EFFECTS OF SACUBITRIL/VALSARTAN ON CARDIAC FUNCTION, VENTRICULAR REMODELING AND SERUM NT-PROBNP, CTNT, ICAM-1 IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND HEART FAILURE

Jing Wu¹, Nana Shi², Jie Ren², Gaibian Mou^2*

¹Department of Surgical Oncology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China - ²Department of Cardiovascular Medicine, the Fourth People’s Hospital of Shaanxi Province, Xi'an 710043, Shaanxi Province, China

Objective: To investigate the effects of sacubitril/valsartan on cardiac function, ventricular remodeling and serum NT-proBNP, cTnT, ICAM-1 in patients with acute myocardial infarction and heart failure.

Methods: 240 patients with acute myocardial infarction and heart failure admitted to our hospital from April 2015 to August 2019 were selected for comparative treatment. They were divided into a study group (120 cases) and a control group (120 cases) using a random number method. The patients in the control group were given conventional drugs and symptomatic treatment, and the study group was given sacubitril/valsartan for comparison with the control group. The clinical effect, cardiac function measurements (including left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), left ventricular ejection fraction (LVEF)), and ventricular remodeling indicators (including diastolic ventricular septal thickness (IVST), diastolic left posterior wall thickness (LVPWT) and left ventricular mass index (LVMI)) were measured. In addition, differences in NT-proBNP, cTnT and ICAM-1 concentrations were analysed. 

Results: The total effective rate of the study group was significantly higher than that of the control group (P<0.05). For both groups, the mean LVESV and LVEDV were significantly smaller after treatment, with greater volume reductions in the study group than in the control group (P<0.05). LVEF values were found to be significantly higher after treatment, with larger increases in the study group than in the control group, with a statistically significant difference (P<0.05). After treatment, both groups exhibited lower IVST and LVPWT than before treatment, with significantly larger decreases in the study group than in the control group (P<0.05). LVMI values were significantly higher following treatment, with significantly higher increases in the study group than in the control group (P<0.05). After treatment, NT-proBNP, cTnT and ICAM-1 all showed significant decreases in the two groups, with all three indexes being significantly lower in the study group than those in the control group (P<0.05). 

Conclusion: Sacubitril/valsartan was found to significantly improve cardiac function and ventricular remodeling, and reduce the inflammatory response when used for the treatment of acute myocardial infarction with heart failure. With significant clinical effects, it is worthy of clinical application.