Effects of sacubitril-valsartan at different dosages on cardiac function and adverse events in patients with heart failure of reduced ejection fraction
Sun Hong-xia
Jin Pei-yin
Yang Pei-ling
Wang Zhi-bin
Abstract：Objective To explore the effects of different doses of sacubitril-valsartan on cardiac function and adverse events in patients with heart failure of reduced ejection fraction(HFrEF).Methods The medical records of 105 patients with HFrEF who were treated with angiotensin receptor enkephalase inhibitors(ARNI)in Anyang People's Hospital from May 2020 to July 2024 were retrospectively analyzed.According to the dosage of sackubactril valsartan tablets,the patients were divided into the low-dose group,medium-dose group and high-dose group,with 35 in each group.All the patients in three groups received sacubactril valsartan tablet orally,25 mg each time twice daily in the low-dose group,50 mg each time twice daily in the middle-dose group and 100 mg each time twice daily in the high-dose group.The six minute walk distance(6 MWD),Minnesota living with heart failure questionnaire(MLHFQ)score,cardiac function indicators including cardiac index(CI),left ventricular end-diastolic(LVEDD),left ventricular ejection fraction(LVEF),heart rate(HR),left ventricular end-diastolic(LVEDD),left atrial diameter(LAD)and left atrial volume index(LAVI)before and after 3 months of medication was compared among the three groups.Meanwhile,the incidence of adverse events(dizziness,hypotension,vomiting,hyperkalemia,renal dysfunction)was statistically analyzed.Results The 6 MWD of the low-dose group,middle-dose group,and high-dose group were(403.65±31.92)m,(434.91±33.74)m,and(453.64±35.79)m respec-tively,after treatment,which was increased as compared with that before treatment,and the high-dose group increased the most and the low-dose group had the smallest increase(P<0.05).The MLHFQ score of the low-dose group,middle-dose group,and high-dose group was(38.75±8.98)points,(35.36±8.24)points,and(30.89±7.33)points respectively,which was higher than that before treat-ment.The high-dose group had the greatest decrease while the low-dose group had the smallest one(P<0.05).The CI of the low-dose group,middle-dose group,and high-dose group was(5.56±1.08)L·min-1·m-2 and(6.17±1.15)L·min-1·m-2,(7.11±1.21)L·min-1·m-2 respectively,LVEF was(46.96±7.08)%,(51.23±7.71)%,(54.78±8.96)%respectively,which were increased as compared with those before treatment,and the high-dose group increased the most whereas the low-dose group increased the least(P<0.05).The LVEDD of the low-dose group,middle-dose group,and high-dose group was(54.13±7.11)mm,(50.21±7.02)mm,and(45.79±6.83)mm respectively,HR was(82.33±7.57)times·min-1,(78.59±7.42)times·min-1,(74.44±7.29)times·min-1 respectively,which were lower than those before treatment,and the degree of reduction in the high-dose group was the largest,the low-dose group had the smallest reduction(P<0.05).The LAD of the low-dose group,middle-dose group,and high-dose group were(46.46±6.48)mm,(45.32±6.33)mm,and(44.83±6.55)mm,respectively.LAVI were(40.83±9.66)mL·m-2,(41.41±8.79)mL·m-2,and(40.26±9.57)mL·m-2 respectively,showing no statistical significance as compared with those before treatment(P>0.05).The occurring rates of dizziness,hypotension,vomiting,hyperkalemia and abnormal renal function were not statistically significant among the three groups(P>0.05).Conclusion Sacubi-tril-valsartan has ideal efficacy and high safety for HFrEF.The 100 mg bid dose of sacubitril-valsartan is more effective than the 25 mg bid and 50 mg bid doses of sacubitril-valsartan.It is helpful to improve cardiac function.
Keywords：Heart failure of reduced ejection fractionSacubitril-valsartanDoseCardiac functionAdverse events
Publication Date：2025-02-24
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 144-148 )