沙库巴曲缬沙坦对房颤伴心功能不全、心功能正常射频消融术后患者心功能及房颤复发率的影响

Effects of sacubitril valsartan on cardiac function and recurrence rate of atrial fibrillation in patients with atrial fibrillation complicated with cardiac insufficiency and normal cardiac function after radiofrequency ablation

目的比较沙库巴曲缬沙坦对房颤伴心功能不全、心功能正常射频消融术后患者心功能及房颤复发率的影响。方法选取47例经射频消融术治疗的房颤患者,根据心功能情况将其分为心功能不全组(18例)与心功能正常组(29例)。两组均给予沙库巴曲缬沙坦治疗,比较两组的治疗效果。结果术后随访1年,两组的超敏C反应蛋白(hs-CRP)水平低于术后即刻,差异具有统计学意义(P<0.05);术后即刻,心功能不全组的N-末端B型脑钠肽前体(NT-proBNP)水平高于心功能正常组,差异具有统计学意义(P<0.05);术后随访1年,心功能不全组的NT-proBNP水平低于术后即刻,差异具有统计学意义(P<0.05)。术后随访1年,心功能不全组的左心室舒张末期内径(LVEDD)、左心房前后径(LAD)低于术后即刻,左心室射血分数(LVEF)高于术后即刻,差异具有统计学意义(P<0.05)。术后随访1年,共4例房颤复发(8.51%),其中心功能不全组2例(11.11%),心功能正常组2例(6.90%),两组间比较,差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦应用于房颤伴心功能不全射频消融术后患者,可改善心功能和心脏重构,并达到与心功能正常者相同的效果。

Objective To compare the effects of sacubitril valsartan on cardiac function and recurrence rate of atrial fibrillation in patients with atrial fibrillation complicated with cardiac insufficiency and normal cardiac function after radiofrequency ablation.Methods A total of 47 patients with atrial fibrillation treated by radiofrequency ablation were selected and divided into cardiac insufficiency group(18 cases)and normal cardiac function group(29 cases)according to cardiac function.Both groups were treated with sacubitril valsartan,and the therapeutic effects of the two groups were compared.Results At 1 year of postoperative follow-up,the level of hypersensitive C-reactive protein(hs-CRP)in the two groups was lower than that immediately after operation,and the difference was statistically significant(P<0.05);immediately after operation,the level of N-terminal pro-B-type natriuretic peptide(NT-proBNP)in the cardiac insufficiency group was higher than that in the normal cardiac function group,and the difference was statistically significant(P<0.05);at 1 year of postoperative follow-up,the level of NT-proBNP in the cardiac insufficiency group was lower than that immediately after operation,and the difference was statistically significant(P<0.05).At 1 year of postoperative follow-up,left ventricular end diastolic diameter(LVEDD)and left atrial diameter(LAD)in the cardiac insufficiency group were lower than those immediately after operation,left ventricular ejection fraction(LVEF)was higher than that immediately after operation,and the differences were statistically significant(P<0.05).At 1 year of postoperative follow-up,4 cases(8.51%)of atrial fibrillation recurred,including 2 cases(11.11%)in the cardiac insufficiency group and 2 cases(6.90%)in the normal cardiac function group,and there was no statically significant difference between the two groups(P>0.05).Conclusion The application of sacubitril valsartan in patients with atrial fibrillation and cardiac insufficiency after radiofrequency ablation can improve cardiac function and cardiac remodeling,and achieve the same effect as those with normal cardiac function.