诺欣妥与缬沙坦治疗新发高血压急性心力衰竭的效果对比

doi:10.5246/jcps.2025.05.035

摘要/Abstract

摘要：

本研究旨在评价诺欣妥与缬沙坦治疗新发高血压急性心力衰竭的效果对比。收集63例高血压急性心力衰竭患者进行回顾性研究, 分为诺欣妥组(n = 32)和缬沙坦组(n = 31)。分析患者的基线、住院期间和随访时的临床资料、实验室检查、超声心动图和心电图数据。与缬沙坦组相比, 诺欣妥组患者的收缩压、舒张压、NT-proBNP、hs-TnI和肌酐显著降低, eGFR明显升高, LVEF和E/e'比值也有显著改善, LAD和LVMI减少。诺欣妥坦亦减少房颤、室性及室上性期前收缩、左束支传导阻滞等的发生。因此, 诺欣妥不仅在降低血压、实验室指标、改善心功能和减缓心脏重塑方面比缬沙坦更有效, 同时对新发高血压急性心力衰竭患者的肾功能损害和心律失常有良好的治疗效果。

关键词: 沙库巴曲/缬沙坦, 高血压, 急性, 心力衰竭, 心脏

Abstract:

In the present study, we aimed to investigate the clinical potential of sacubitril/valsartan compared with valsartan in patients with newly diagnosed hypertensive acute heart failure (H-AHF). A total of 63 patients were retrospectively enrolled from our hospital, with 32 patients assigned to the sacubitril/valsartan group and 31 patients to the valsartan group. Clinical characteristics, laboratory examinations, and echocardiographic data at baseline, during hospitalization, and follow-up were collected to assess. The results demonstrated that patients treated with sacubitril/valsartan achieved better control of systolic and diastolic blood pressures than those treated with valsartan. Sacubitril/valsartan also resulted in more significant reductions in N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin I (hs-TnI), and creatinine, as well as an increase in estimated glomerular filtration rate (eGFR). Moreover, sacubitril/valsartan significantly improved left ventricular ejection fraction (LVEF), the E/e' ratio [the ratio between the early diastolic filling velocity (E-wave) and early diastolic mitral annular velocity (E')], and reduced left atrial dimension (LAD) and left ventricular mass index (LVMI). Additionally, sacubitril/valsartan might offer potential benefits in managing cardiac arrhythmias such as atrial fibrillation, ventricular or supraventricular premature beats, and left bundle branch block (LBBB). No fatal or nonfatal adverse effects were observed in the sacubitril/valsartan group, although one patient in the valsartan group experienced angioedema. In conclusion, after short-term administration, sacubitril/valsartan proved to be more effective than valsartan in lowering blood pressure, improving cardiac function and remodeling, and enhancing biomarker profiles. Furthermore, it had favorable effects on renal function and cardiac arrhythmias in newly diagnosed H-AHF patients.

Key words: Sacubitril/valsartan, Hypertension, Acute, Heart failure, Cardiac

Supporting:

宫成霞, 王慧, 石孝云, 王文文, 巩会平. 诺欣妥与缬沙坦治疗新发高血压急性心力衰竭的效果对比[J]. 中国药学(英文版), 2025, 34(5): 458-469.

Chengxia Gong, Hui Wang, Xiaoyun Shi, Wenwen Wang, Huiping Gong. Comparative effectiveness of sacubitril/valsartan versus valsartan in patients with newly diagnosed hypertensive acute heart failure[J]. Journal of Chinese Pharmaceutical Sciences, 2025, 34(5): 458-469.

图/表 5

Table 1. Baseline and clinical characteristics of study population.

Figure 1. Comparison of change from baseline in BP between both treatments. SBP: systolic blood pressure. DBP: diastolic blood pressure (*P < 0.05; **P < 0.001).

Table 2. Inter-group comparison of changes in laboratory examination at week 1 and week 2.

Table 3. Inter-group comparison of echocardiographic analyses at week 2 and follow-up.

Table 4. Inter-group comparison of arrhythmic events at baseline and week 2.

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