Efficacy and safety of sacubitril/valsartan after six months in patients with heart failure with reduced ejection fraction and asymptomatic hypotension  

作　　者：An-Hu WU Zong-Wei LIN Zhuo-Hao YANG Hui ZHANG Jia-Yi HU Yi WANG Rui TANG Xin-Yu ZHANG Xiao-Ping JI Hui-Xia LU 

机构地区：[1]National Key Laboratory for Innovation and Transformation of Luobing Theory,The Key Laboratory of Cardiovascular Remodeling and Function Research,Chinese Ministry of Education,Chinese National Health Commission and Chinese Academy of Medical Sciences,Department of Cardiology,Qilu Hospital of Shandong University,Jinan,China

出　　处：《Journal of Geriatric Cardiology》2023年第12期855-866,共12页老年心脏病学杂志（英文版）

基　　金：supported by the National Natural Science Foundation of China(No.81873516&No.821704-63);the National Key Research and Development Program of China(2021YFF0501404&2021YFF0501403&2017YFC1308303);the Natural Science Foundation of Shandong Province(ZR2019PH030&ZR2019BH052);the China International Medical Foundation(Z-2019-42-1908-2).

摘　　要：BACKGROUND It is not clear whether sacubitril/valsartan is beneficial for patients with heart failure(HF)with reduced ejec-tion fraction(HFrEF)and low systolic blood pressure(SBP).This study aimed to investigate the efficacy and tolerability of sacu-bitril/valsartan in HFrEF patients with SBP<100 mmHg.METHODS&RESULTS An observational study was conducted on 117 patients,40.2%of whom had SBP<100 mmHg wit-hout symptomatic hypotension,and 59.8%of whom had SBP≥100 mmHg in an optimized HF follow-up management system.At the 6-month follow-up,52.4%of patients with SBP<100 mmHg and 70.0%of those with SBP≥100 mmHg successfully rea-ched the target dosages of sacubitril/valsartan.A reduction in the concentration of N-terminal pro-B-type natriuretic peptide was similar between patients with SBP<100 mmHg and SBP≥100 mmHg(1627.5 pg/mL and 1340.1 pg/mL,respectively;P=0.75).The effect of sacubitril/valsartan on left ventricular ejection fraction was observed in both SBP categories,with a 10.8%increase in patients with SBP<100 mmHg(P<0.001)and a 14.0%increase in patients with SBP≥100 mmHg(P<0.001).The effects of sac-ubitril/valsartan on SBP were statistically significant and inverse across both SBP categories(P=0.001),with an increase of 7.5 mmHg in patients with SBP<100 mmHg and a decrease of 11.5 mmHg in patients with SBP≥100 mmHg.No statistically signi-ficant differences were observed between the two groups in terms of the occurrence of symptomatic hypotension,deteriorating re-nal function,hyperkalemia,angioedema,or stroke.CONCLUSIONS Within an optimized HF follow-up management system,sacubitril/valsartan exhibited excellent tolerability and prompted left ventricular reverse remodeling in patients with HFrEF who presented asymptomatic hypotension.

关 键 词：PATIENTS HYPOTENSION DOSAGE 

分 类 号：R541.6[医药卫生—心血管疾病]