Therapeutic effect of sacubitril valsartan combined metoprolol on patients with chronic cardiac insuffi-ciency and its impact on CXCL13 and SERCA2a levels
Objective:To study the therapeutic effect of sacubitril valsartan combined metoprolol on patients with chronic cardiac insufficiency and its impact on levels of chemokine CXC ligand 13(CXCL13)and human cardiac sarcoplasmic reticulum calcium ion ATPase 2a(SERCA2a).Methods:This randomized controlled study enrolled 120 patients with chronic cardiac insufficiency admitted in Peking University Shenzhen Hospital between June 2018 and December 2021.They were divided into control group(n=60,metoprolol therapy)and combined treatment group(n=60,additional sacubitril valsartan therapy based on control group).After 90d treatment,therapeutic effect,cardiac function,coronary hemodynamics,levels of CXCL13 and SERCA2a,and safety were compared between two groups.Results:Total effective rate in combined treatment group was significantly higher than that of control group(91.67%vs.76.67%,P=0.024).Compared with patients in control group after treatment,those in combined treatment group had significant higher left ventricular ejection fraction(LVEF),cardiac output(CO),coronary diastolic peak veloci-ty(DPV),systolic peak velocity(SPV),diastolic velocity time integral(DVTI),systolic velocity time integral(SVTI)and SERCA2a level,and significant lower left ventricular end-diastolic volume(LVEDV),left ventricular end-diastolic di-ameter(LVEDd)and CXCL13 level(P<0.001 all).We detected no significant difference in incidence of adverse reac-tions between two groups during treatment(P=0.378).Conclusion:Sacubitril valsartan combined with metoprolol has good therapeutic effect in patients with chronic cardiac insufficiency.It can improve cardiac function,increase the coronary blood flow velocity,reduce CXCL13 level and increase SERCA2a level with good safety.