Effect of Sacubitril Valsartan Sodium Combined with Trimetazidine on Dilated Cardiomyopathy

doi:10.3969/j.issn.1674-3245.2025.03.039

Abstract：Objective To observe the effect of sacubitril valsartan sodium combined with trimetazidine on dilated cardiomyopathy and to study its possible mechanisms. Methods A total of 84 patients with dilated cardiomyopathy admitted to Lu'an Shili Hospital from January 2023 to January 2024 were selected. They were randomly divided into a monotherapy group and a combination therapy group using a random number table method, with 42 cases in each group. The monotherapy group was treated with sacubitril valsartan sodium, while the combination therapy group received sacubitril valsartan sodium combined with trimetazidine. The therapeutic effects of the two groups were compared. Results After treatment, the left ventricular end-diastolic diameter (LVEDD) of both groups decreased compared to before treatment, and the combination group had a lower value; the left ventricular ejection fraction (LVEF) increased compared to before treatment, and the combination group had a higher value, with statistically significant differences (t=6.157, 5.247, P<0.05). The myocardial fibrosis markers, including type I procollagen (PC-Ⅰ), type III procollagen (PCⅢ), hyaluronic acid (HA), and laminin (LN), decreased compared to before treatment, and the combination group showed a greater reduction, with statistically significant differences (t=4.863, 3.928, 3.376, 2.993, P<0.05). The levels of fractalkine (FKN), transforming growth factor-β1 (TGF-β1), tumor necrosis factor α-stimulated gene 6 (TSG-6), and N-terminal pro-brain natriuretic peptide (NT-proBNP) also decreased compared to before treatment, and the combination group showed a greater reduction, with statistically significant differences (t=9.614, 11.206, 3.978, 5.360, P<0.05). After treatment, the pre-enhancement left ventricular myocardial T1 values of both groups decreased compared to before treatment, while the post-enhancement values increased (P<0.05); the pre-enhancement left ventricular myocardial T1 values of the combination group were lower than those of the monotherapy group, and the post-enhancement values were higher (P<0.05). The overall effective rate of the combination group was higher than that of the monotherapy group, with statistically significant differences (χ²=4.941, P<0.05). Conclusion The treatment of dilated cardiomyopathy with sacubitril valsartan sodium combined with trimetazidine is superior to monotherapy.