Objective  To investigate the clinical effect of sacubitril valsartan sodium combined with metoprolol sustained-release tablets in the treatment of refractory heart failure.

  Methods  A total of 159 patients with refractory heart failure in our hospital were divided into combination group (n=80) and reference group (n=79) according to the treatment plan. The original treatment plan was re-examined, and the combined anti-heart failure treatment was applied. The reference group was added with metoprolol sustained-release tablets, and the combined group was combined with sacubitril valsartan sodium and metoprolol sustained-release tablets. Clinical efficacy, adverse reactions and cardiac function left ventricular ejection fraction (LVEF), stroke volume (SV), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), serum intercellular adhesion molecule-1 (ICAM-1), N-terminal B-type brain natriuretic peptide (NT-proBNP), aldosterone (ALD) levels, Minnesota Living with Heart Failure Questionnaire(MLHFQ) scores were compared between the two groupsbefore treatment and after 8-week treatment.

  Results  The total effective rate of the combined group was higher than that of the reference group88.75% (71/80) vs. 73.42% (58/79), P < 0.05. The serum ICAM-1, NT-proBNP, ALD level of the combined group after 8 weeks of treatment were lower than that of the reference group (P < 0.05); after 8 weeks of treatment, LVESD and LVEDD were lower, and LVEF and SV were larger than that of the reference group (P < 0.05). After 8 weeks of treatment, the MLHFQ scores of both groups were significantly lower, and the combined group was lower than that of the reference group (P < 0.05). No intolerance occurred in the two groups, and the adverse reactions were mild, without any impact on the treatment. The incidence of adverse reactions in the combined group was 5.00% (4/80), and 3.90% (3/77) in the reference group, but there was no significant difference (P>0.05).

  Conclusion  sacubitril valsartan sodium combined with metoprolol sustained-release tablets is safe and effective in the treatment of refractory heart failure, which can further reduce serum ICAM-1, NT-proBNP, ALD levels, improve heart function and quality of life, and can not increase adverse reactions.