Objective To study the domestic market environment and its advantages and disadvantages of angiotensin receptor-neprilysin inhibitor(ARNI)anti-heart failure drugs so as to provide reference for the promotion of this s...Objective To study the domestic market environment and its advantages and disadvantages of angiotensin receptor-neprilysin inhibitor(ARNI)anti-heart failure drugs so as to provide reference for the promotion of this sort of drugs in Chinese market.Methods Based on SWOT model,the anti-heart failure drugs were analyzed from four aspects:strength,weakness,opportunity and threat.Results and Conclusion ARNI anti-heart failure drugs have greater opportunities than threats in China,and their advantages outweigh the disadvantages.However,in order to gain more market share,it is still necessary to pay attention to the clinical verification of their long-term safety and effectiveness.In addition,consumers are interested in the price of ARNI anti-heart failure drugs and its popularity.展开更多
This study aims to evaluate the torsional dynamics and 2D speckle tracking in heart failure with reduced ejection fraction on patients taking angiotensin receptor neprilysin inhibitors (ARNI) and none.?ARNI has been s...This study aims to evaluate the torsional dynamics and 2D speckle tracking in heart failure with reduced ejection fraction on patients taking angiotensin receptor neprilysin inhibitors (ARNI) and none.?ARNI has been shown to be superior to enalapril in?the?long term reducing the mortality and hospitalization of heart failure (HF). However short-term effects on diastolic function remain unclear. We sought to evaluate 6 months' effects of ARNI on left ventricular (LV) diastolic parameters determined by speckle tracking and tissue Doppler imaging. This study was carried out in Menoufia University Hospitals including 60 patients of HFrEF during the period from August 2019 to January 2020. (50%) of patients were?treated with traditional treatment of heart failure and the remaining were?treated with ARNI. Data were collected including history and clinical examination. ECG and speckle tracking and tissue Doppler imaging were?done to evaluate the diastolic function. Our results showed no significant difference between the two groups at baseline. There was?a?significant improvement?in?the LV diastolic function parameters. Untwisting?time and untwisting?onset showed the highly significant parameters of improvement. This study concluded that ARNI showed short term improvement of diastolic function of the left ventricle that could be detected by STE.展开更多
Objective:To systematically review the effect of Sacubitril valsartan combined with Qiliqiangxincapsule on clinical effect,serological index,cardiac function,quality of live,and adverse reactions in patients with hear...Objective:To systematically review the effect of Sacubitril valsartan combined with Qiliqiangxincapsule on clinical effect,serological index,cardiac function,quality of live,and adverse reactions in patients with heart failure.Methods:Search the databases of CNKI,VIP,WanFang,CBM,DuXiu,ChiCTR,Web of science,The Cochrane Library,PubMed and Embase to collect the randomized controlled trial(RCT)of Sacubitril valsartan combined with Qiliqiangxin capsule in the treatment of patients with heart failure,The search time limit is from the establishment of the database to May 2021.After the literatures were screened,evaluated and extracted by two researchers independently,Meta analysis was carried out with Stata 16.1 software.Results:A total of 18 RCTs,were included,including 1613 patients.The results of the Meta-analysis showed that there was statistical significance in improving the effective rate(OR=2.60,95%CI[2.09,3.24],P<0.00001),N-terminal pro-brain natriuretic peptide(MD=-468.36,95%CI[-606.80,-329.92],P<0.00001),left ventricular ejection fraction(MD=5.41,95%CI[4.93,5.89],P<0.00001),left ventricular end-diastolic diameter(MD=-3.27,95%CI[-3.65,-2.90],P<0.00001),left ventricular end-systolic diameter(MD=-3.60,95%CI[-4.99,-2.21],P<0.00001),6-minute walking distance(MD=61.42,95%CI[50.04,72.80],P<0.00001),Minnesota living with heart failure questionnaire(MD=-11.39,95%CI[-14.50,-8.28],P<0.00001),and traditional Chinese medicine syndrome score scale(MD=-3.62,95%CI[-6.45,-0.80],P=0.01),but there was no significant difference in cardiac output(MD=0.26,95%CI[-0.02,0.54],P=0.07)and adverse reactions.Conclusion:The current evidence shows that Sacubitril Valsartan combined with Qiliqiangxin capsule can better improve cardiac function,TCM symptoms and quality of life in patients with heart failure than simple Sacubitril Valsartan.However,there was no significantdifference in improving cardiac output between the two groups.However,higher quality RCTs are needed to verify.展开更多
