Application of 2D-STE to evaluate the effect of Sacubitril valsartan on left atrial function in patients with early essential hypertension with left atrial enlargement
Objective:To observe the antihypertensive efficacy of sacubitril valsartan in the treatment of pa-tients with early essential hypertension with left atrial enlargement,and to observe whether there was a reversal of the left atrial size and an improvement of its function.Methods:Patients with early essential hypertension with left atrial enlargement were included and randomly divided into 98 cases in the observation group and 96 cases in the control group.The observation group was treated with an antihypertensive regimen based on sarcobarbital valsar-tan,and the control group was treated with an antihypertensive regimen based on a RAAS inhibitor.The two groups were compared before and after treatment in blood pressure,heart rate,and conventional ultrasound inde-xes including:left atrial diameter(LAD),left atrial maximum volume(LAVmax),left atrial volume index(LA-Vi),mean value of mitral flow E peak divided by lateral wall and septal early diastolic velocities at the mitral an-nulus e'(E/e'),left ventricular end-diastolic internal diameter(LVEDD),left ventricular ejection fraction(LVEF),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),early mitral diastolic E peak divided by late diastolic A peak velocity(E/A),and two-dimensional speckle-tracking imaging(2D-STE)metrics including left atrial systolic strain and strain rate(LAs-s and LASR-S),left atrial early diastolic strain and strain rate(LAS-Eand LASR-E),left atrial late diastolic strain and strain rate(LAS-A and LASR-A),and adverse effects.Results:(1)After treatment,systolic blood pressure,diastolic blood pressure,and heart rate decreased significantly in the observation and control groups(P＜0.05),but there was no statistically significant difference between the two groups(P＞0.05).(2)There was no significant difference in the levels of LAD,LAVmax,LA-Vi,LVEF,IVST,LVPWT,LVEDD,and E/A before and after treatment between the two groups(P＞0.05),and the E/e'levels of the two groups decreased significantly after treatment(P＜0.05),and the observation group's E/e'levels decreased significantly after treatment.(3)The absolute values of LAS-sand LASR-S,LAS-Eand LASR-Ewere significantly higher in the observation and control groups after treatment(P＜0.05),and the observa-tion group was significantly higher than the control group(P＜0.05).On the contrary,the absolute values of LAS-Aand LASR-Ain both groups decreased significantly after treatment(P＜0.05),and were lower in the observa-tion group than in the control group(P＜0.05).Conclusion:After observing the relevant parameters of left atrial function evaluated by 2D-STE technique,it was found that the antihypertensive treatment program based on Sacu-bitril valsartan was better than the antihypertensive treatment program based on RAAS inhibitors in improving the left atrial function of patients at the same level of blood pressure control.
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