Observation of the Effect of Empagliflozin Combined with Sacu-bitril/Valsartan on Atrial Fibrillation Complicated by Heart Fail-ure with Preserved Ejection Fraction

FENG Qian; SHI Miao; ZHAO Dongpo; LIU Xueying

doi:10.3969/j.issn.1002-3429.2024.11.009

Abstract：Objective To explore the effect of Empagliflozin combined with sacubitril/valsartan on patients with atri-al fibril-lation(AF)and heart failure with preserved ejection fraction(HFpEF).Methods A total of 98 patients with atrial fi-brillation and HFpEF from July 2022 to July 2023 were selected and randomly divided into the research group(n=49)and the control group(n=49)using a random number table method.Both groups received conventional treatment,and on this basis,the control group was treated with sacubitril/valsartan and the research group was supplemented with Empagliflozin on the ba-sis of the control group.At 6 months after treatment,the effects were compared.The clinical efficacy of the two groups was compared,and the cardiopulmonary function[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),maximum voluntary ventilation(MVV),forced expiratory volume in one second(FEV1),left ventricular remodeling index(LVRI)],inflammatory factors[interleukin-1β(IL-1β),lipoprotein-associated phospholipase A2(Lp-PLA2),sirtuin 1(SIRT1)],exercise tolerance[6-minute walk distance(6MWD)],quality of life[Minnesota Heart Failure Quality of Life Scale(MLHFQ)],serum microRNA(miR)-101a,miR-30a levels,and major adverse cardiovascular events(MACE)and adverse reac-tions during treatment in both groups were compared.Results The total clinical effective rate of the research group was 89.80%(44/49),which was higher than that of the control group[73.47%(36/49)](P<0.05).At 3 and 6 months after treat-ment,LVEDD,IL-1β,Lp-PLA2,MLHFQ score,and serum miR-30a in both groups were lower than those before treatment,while LVEF,MVV,FEV1,LVRI,SIRT1,6MWD,and serum miR-101a were higher than those before treatment(P<0.05).At 3 and 6 months after treatment,LVEDD,IL-1β,Lp-PLA2,MLHFQ score,and serum miR-30a in the research group were lower than those in the control group,while LVEF,MVV,FEV1,LVRI,SIRT1,6MWD,and serum miR-101a were higher than those in the control group(P<0.05).The incidence of MACE in the research group was lower than that in the control group(P<0.05);there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The efficacy of Empagliflozin combined with sacubitril/valsartan in the treatment of patients with AF and HFpEF is significant,which can reduce inflammatory response,improve patients'cardiopulmonary function,reduce the risk of MACE,enhance exercise tolerance,improve quality of life,and has high safety.