Volume 21 Issue 4
Apr.  2023
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ZHU Zhangjin, LI Jingfeng, WANG Chao, LI Yin, NIU Jie, XU Xiaofei, HU Hao. Effect of sacubitril/valsartan on left atrial remodeling in patients with class Ⅳ cardiac function[J]. Chinese Journal of General Practice, 2023, 21(4): 602-605. doi: 10.16766/j.cnki.issn.1674-4152.002940
Citation: ZHU Zhangjin, LI Jingfeng, WANG Chao, LI Yin, NIU Jie, XU Xiaofei, HU Hao. Effect of sacubitril/valsartan on left atrial remodeling in patients with class Ⅳ cardiac function[J]. Chinese Journal of General Practice, 2023, 21(4): 602-605. doi: 10.16766/j.cnki.issn.1674-4152.002940

Effect of sacubitril/valsartan on left atrial remodeling in patients with class Ⅳ cardiac function

doi: 10.16766/j.cnki.issn.1674-4152.002940
Funds:

 AHWJ2021b080

  • Received Date: 2022-07-04
    Available Online: 2023-05-31
  •   Objective  To investigate the effects of sacubitril/valsartan on the left atrial parameters and remodeling in echocardiography among patients with New York Heart Association(NYHA) class Ⅳ heart failure.  Methods  A total of 90 heart failure and a reduced ejection fraction (HFrEF) patients with NYHA class Ⅳ hospitalized in the First People's Hospital of Chuzhou were retrospectively analyzed. According to drug treatment, they were divided into two groups: the angiotensin enkephalin inhibitor (ARNI) group (48 cases) and the angiotensin converting enzyme inhibitor/angiotensin Ⅱ receptor antagonist (ACEI/ARB) group (42 cases), and the changes and amplitude of left atrial remodeling ultrasound indexes in the two groups after 1 year of treatment were compared.  Results  During follow up, the left atrial transverse diameter (LATD) in ARNI group was significantly shorter than that in ACEI/ARB group [(-6.92±4.09) mm vs. (-3.60±4.48) mm, P < 0.001]; the left atrial volume (LAV) of ARNI group was significantly smaller than that of ACEI/ARB group [(-11.76±5.73) mL vs. (-8.14±6.21) mL, P=0.005]; the left atrial volume index (LAVI) in ARNI group decreased more significantly than that in ACEI/ARB group [(-6.38±4.55) mL/m2 vs. (-4.16±3.69) mL/m2, P=0.014)]; the left atrial globular index (LASI) in ARNI group decreased more significantly than that in ACEI/ARB group (-0.09±0.14 vs. 0.01±0.11, P=0.003). In addition, the number of patients with left atrial reverse remodeling (LARR) in ARNI group was higher [26 (54.2%) vs. 14 (33.3%), P=0.047].  Conclusion  Compared with ACEI/ARB group, the treatment of sacubitril/valsartan can better reduce the LATD, LAV, LAVI, LASI, and improve LARR in HFrEF patients with NYHA class Ⅳ.

     

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