Efficacy and Difference of Sacubactril Valsartan in the Treatment of Ischemic Cardiomyopathy and Dilated Cardiomyopathy

LIN Liyun; YANG Zhi; LI Ang; Dilixiati Siti; ZHANG Li; SONG Changlai

doi:10.12102/j.issn.1672-1349.2025.13.010

Abstract：Objective: To study the improvement of cardiac function in patients with different types of chronic heart failure after treatment with sacubitril/valsartan and the differences in therapeutic effects. Methods: A total of 41 patients with ischemic cardiomyopathy (ICM group) and 56 patients with dilated cardiomyopathy (DCM group) who were treated at the Changji Branch of the First Affiliated Hospital of Xinjiang Medical University from July 2021 to July 2022 were selected as the study subjects. They were randomly divided into observation and control groups using a random number table method. The control group received conventional heart failure treatment, while the observation group received sacubitril/valsartan treatment in addition to conventional therapy. The treatment lasted for one year. Changes in echocardiographic indicators and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were compared before and after treatment at 1, 3, 6, and 12 months. Results: After 6 months of treatment, the NT-proBNP level in the observation group of the ICM group was significantly lower than that in the control group. After 12 months of treatment, the left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and NT-proBNP in the observation group were significantly lower than those in the control group, while the left ventricular ejection fraction (LVEF) was higher (P < 0.05). In the DCM group, after 3 months of treatment, the NT-proBNP level in the observation group was significantly lower than that in the control group. After 6 and 12 months of treatment, LVESD, LVEDD, right ventricular diameter (RV), and NT-proBNP in the observation group were significantly lower than those in the control group, while LVEF was higher (P < 0.05). After 3 months of treatment, LVESD and RV in the DCM group were significantly lower than those in the ICM group, while LVEF was higher (P < 0.05). After 6 months of treatment, LVESD, right atrial diameter (RA), and RV in the DCM group were significantly lower than those in the ICM group, while LVEF was higher (P < 0.05). After 12 months of treatment, LVESD, LVEDD, and RA in the DCM group were significantly lower than those in the ICM group, while LVEF was higher (P < 0.05). However, there was no statistically significant difference in NT-proBNP between the two groups at all time points (P > 0.05). Conclusion: Compared with traditional angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), sacubitril/valsartan showed better improvement in cardiac function in patients with different types of chronic heart failure (ICM and DCM), and there were differences in therapeutic effects between the two types of heart failure, with DCM patients benefiting more.