Impact of sacubitril/valsartan and valsartan on cardiac structure in heart failure patients with mildly reduced ejection fraction
Objective To observe the impact of sacubitril/valsartan and valsartan on cardiac structure in patients with heart failure and mildly reduced ejection fraction(HFmrEF)using echocardiography.Methods Totally 244 HFmrEF patients who would undergo echocardiography were prospectively enrolled and randomly divided into sacubitril/valsartan group(group A,n=122)or valsartan group(group B,n=122)at the ratio of 1∶1.Baseline data and changes in ultrasonic indexes after one-year treatment were compared between groups.Multivariate Cox regression model was used to analyze the relationships of baseline ultrasonic data and the risk of endpoint events.Results No significant difference of baseline data was found between groups(all P＞0.05).After one-year treatment,left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left atrial maximum volume(LAVmax),left ventricular mass(LVM),LVEDV index(LVEDVI),LVESV index(LVESVI),LAVmax index(LAVI)and LVM index(LVMI)decreased in both groups,and the descendent degrees in group A were greater than those in group B(all P＜0.05).After correction for baseline characteristics using covariance analysis,significant differences of primary endpoint(LVEDV,LVESV,LAVI)and secondary endpoint(LVEDV,LVESV,LAVmax)were found between groups(all P＜0.05).Cox regression model showed that the larger the ultrasounic parameters including LVEDV,LVESV,LAVmax,LVM,LVEDVI,LVESVI,LAVI and LVMI before treatment,the higher risk of endpoint events.Conclusion Both sacubitril/valsartan and valsartan could improve cardiac remodeling in patients with HFmrEF,and the former had better effect.
万方数据
维普
