Volume 44 Issue 11
Nov.  2023
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Meng SHANG, Xiaolong GAO, Xiaohui KUANG, Xi ZHANG, Jin ZHANG, Lilin WANG. Application of Sacubitril/valsartan in Patients with Chronic Heart Failure Implanted with Implantable Cardioverter Defibrillators[J]. Journal of Kunming Medical University, 2023, 44(11): 63-69. doi: 10.12259/j.issn.2095-610X.S20231109
Citation: Meng SHANG, Xiaolong GAO, Xiaohui KUANG, Xi ZHANG, Jin ZHANG, Lilin WANG. Application of Sacubitril/valsartan in Patients with Chronic Heart Failure Implanted with Implantable Cardioverter Defibrillators[J]. Journal of Kunming Medical University, 2023, 44(11): 63-69. doi: 10.12259/j.issn.2095-610X.S20231109

Application of Sacubitril/valsartan in Patients with Chronic Heart Failure Implanted with Implantable Cardioverter Defibrillators

doi: 10.12259/j.issn.2095-610X.S20231109
  • Received Date: 2022-08-22
    Available Online: 2023-11-09
  • Publish Date: 2023-11-30
  •   Objectives  To investigate the effects of sacubitril/valsartan (S/V) on cardiac function and ventricular arrhythmias in patients with chronic heart failure with reduced ejection fraction(HFrEF)who underwent primary prevention of sudden cardiac death (SCD) after implantation of an implantable cardioverter defibrillator (ICD).   Methods  HFrEF patients who were hospitalized in the Cardiovascular Department of the First People’ s Hospital of Yunnan Province from September 2017 to December 2022 and received S/V treatment and ICD implantation for primary prevention of SCD were included. ① We calculated the S/V dose of patients at 12 months of follow-up, as well as cardiac ultrasound indicators (LVEF, LVEDD, LAD) at 3, 6, and 12 months of treatment; ② ICD was used to record ventricular arrhythmia events and treatment status, dynamic electro-cardiogram indicators: average number of ventricular premature beats per hour, standard deviation (SDNN) of all sinus rhythm RR intervals, and corrected average QT interval (QTc).   Results  A total of 56 patients were included. (1) At one-year follow-up, the average medication dose for S/V in all patients was 94.6 mg bid. (2) Following up for 3 months, LVEF, LVEDD, and LAD improved compared to before treatment (P < 0.05); LVEF, LVEDD, and LAD improved after 6 months of follow-up compared to 3 months of treatment (P < 0.05); LVEF, LVEDD, and LAD improved after 12 months of follow-up compared to 6 months of treatment (P < 0.05). (3) Compared with 1-6 months of follow-up, the incidence of VT/VF, NSVT and monitored ventricular brachytherapy decreased during 7-12 months of follow-up (P < 0.05).(4) Compared with before treatment, SDNN increased from (94.38±26.42)ms to (102.23±20.36)ms and average QTc decreased from (441.92±10.64)ms to (411.46±6.00)ms during 1-year follow-up(P < 0.05).   Conclusions  (1) For HFrEF patients implanted with ICD for primary prevention of SCD, their cardiac structure and function was continued to improve within one year of receiving S/V treatment; (2) S/V reduced the occurrence of ventricular arrhythmias during the follow-up period of this study.
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