Background: Heart failure with reduced ejection fraction has a significant association with considerable morbidity and mortality, but there is still inadequacy in appropriate treatment to prevent this condition. We ob...Background: Heart failure with reduced ejection fraction has a significant association with considerable morbidity and mortality, but there is still inadequacy in appropriate treatment to prevent this condition. We observed the effect of angiotensin receptor neprilysin inhibitor (ARNi) with such disorder compared to valsartan. Methods: In this single-blind trial, the patients were enrolled with chronic HF aged on or above 40 years, symptomatic NYHA class II - IV, an elevated NT-proBNP above 400 pg/ml level and a reduced LVEF of 40% or less. The patients were randomly assigned 1:1 to the treatment arms either ARNi (50 mg titrated to 100 mg twice a day) or valsartan (40 mg titrated to 80 mg twice a day) and followed for a median of 88 days. The primary outcome was mode of cardiovascular death and re-hospitalization for heart failure. Changes in the level of NT-proBNP and rate of ejection fraction were also measured. Results: Cardiovascular deaths occurred 4 (8%) in the ARNi treatment arm, while 11 (22%) in the valsartan treatment arm with significant hazard ratio in the ARNi group [Hazard Ratio = 0.37;95% CI: 0.34, 0.64;p = 0.042] during a median of 88 days of follow up period and 2 (4%) of the patients from the ARNi treatment arm were hospitalized due to HF, while in the valsartan treatment arm, 10 (20%) patients were hospitalized due to HF followed by receiving treatment respectively with hazard ratio in the ARNi group [Hazard Ratio = 0.80;95% CI: 0.57, 0.92;p Conclusion: Chronic treatment with the angiotensin receptor neprilysin inhibitor (ARNi) strongly decreases the NT-proBNP as well as morbidity and mortality and increases LVEF in patients with heart failure compared to valsartan.展开更多
文摘Objective To study the domestic market environment and its advantages and disadvantages of angiotensin receptor-neprilysin inhibitor(ARNI)anti-heart failure drugs so as to provide reference for the promotion of this sort of drugs in Chinese market.Methods Based on SWOT model,the anti-heart failure drugs were analyzed from four aspects:strength,weakness,opportunity and threat.Results and Conclusion ARNI anti-heart failure drugs have greater opportunities than threats in China,and their advantages outweigh the disadvantages.However,in order to gain more market share,it is still necessary to pay attention to the clinical verification of their long-term safety and effectiveness.In addition,consumers are interested in the price of ARNI anti-heart failure drugs and its popularity.
文摘This study aims to evaluate the torsional dynamics and 2D speckle tracking in heart failure with reduced ejection fraction on patients taking angiotensin receptor neprilysin inhibitors (ARNI) and none.?ARNI has been shown to be superior to enalapril in?the?long term reducing the mortality and hospitalization of heart failure (HF). However short-term effects on diastolic function remain unclear. We sought to evaluate 6 months' effects of ARNI on left ventricular (LV) diastolic parameters determined by speckle tracking and tissue Doppler imaging. This study was carried out in Menoufia University Hospitals including 60 patients of HFrEF during the period from August 2019 to January 2020. (50%) of patients were?treated with traditional treatment of heart failure and the remaining were?treated with ARNI. Data were collected including history and clinical examination. ECG and speckle tracking and tissue Doppler imaging were?done to evaluate the diastolic function. Our results showed no significant difference between the two groups at baseline. There was?a?significant improvement?in?the LV diastolic function parameters. Untwisting?time and untwisting?onset showed the highly significant parameters of improvement. This study concluded that ARNI showed short term improvement of diastolic function of the left ventricle that could be detected by STE.
