Effect of Vericiguat combined with Sacubitril/Valsartan on ventricular remodeling and serum miR-133a and miR-433 in elderly patients with dilated cardiomyopathy and heart failure

WANG Hao; ZHANG Yi; ZHOU Peng

doi:10.13431/j.cnki.immunol.j.20250098

Abstract：Objective To investigate the efficacy of Vericiguat combined with Sacubitril/Valsartan(Sac/Val)in the treatment of heart failure in elderly patients with dilated cardiomyopathy(DCM).Methods From January 2023 to January 2024,96 elderly patients with DCM and heart failure were selected and randomly divided into two groups by the random number table method,with 48 patients in each group.The control group was treated with Sac/Val,while the combination group was treated with Vericiguat combined with Sac/Val for a course of 3 months.The clinical efficacy,adverse reactions,parameters of cardiac structure and function[left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),stroke volume(SV)],myocardial injury indicators[N-terminal pro-brain natriuretic peptide(NT-proBNP),troponin I(cTnI),creatine kinase isoenzyme(CK-MB)],and serum miR-133a and miR-433 expression levels before and after treatment were compared between the two groups.The patients were followed up for 6 months to statistically analyze the occurrence of major adverse cardiovascular events(MACE).Results Compared with 77.08%(37/48)in the control group,the total effective rate of the combination group was significantly increased to 93.75%(45/48)after treatment(P<0.05).Compared with the control group,SV and LVEF increased,while LAD and LVEDD decreased in the combination group after treatment(P<0.05).Compared with the control group,the levels of serum NT-proBNP,cTnI,CK-MB and the expression levels of serum miR-133a and miR-433 in the combination group decreased after treatment(P<0.05).During the treatment period,there was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).After a 6-month follow-up,there was no significant difference in the incidence of MACE between the two groups(P>0.05).Conclusion Vericiguat combined with Sac/Val has a definite therapeutic effect in the treatment of heart failure in elderly patients with DCM,which can reduce the levels of myocardial injury markers in patients,improve cardiac structure and function,and has favorable safety profile.It may be related to the regulation of miR-133a and miR-433 expression.