■舒必曲/缬沙坦已被证明可以降低住院率,甚至降低心力衰竭的死亡率。在心力衰竭和急性冠脉综合征中,沙库巴曲/缬沙坦的作用已被研究,但对冠状动脉血流的影响尚不清楚。
■我们旨在通过使用超声心动图冠状动脉血流储备(CFR)来了解沙库巴曲/缬沙坦对冠状动脉血流的影响。
■招募了36名符合沙库巴曲/缬沙坦治疗条件的心力衰竭患者(17名缺血性患者和19名非缺血性患者),射血分数降低(EF<40%),以及21名正常对照。研究组和对照组在性别方面相似,吸烟状况,和年龄分布(分别为p=0.874,p=0.709和p=0.765)。血压,心率,6分钟步行测试(6MWT),N末端B型利钠肽原(NT-pro-BNP)水平,标准超声心动图,从左前降中远端血流可见,基线峰值舒张流速和双嘧达莫输注后2分钟,测量充血舒张峰流速,在沙库巴曲/缬沙坦开始前和开始后6个月,用超声心动图评估CFR.
■基线峰值舒张流速在6个月时没有显着差异(p=0.143),但充血峰值舒张流速,CFR,EF(%),6MWD值显着增加(所有p<0.001),纽约心脏协会功能课,NT-pro-BNP(pg/mL),左心室舒张末期内径(mm),sacubitril/缬沙坦治疗后,左心室收缩末期直径(mm)值显着降低(均p<0.001)。
■沙库必曲/缬沙坦显著改变冠状动脉血流量,尤其是它的动态特征,射血分数降低的心力衰竭患者。
UNASSIGNED: Sacubitril/valsartan has been shown to reduce hospital admissions and even mortality for heart failure. In heart failure and acute coronary syndrome, the effects of
sacubitril/valsartan have been studied, but the effect on coronary artery flow is not known.
UNASSIGNED: We aimed to understand the effect of
sacubitril/valsartan on coronary artery flow by using echocardiographic coronary flow reserve (CFR).
UNASSIGNED: Thirty-six patients (17 ischemic and 19 non-ischemic) with heart failure with reduced ejection fraction (EF of < 40%) eligible for sacubitril/valsartan treatment and 21 normal controls were recruited. The study group and controls were similar with regard to gender, smoking status, and age distribution (p = 0.874, p = 0.709, and p = 0.765, respectively). Blood pressure, heart rate, 6-minute walk test (6MWT), N terminal pro B type natriuretic peptide (NT-pro-BNP) level, standard echocardiography, from where left anterior descending mid-distal flow was seen, baseline peak diastolic flow rate and 2 minutes after dipyridamole infusion, and hyperemic peak diastolic flow rate were measured, and CFR with echocardiography was assessed prior to and at 6 months after
sacubitril/valsartan initiation.
UNASSIGNED: Baseline peak diastolic flow rate did not exhibit a significant difference at 6 months (p = 0.143), but hyperemic peak diastolic flow rate, CFR, EF (%), and 6MWD values were significantly increased (all p < 0.001), and New York Heart Association Functional Class, NT-pro-BNP (pg/mL), left ventricule end diastolic diameter (mm), and left ventricule end systolic diameter (mm) values were significantly decreased (all p < 0.001) after sacubitril/valsartan treatment.
UNASSIGNED: Sacubitril/valsartan significantly alters coronary blood flow, especially its dynamic features, in patients with heart failure with reduced ejection fraction.