MicroRNA-155与沙库巴曲缬沙坦治疗心肌梗死后射血分数降低心力衰竭患者疗效的关系

The relationship between microRNA-155 and therapeutic efficacy of sacubitril/valsartan in patients with heart failure with reduced ejection fraction after myocardial infarction

摘要:

目的 分析沙库巴曲缬沙坦治疗心肌梗死后心力衰竭患者的疗效及microRNA-155（miR-155）水平与左心室射血分数的关系。方法 选取2019年1月—2020年12月在聊城市第四人民医院就诊的心肌梗死后射血分数降低心力衰竭患者80例。随机分为试验组和对照组，每组40例。对照组患者给予利尿剂等基础治疗。试验组患者在对照组治疗基础上额外给予沙库巴曲缬沙坦治疗。比较两组患者治疗前后LVEDVi、LVESVi、LVEF以及miR-155水平的差异，并分析miR-155水平与LVEF水平的相关性。结果 试验组治疗前后LVEDV、LVESV的差值小于对照组（P <0.05），LVEF水平及6min步行距离小于对照组（P <0.05）。试验组治疗前后miR-155相对表达量的的差值大于对照组（P <0.05）。miR-155相对表达量与LVEF的表达水平呈负相关（r =-0.447，P <0.05）。结论 心肌梗死后射血分数降低的心力衰竭患者经沙库巴曲缬沙坦治疗后，患者心功能评级明显改善，miR-155水平明显下降，且LVEF与miR-155水平呈负相关。

Abstract:

Objective To analyze the efficacy of sacubitril/valsartan in the treatment of patients with heart failure after myocardial infarction and the relationship between microRNA-155 (miR-155) level and left ventricular ejection fraction (LVEF).Methods A total of 80 patients with heart failure with reduced ejection fraction after myocardial infarction admitted to our hospital from January 2019 to December 2020 were enrolled. They were randomly divided into experimental group and control group, with 40 cases in each group. The control group was given diuretics and other basic treatment, while the experimental group was additionally treated with sacubitril/valsartan. The differences of left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), LVEF and miR-155 level before and after treatment in the two groups were measured, and the relationship between miR-155 level and LVEF was analyzed.Results Compared with the control group, the differences of LVEDV and LVESV before and after the treatment were higher (P < 0.05), while those of LVEF and 6‐min walk distance before and after the treatment were lower in the experimental group (P < 0.05). The difference of miR-155 level before and after the treatment in the experimental group was higher than that in the control group (P < 0.05). Besides, the relative expression level of miR-155 negatively correlated with LVEF (r = -0.447, P < 0.05).Conclusions After the treatment with sacubitril/valsartan, heart failure patients with reduced ejection fraction after myocardial infarction exhibited improved cardiac function and decreased miR-155 level, and LVEF was negatively correlated with miR-155 level.