Objective To explore the efficacy and safety of sacubitril/valsartan in patients with end-stage renal disease combined with heart failure(HF).Methods A total of 63 patients with end-stage renal disease combined with heart failure at the First Affiliated Hospital of Xinxiang Medical University from September 2018 to September 2021 were selected as research subjects.According to the treatment methods,these patients were divided into the observation group(n=32)and the control group(nt=31).All patients in the two groups received persistent peritoneal dialysis and conventional treatment for chronic heart failure.On this basis,patients in the observation group were given sacubitril valsartan sodium tablets,starting with a dose of 50 mg twice a day.According to the patient's blood pressure,the dose was doubled every 2 to 4 weeks,and the highest dose was 200mg.Patients in the control group were given valsartan capsules 80 mg once daily,and the dose was adjusted according to the blood pressure,with 160 mg being the highest.Ventricular functional parameters,including left ventricular ejection fraction(LVEF),left ventricular fraction shortening(LVFS),stroke volume(SV)and left ventricular end-diastolic volume(LVEDV),and ventricular configuration parameters,including left ventricular end-diastolic diameter(LVDd),left ventricular end-systolic diameter(LVDs),interventricular septal thickness(IVS)and left ventricular posterior wall thickness(LVPW),were measured by color Doppler ultrasound before and after treatment.The cardiac function grade of patients in the two groups was assessed using the New York Heart Association's grading criteria before and after treatment.The systolic blood pressure(SBP)and diastolic blood pressure(DBP)of patients in the two groups were compared before and after treatment.The occurrence of adverse events such as hypotension,hyperkalemia,abnormal liver function,and rehospitalization for HF during the follow-up period in the two groups was recorded.Results There was no significant difference in ventricular functional and configuration parameters between the two groups before treatment(P＞0.05).There was no significant difference in ventricular functional and configuration parameters before and after treatment in the control group(P＞0.05).The LVEF and LVFS of patients in the observation group were greater than those before treatment,while the LVDd and LVDs were smaller than those before treatment(P＜0.05);there was no significant difference in the remaining indicators before and after treatment in the observation group(P＞0.05).After treatment,the LVDs of patients in the observation group was less than that in the control group(P＜0.05),and there was no significant difference in the remaining indicators between the two groups(P＞0.05).No significant difference was found in the cardiac function grade of patients in the two groups before and after treatment(P＞0.05).The proportion of patients with cardiac function grade Ⅳ after treatment in the observation group was significantly lower than that before treatment(P＜0.05),and there was no significant difference in the proportion of patients with cardiac function grade Ⅱ-Ⅲ before and after treatment(P＞0.05).There was no significant difference in the cardiac function grade before and after treatment in the control group(P＞0.05).The SBP and DBP showed no significant difference between the two groups before treatment(P＞0.05).The SBP and DBP also showed no significant difference before and after treatment in the control group(P＞0.05).The SBP and DBP of patients in the observation group after treatment were significantly lower than those before treatment(P＜0.05).The SBP and DBP of patients in the observation group were significantly lower than those in the control group after treatment(P＜0.05).The incidences of adverse reactions in the control group and observation group were 22.58％(7/31)and 43.75％(14/32),respectively,showing no statistically significant difference between the two groups(x2=3.175,P＞0.05).Conclusion Sacubitril/valsartan can effectively improve the ventricular function,reverse the ventricular remodeling,increase the cardiac function grade,and reduce the blood pressure of patients with end-stage renal disease combined with heart failure,exhibiting good safety.
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