B01460) （2021B01460）
