Abstract:

Objective To compare the therapeutic effects of conventional dose of sacubitril⁃valsartan（ARNI）and target dose of ACEI in patients with heart failure with reduced ejection fraction（HFrEF）. Methods Totally 223 patients with heart failure diagnosed as dilated cardiomyopathy were continuously included in our hospital，of which 111 patients were treated with ARNI （experimental group） and 112 with ACEI standard treatment（control group），in addition to the treatments followed the guidelines. Follow⁃up treatment for 18 months wasconducted. Results The average dose of ARNI was 138.96 mg，and 1.8% of the patients achieved target dose.The target dose reached in 47.3% of the patients in the control group. The clinical efficiency，6⁃minute walking testand SBP decrease in the experimental group were all higher than those in the control group，and BNP and MLHFQscores，readmitted time and times were all lower than those in the control group（P < 0.05）. Conclusions In thereal world treatment of HFrEF patients in our hospital，a very small number of patients achieve the target dose ofARNI. However，the effect of frequently⁃used dose of ARNI is not inferior to that of target dose of ACEI in terms ofinhibiting ventricular remodeling，while the improvement of quality of life is even obvious.

Key words: sacubitril?valsartan, heart failure, angiotensin converting enzyme inhibitors, cohort study