Observation of the therapeutic effect of sacubitril/valsartan on elderly patients with heart failure with mid-range ejection fraction
Objective To investigate the clinical efficacy of sacubitril/valsartan in elderly patients with heart failure with mid-range ejection fraction(HFmrEF).Methods A total of 116 patients≥80 years old with HFmrEF who were ad-mitted to the department of geriatrics and cardiology of Weifang People's Hospital from September 2020 to February 2023 were selected as the research subjects.Patients were randomly divided into an observation group and a control group.The control group received conventional anti heart failure treatment including angiotensin-converting enzyme inhibitor(ACEI)or angiotensin receptor blocker(ARB);while for the observation group patients,the ACEI or ARB were replaced with sa-cubitril/valsartan(50-100 mg,twice a day).Both groups received continuous treatment for 6 months,and the levels of NT-proBNP,LVEF,LVEDD,clinical total effective rate,and treatment safety were observed before and after 6 months of treatment.Results Before treatment,there was no statistically significant difference in NT-proBNP levels,LVEF and LVEDD between the two groups(all P＞0.05).After treatment,the levels of NT-proBNP and mean LVEDD in both groups were lower than before medication,and the observation group was lower than the control group(both P＜0.05).However,after treatment,the mean LVEF in both groups was higher than before treatment,and the observation group was higher than the control group(both P＜0.05).After treatment,13 cases showed significant improvement,23 cases showed im-provement,and 14 cases showed no improvement in the observation group,with a total effective rate of 72.0%;In the con-trol group,2 cases showed significant improvement,29 cases showed improvement,and 28 cases showed no improve-ment,with a total effective rate of 52.5%.The total effective rate of the observation group was higher than that of the con-trol group(P=0.038).During the treatment process,both the control group and the observation group experienced one case of transient hypotension.After timely adjustment of medication,the condition returned to normal without any adverse consequences.Both groups did not experience renal function deterioration,electrolyte imbalance,or other adverse reac-tions such as allergies or vascular edema.Conclusion Sacubitril/valsartan is a safe and effective medication for the treat-ment of elderly HFmrEF patients,which can significantly improve their cardiac function and has better clinical efficacy than ACEI or ARB.
sacubitril/valsartanadvanced ageheart failure with mid-range ejection fractionheart failure
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维普
