Clinical Effect and Potential Mechanism of Sacubatrol Valsartan in Adju-vant Treatment of Atrial Fibrillation Combined with Heart Failure with Preserved Ejection Fraction
Clinical Effect and Potential Mechanism of Sacubatrol Valsartan in Adju-vant Treatment of Atrial Fibrillation Combined with Heart Failure with Preserved Ejection Fraction
Objective To analyze the clinical effect and potential mechanism of Sacubatrol Valsartan in the treatment of atrial fibrillation(AF)combined with heart failure with preserved ejection fraction(HFpEF).Methods A total of 100 patients with AF combined with HFpEF treated from January to August 2022 were selected as the study subjects,and then randomly divided into observation group(n=50)and control group(n=50).Both groups were given basic treatment.The control group was treated with Rosuvastatin,and the observation group was treated with Sacubactril Valsartan combined with Rosuvastatin.After 6 months of treatment,the clinical efficacy and adverse reactions of the two groups were compared.The cardiac function index,ventricular structure index,myocardial injury index,and mRNA expression levels of Toll-like receptor4(TLR4)/nuclear transcription factor-κB(NF-κB)signaling pathway-related factors as well as duration of atrial fibrillation attacks and frequency of ventricular beat were compared between the two groups before treatment and at 3 and 6 months after treatment.Results The total effective rate of obser-vation group was 90.00%(45/50),which was higher than that of control group[74.00%(37/50)](P<0.05).At 3 and 6 months after treatment,left ventricular ejection fraction,stroke output and cardiac output in the two groups were higher than those before treatment,while left atrial diameter,right ventricular diameter and left ventricular end-diastolic diameter were lower than those before treatment;the increase or decrease was greater in the observation group(P<0.05).At 3 and 6 months after treatment,the levels of serum cardiac troponin I,creatine kinase,myocardial creatine kinase isoenzyme,N-terminal brain natritic peptide pre-cursor and mRNA expression levels of TLR4,NF-κB,tumor necrosis factor-α and interleukin-6 in the two groups were decreased compared with those before treatment,and the reduction was greater in the observation group(P<0.05).At 3 and 6 months after treatment,the duration of atrial fibrillation attacks in both groups was shortened compared with that before treatment,and the fre-quency of ventricular beats was reduced compared with that before treatment;changes were greater in the observation group(P<0.05).The difference of the above indexes in the observation group before treatment and at 3 and 6 months after treatment was grea-ter than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Sackubactril Valsartan has significant effect in the treatment of AF combined with HFpEF,which can improve cardiac function,inhibit ventricular remodeling,and alleviate myocardial injury with certain safety.It may play a role by regulating TLR4/NF-κB signaling pathway.
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