Abstract:

Objective To investigate the efficacy and safety of recombinant human brain natriuretic peptide（rhBNP）⁃Sacubitril/Valsartan in the sequential treatment of acute heart failure from admission to vulnerable period（3 months after onset）. Methods A total of 132 patients with acute heart failure（AHF）were selected during Jan. 2018 to Oct. 2019. They were randomly divided into conventional group（n = 46），rhBNP group（n = 45） and sequential group（n = 41）. The patients in the conventional group were given routine regimen，such as digitalis， diuretic，valsartan，and β⁃blocker during hospitalization. Those in the rhBNP group were treated with rhBNP for 3 ~ 5 days within 24 hours after admission on the basis of routine regimen and those in the sequential group were treated on the basis of rhBNP group while Sacubitril/Valsartan was added into the regimen after stopping administra⁃ tion of rhBNP. The three groups were compared in terms of the changes of cardiac function，renal function，incidence of hypotension，quality of life and heart failure re⁃admission. Results At discharge，there were statistical differenc⁃ es on the level of NT⁃proBNP among the 3 groups（P < 0.05）. The levels of the NT⁃proBNP in rhBNP group and sequential group decreased mostly. The incidence of hypotension was significantly different among the 3 groups（P < 0.05），the lowest in the conventional group. After 3⁃month follow⁃up，there was a statistical difference in the level of NT⁃proBNP among the 3 groups（P < 0.05），the lowest in the sequential group. There were significant differences in Minnesota living with heart failure questionnaire（MLHFQ）scores among the 3 groups（P < 0.05）. There were signif⁃ icant differences in the number of heart failure re⁃admission cases among the 3 groups（P < 0.05），the least in the sequential group. Conclusion The sequential treatment with rhBNP ⁃ sacubitril/valsartan can improve cardiac function and quality of life，reduce the risk of re⁃admission within 3 months in patients with acute heart failure.

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