Effects of sacubitril/valsartan combined with basic therapy on hemorheology,cardiac function status and exercise tolerance in patients with chronic heart failure

Wu Qian; He Chunyang; Xu Chaoran

doi:10.3760/j.issn.1673-4777.2024.09.006

Abstract：Objective To investigate the effects of sacubitril/valsartan combined with basic therapy on hemorheology,cardiac function status and exercise tolerance in patients with chronic heart failure(CHF).Methods A total of 114 CHF patients admitted to the Third People's Hospital of Chengdu from April 2019 to April 2023 were selected and divided into observation group and control group by block randomization method,with 57 cases in each group.The control group received conventional CHF basic treatment,and the observation group was given sacubitril/valsartan combined treatment on this basis.The clinical effects of the two groups were compared after 6 months of treatment.Including heart function[left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV)],hemorheology indexs[whole blood viscosity,plasma viscosity,erythrocyte deformation index(DI)],sports endurance[6 min walking distance test(6MWT)and peak oxygen uptake].The occurrence of adverse reactions of patients in the two groups during treatment was recorded.Results After 6 months of treatment,the total effective rate of the observation group was higher than that of the control group[84.2％(48/57)vs 68.4％(39/57)](P=0.047).After 6 months of treatment,the LVEDV and LVESV of the two groups were lower than those before treatment,and those of the observation group were lower than those of the control group[(222±4)ml vs(226±5)ml,(100±4)ml vs(102±5)ml](all P＜0.05).After 6 months of treatment,the hemorheological indexes of whole blood viscosity and plasma viscosity in the two groups were lower than those before treatment,and the observation group were lower than the control group[(3.1±1.0)mPa·s vs(3.7±1.1)mPa·s,(1.2±1.0)mPa·svs(1.9±1.1)mPa·s];DI was higher than that before treatment,and the observation group was higher than the control group[(0.51±0.23)vs(0.41±0.24)](all P＜0.05).After 6 months of treatment,the 6MWT distance and peak oxygen uptake in exercise tolerance of the two groups were longer/higher than those before treatment,and those in the observation group were longer/higher than those in the control group[(509±6)m vs(501±6)m,(22.4±2.9)ml/(kg·min)vs(20.7±3.8)ml/(kg·min)](all P＜0.05).During the treatment period,there was no statistically significant difference in the incidence of adverse reactions between the two groups of patients(P=0.297).Conclusion Sacubitril/valsartan combined with basic therapy has a significant effect on CHF,which makes the hemorheology of patients tend to be normal,and has a positive effect on the improvement of cardiac function and exercise endurance.