Therapeutic effect and safety of L-carnitine combined with sacubitril valsartan in patients with heart failure and renal insufficiency
10.3969/j.issn.1008-0074.2024.06.11
- VernacularTitle:左卡尼汀联合沙库巴曲缬沙坦对心力衰竭合并肾功能不全患者的疗效及安全性
- Author:
Bing LIAO
1
;
Ye LIANG
1
;
Lu LI
1
;
Xiang-ning YU
1
Author Information
1. 南宁市第一人民医院肾内科,广西南宁 530022
- Publication Type:Journal Article
- Keywords:
Heart failure;
Renal insufficiency;
L-carnitine;
Sacubitril/Valsartan
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2024;33(6):704-709
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aims to investigate therapeutic effect and safety of L-carnitine(LC)combined with sacubitril valsartan in patients with heart failure(HF)and renal insufficiency,and their influence on serum lev-els of Irisin,soluble growth stimulation expressed gene 2(sST2)and N terminal pro brain natriuretic peptide(NT-proBNP).Methods:This randomized control study enrolled 150 HF patients with renal insufficiency admitted in First People's Hospital of Nanning between January 2018 and December 2020.The patients were divided into control group(n=75,sacubitril valsartan therapy)and combined treatment group(n=75,LC combined sacubitril valsartan therapy),each group received corresponding therapy based on routine treatment.After 4-week continuous treat-ment,clinical therapeutic effect,safety,kidney function,cardiac function,blood gas,serum levels of Irisin,sST2 and NT-proBNP were compared between two groups.Results:Total effective rate of combined treatment group was significantly higher than that of control group(97.33％vs.86.67％,P=0.016).Compared with patients in control group after treatment,those in combined treatment group had significant higher left ventricular ejection fraction(LVEF)[(42.70±1.49)％vs.(45.12±1.68)％],Irisin[(406.36±20.05)ng/L vs.(426.19±15.58)ng/L]and arterial partial pressure of oxygen(PaO2)[(78.94±2.71)mmHg vs.(88.87±2.24)mmHg](P＜0.001 all),and significant lower left ventricular end-systolic diameter(LVESd)[(41.17±1.34)mm vs.(33.88±1.13)mm],left ventricular end-diastolic diameter(LVEDd)[(50.54±2.12)mm vs.(43.04±2.08)mm],NT-proBNP[(1939.15±186.14)ng/L vs.(1344.42±145.85)ng/L],serum creatinine(Scr)[(273.61±13.24)μmol/L vs.(242.38±9.57)μmol/L],blood urea nitrogen(BUN)[(14.16±1.16)μmol/L vs.(10.01±1.26)μmol/L],arterial partial pressure of carbon dioxide(PCO2)[(37.61±2.27)mmHg vs.(31.76±1.40)mmHg]and sST2[(44.35±4.65)μg/L vs.(38.52±3.66)μg/L](P＜0.001 all).We detected no significant difference in incidence of adverse reactions between two groups(P=0.716).Conclusion:L-carnitine combined with sacubitril valsartan has good efficacy and safety in the treatment of HF patients with renal insufficiency,which can effectively reduce the levels of NT-proBNP and sST2,and improve renal function and cardiac function.
