Observation on effect of combination of ivabradine and sacubitril valsartan on HFrEF patients with hypotension
Objective To observe the effect of combination of ivabradine and sacubitril valsartan on heart failure with reduced ejection fraction(HFrEF)patients with hypotension.Methods A total of 118 HFrEF patients with hypotension were randomly divided into an observation group(60 cases)and a control group(58 cases).The control group was given oral sacubitril valsartan,and the observation group was given oral ivabradine on the basis of the control group.Comparison was made on cardiac function indicators[heart rate,left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proBNP),6-min walking test(6MWT),interleukin-1(IL-1)and interleukin-6(IL-6)]levels,quality of life score,and occurrence of hypotension between the two groups.Results The heart rate,LVEF,NT-proBNP and 6MWT of the observation group were(57.36±11.24)beats/min,(46.32±5.67)%,(1137.68±462.35)ng/L and(586.32±48.76)m,respectively.Those of the control group were(64.28±10.62)beats/min,(42.62±5.18)%,(1628.64±473.54)ng/L and(506.37±46.82)m,respectively.After treatment,the heart rate and NT-proBNP level of patients in the observation group were significantly lower than those in the control group,while the LVEF was significantly higher than that in the control group,and the 6MWT was significantly longer than that in the control group.The difference was statistically significant(P＜0.05).The levels of IL-1 and IL-6 in the observation group were(101.26±12.58)and(89.26±7.32)pg/ml,respectively,while those in the control group were(106.53±13.54)and(101.65±8.05)pg/ml,respectively.The levels of IL-1 and IL-6 in the observation group were significantly lower than those in the control group,and the difference was statistically significant(P＜0.05).The quality of life scores of emotional function,social function,physical function,cognitive function and role function in the observation group were(62.56±6.23),(52.21±4.62),(52.16±7.26),(58.69±5.01)and(50.28±8.06)points,which were significantly higher than(42.62±5.16),(43.52±5.06),(46.58±7.02),(46.32±4.98)and(41.32±7.85)points in the control group,and the difference was statistically significant(P＜0.05).Hypotension occurred in 5 patients(8.33%)in the observation group,which was significantly less than 18 patients(31.03%)in the control group,and the difference was statistically significant(P＜0.05).Conclusion Treatment of HFrEF patients with hypotension by combining ivabradine and sacubitril valsartan can significantly relieve the symptoms of heart failure,reduce inflammatory damage,and increase the level of daily activity,and more safe and reliable,which can be promoted in clinical practice.
HypotensionHeart failure with reduced ejection fractionIvabradineSacubitril valsartanQuality of life
万方数据
维普
