维立西呱联合 "新四联" 药物对扩张型心肌病心衰患者的治疗 效果分析.

刘加宝; 张艳娟; 王连生; 赵 迪

Objective: To explore the clinical efficacy and safety of vericiguat combined with the "new quadruple" in treating heart failure caused by dilated cardiomyopathy (DCM). Methods: Between December 1, 2022 and February 1, 2024, a total of 43 patients with heart failure resulting from DCM (33 males, 10 females) were consecutively recruited from the outpatient clinic and inpatient wards of the Cardiology Department at the First Affiliated Hospital of Nanjing Medical University. Before treatment, various parameters were measured, including left atrial diameter (LAD), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), N -terminal pro B -type natriuretic peptide (NT - proBNP), liver and kidney function, electrolytes, Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores, and 6 - minute walk test (6MWT) distances. Patients with heart failure with reduced ejection fraction (HFrEF) or mildly reduced ejection fraction (HFmrEF) were treated with vericiguat combined with“ARNI, BB, MRA, SGLT2i" (the "new quadruple" therapy) . For patients with heart failure with preserved ejection fraction (HFpEF), vericiguat was combined with ARNI, BB, and SGLT2i. After 3 months of treatment, the aforementioned indicators were re -evaluated and compared with baseline values. Results: After 3 months of treatment, significant improvements were observed in all DCM patients with heart failure: LAD [ (41.37±6.97) mm vs. (39.30±5.19) mm, P < 0.01) ]; LVEF [ (41.02±10.33) % vs. (46.43±10.74) %, P < 0.01) ]; LVEDD [ (61.40±7.65) mm vs. (58.56±7.03) mm, P < 0.01) ]; NT-proBNP [1 642.5 (936.4, 4 019.0) ng/L vs. 659.3 (213.2, 1 297.0) ng/L, P < 0.01) ]; MLHFQ (47.79 ± 9.67 vs. (34.86 ± 8.94), P < 0.01) ; 6MWT [ (348.85 ± 82.43) m vs (. 401.76 ± 95.56) m, P < 0.01) ]. No significant differences were found in liver or kidney function, or electrolytes levles. Further subgroup analysis showed that vericiguat combined with ARNI, BB, MRA, and SGLT2i improved the LVEF, reduced LVEDD and NT - proBNP levels, and enhanced 6MWT performance in patients with HFrEF, HFmrEF, and HFpEF due to DCM. Conclusion: Vericiguat combined with the "new quadruple" drugs has a significant therapeutic effect on patients with heart failure caused by DCM. This study provides potential data support and guidance for the clinical treatment of DCM patients with heart failure.

HEART failure patients; VENTRICULAR ejection fraction; LEFT heart atrium; HEART failure; KIDNEY physiology

Journal of Nanjing Medical University: Natural Sciences, 2024, Vol 44, Issue 12, p1682

1007-4368

Academic Journal

10.7655/NYDXBNSN240705