Clinical trial of sacubitril/valsartan in the treatment of Pulmonary hypertension (PH) due to left heart disease (LHD)

doi:10.12092/j.issn.1009-2501.2019.01.010

Abstract

Abstract:

AIM: To observe the clinical efficacy of sacubitril/valsartan in patients with pulmonary hypertension due to left heart disease (PH-LHD) as well as investigate the mechanism of it. METHODS: A total of 60 patients including 35 males and 25 females with PH-LHD were randomly divided into control group（n=30 cases）and observation group（n=30 cases）. Observation group was treated with sacubitril/valsartan by 50 mg twice daily and control group with valsartan by 80 mg daily on the basis of routine treatment. The world health organization functional class (WHO-FC), 6-minute walking distance (6MWD) were compared before and 90 days after treatment between the two groups. The plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and endothelin-1(ET-1) as well as the serum level of sICAM-1and sCD40L were measured before and after treatment by ELISA. Concomitantly, left ventricular end diastolic diameter (LVEDD), right ventricular end diastolic diameter (RVEDD), left atrial diameter (LAD), tricuspid regurgitant velocity (TRV), ejection fraction (EF), pulmonary arterial systolic pressure (PASP) were measured before and after treatment by echocardiography. RESULTS: No significant differences of WHO-FC, 6MWD and EF between the two groups prior to administration of sacubitril/valsartan were observed （P=0.371）, whereas the factors monitored above show a remarkable amelioration in observation group compared to the control group after treatment （P<0.05）. In addition, utility of sacubitril/valsartan has shown more efficacy on the blood levels of NT-proBNP, ET-1, sICAM-1, sCD40L and LVEDD,RVEDD,LAD,TRV,EF and PASP in observation group. CONCLUSION: Sacubitril/valsartan can effectively reduce PASP as well as blood levels of ET-1,sICAM-1 and sCD40L in patients with pulmonary hypertension due to left heart disease，improve the cardiac function and prognosis, relieve the clinical symptoms with relatively high safety.

Key words: heart failure, congestive, hypertension, pulmonary, sacubitril/valsartan

CLC Number:

R544.1

WEI Zihan,LI Dongbo，YUAN Zheng,LU Ying, YANG Guojie. Clinical trial of sacubitril/valsartan in the treatment of Pulmonary hypertension (PH) due to left heart disease (LHD)[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2019, 24(1): 57-62.

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