Efficacy and safety of recombinant human brain natriuretic peptide combined with sacubitril/valsartan in patients with congestive heart failure and rapid atrial fibrillation based on echocardiographic assessment

Congestive heart failure (CHF) represents the end stage of various primary cardiomyopathies, with rapid atrial fibrillation (AF) being a common complication. This study employed echocardiography to evaluate the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) combined with sacubitril/valsartan (Sac/Val) in the treatment of CHF with rapid AF. A total of 187 patients with AF and CHF were randomized into control group, rhBNP group, Sac/Val group, and combination group. Patients were followed up for six months. Cardiac function parameters, including left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), and E-wave to A-wave (E/A) ratio, were assessed via echocardiography. Serological markers-renin, angiotensin II (Ang II), aldosterone (Ald), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble suppression of tumorigenicity 2 (sST2) were measured. Adverse reactions and adverse prognostic events were recorded. Compared to the control group, following treatment, the resting and exercise heart rate (HR), echocardiographic parameters LAD, and LVEDD were significantly reduced ( P < 0.05), LVEF and E/A were significantly increased ( P < 0.05), and the levels of serological indicators Renin, Ang II, Ald, NT-proBNP, and sST2 were significantly decreased in the rhBNP group, Sac/Val group, and combination group ( P < 0.05). The combination group suggested superior echocardiographic parameters, serological indicators, clinical total response rate (95.1 %), and adverse prognosis event rate (4.9 %) compared to the other three groups following treatment ( P < 0.05). Echocardiographic assessment demonstrated that the combination of rhBNP and Sac/Val effectively managed CHF with AF, improved cardiac function, reduced serological factor levels, and exhibited low rates of adverse reactions and poor prognosis events compared to either agent used alone.