文摘Objective:To systematically review the effect of Sacubitril valsartan combined with Qiliqiangxincapsule on clinical effect,serological index,cardiac function,quality of live,and adverse reactions in patients with heart failure.Methods:Search the databases of CNKI,VIP,WanFang,CBM,DuXiu,ChiCTR,Web of science,The Cochrane Library,PubMed and Embase to collect the randomized controlled trial(RCT)of Sacubitril valsartan combined with Qiliqiangxin capsule in the treatment of patients with heart failure,The search time limit is from the establishment of the database to May 2021.After the literatures were screened,evaluated and extracted by two researchers independently,Meta analysis was carried out with Stata 16.1 software.Results:A total of 18 RCTs,were included,including 1613 patients.The results of the Meta-analysis showed that there was statistical significance in improving the effective rate(OR=2.60,95%CI[2.09,3.24],P<0.00001),N-terminal pro-brain natriuretic peptide(MD=-468.36,95%CI[-606.80,-329.92],P<0.00001),left ventricular ejection fraction(MD=5.41,95%CI[4.93,5.89],P<0.00001),left ventricular end-diastolic diameter(MD=-3.27,95%CI[-3.65,-2.90],P<0.00001),left ventricular end-systolic diameter(MD=-3.60,95%CI[-4.99,-2.21],P<0.00001),6-minute walking distance(MD=61.42,95%CI[50.04,72.80],P<0.00001),Minnesota living with heart failure questionnaire(MD=-11.39,95%CI[-14.50,-8.28],P<0.00001),and traditional Chinese medicine syndrome score scale(MD=-3.62,95%CI[-6.45,-0.80],P=0.01),but there was no significant difference in cardiac output(MD=0.26,95%CI[-0.02,0.54],P=0.07)and adverse reactions.Conclusion:The current evidence shows that Sacubitril Valsartan combined with Qiliqiangxin capsule can better improve cardiac function,TCM symptoms and quality of life in patients with heart failure than simple Sacubitril Valsartan.However,there was no significantdifference in improving cardiac output between the two groups.However,higher quality RCTs are needed to verify.
文摘Background: Heart failure with reduced ejection fraction has a significant association with considerable morbidity and mortality, but there is still inadequacy in appropriate treatment to prevent this condition. We observed the effect of angiotensin receptor neprilysin inhibitor (ARNi) with such disorder compared to valsartan. Methods: In this single-blind trial, the patients were enrolled with chronic HF aged on or above 40 years, symptomatic NYHA class II - IV, an elevated NT-proBNP above 400 pg/ml level and a reduced LVEF of 40% or less. The patients were randomly assigned 1:1 to the treatment arms either ARNi (50 mg titrated to 100 mg twice a day) or valsartan (40 mg titrated to 80 mg twice a day) and followed for a median of 88 days. The primary outcome was mode of cardiovascular death and re-hospitalization for heart failure. Changes in the level of NT-proBNP and rate of ejection fraction were also measured. Results: Cardiovascular deaths occurred 4 (8%) in the ARNi treatment arm, while 11 (22%) in the valsartan treatment arm with significant hazard ratio in the ARNi group [Hazard Ratio = 0.37;95% CI: 0.34, 0.64;p = 0.042] during a median of 88 days of follow up period and 2 (4%) of the patients from the ARNi treatment arm were hospitalized due to HF, while in the valsartan treatment arm, 10 (20%) patients were hospitalized due to HF followed by receiving treatment respectively with hazard ratio in the ARNi group [Hazard Ratio = 0.80;95% CI: 0.57, 0.92;p Conclusion: Chronic treatment with the angiotensin receptor neprilysin inhibitor (ARNi) strongly decreases the NT-proBNP as well as morbidity and mortality and increases LVEF in patients with heart failure compared to valsartan.
