Efficacy of Sacubitril/Valsartan in the treatment of chronic heart failure in elderly patients with dilated cardiomyopathy

Abstract

Objective To evaluate the efficacy of Sacubitril/Valsartan in the treatment of chronic heart failure in elderly patients with dilated cardiomyopathy. Methods A total of 126 elderly patients with dilated cardiomyopathy-induced chronic heart failure who were treated in Beijing Anzhen Hospital from January 2017 to December 2017 were enrolled and randomly divided into the experimental group(n=62)and the control group(n=64). All patients were given a standard heart failure treatment, and the experimental group underwent sacubitril/valsartan(100 mg Bid)and the control group received benazepril(10 mg Qd)additionally for 12 months.Left ventricular ejection fraction(LVEF), N-terminal pro-brain natriuretic peptide(NT-proBNP), six-minute walk test(6MWT)and major adverse cardiovascular events(mortality and readmission for heart failure)were compared between the two groups. Results Of 126 elderly patients, 73 patients(57.9%)were male, and 53 were female, with a mean ±SD age of(67.2±5.8)years.Basic characteristics, including age, gender, clinical history of hypertension and diabetes, LVEF, NT-proBNP and 6MWT, showed no significant difference between two groups(P 0.05). In the experimental group, LVEF, NT-proBNP level and 6MWT were significantly improved in post-treatment versus pre-treatment(P>0.05). And LVEF, NT-proBNP level and 6MWT were significantly better in the experimental group than in the control group[(38.5±3.1)% vs.(36.9±3.0)%, (744.5±246.7)ng/L vs.(983.3±326.1)ng/L, (323.4±60.5)m vs.(283.5±45.9)m, P 0.05). Conclusions Compared with benazepril, sacubitril/valsartan can improve the left ventricular function and exercise tolerance, and reduce the readmission rate due to chronic heart failure in patients with dilated cardiomyopathy.However, more studies are needed to assess the effects of sacubitril/valsartanthe on the prognosis of advanced elderly patients(>88 years old)who have a preserved LVEF and a chronic end-stage heart failure(NYHA Ⅳ), and start the drug administration at different time points(before or after discharge). Key words: Cardiomyopathy, dilated; Heart failure; Sacubitril/Valsartan