Abstract:
BACKGROUND Heart failure and end-stage renal disease often coexist, and management of heart failure can be challenging in patients during hemodialysis. Sacubitril-valsartan (SV) is the first drug to receive regulatory approval for use in patients with chronic heart failure with reduced ejection fraction (HFrEF) and New York Heart Association (NYHA) classification II, III, or IV. This study aimed to evaluate the efficacy and safety of SV for use in chronic heart failure patients on maintenance hemodialysis (MHD). MATERIAL AND METHODS From September 2021 to October 2022, 28 patients on MHD with chronic heart failure at the hemodialysis center of Shaanxi Second Provincial People\'s Hospital were regularly followed. During the 12-week follow-up period, all patients were administered SV at doses of 100-400 mg per day. Biochemical indicators, echocardiographic parameters, life quality scores, and adverse events were evaluated. RESULTS We enrolled 28 patients. Compared with the baseline levels, NYHA class III in these patients treated with SV was significantly decreased from 60.71% to 32.14% (P<0.05), left ventricular ejection fraction (LVEF) was significantly improved from 44.29±8.92% to 53.32±7.88% (P<0.001), the Physical Component Summary (PCS) score was significantly improved from 40.0±6.41 to 56.20±9.86 (P<0.001), and the Mental Component Summary (MCS) score was significantly improved from 39.99±6.14 to 52.59±11.0 (P<0.001). CONCLUSIONS We demonstrated that SV improved NYHA classification and LVEF values of patients on MHD with chronic heart failure and also improved their quality of life.
摘要:
背景技术心力衰竭和终末期肾病常共存,在血液透析患者中,心力衰竭的管理可能具有挑战性。Sacubitril-valsartan(SV)是第一种获得监管批准的药物,可用于射血分数降低的慢性心力衰竭(HFrEF)和纽约心脏协会(NYHA)II级患者。III,或者IV.本研究旨在评估SV用于慢性心力衰竭患者维持性血液透析(MHD)的有效性和安全性。材料与方法2021年9月至2022年10月,对陕西省第二人民医院血液透析中心28例MHD合并慢性心力衰竭患者进行定期随访。在12周的随访期间,所有患者均接受SV治疗,剂量为每天100~400mg.生化指标,超声心动图参数,生活质量评分,并对不良事件进行了评估。结果我们纳入了28例患者。与基线水平相比,这些接受SV治疗的患者的NYHAIII级从60.71%显着降低至32.14%(P<0.05),左心室射血分数(LVEF)从44.29±8.92%显著提高到53.32±7.88%(P<0.001),物理成分汇总(PCS)评分从40.0±6.41提高到56.20±9.86(P<0.001),精神成分汇总(MCS)评分从39.99±6.14提高到52.59±11.0(P<0.001)。结论我们证明SV改善了慢性心力衰竭MHD患者的NYHA分级和LVEF值,也改善了他们的生活质量。