Effects of Qili Qiangxin granules in combination with Entresto on quantitative parameters of myocardial motion in patients with cardiomyopathy in end-stage renal disease

Cardiomyopathy is a devastating complication of end-stage renal disease (ESRD), characterized by complex remodeling and high cardiovascular mortality. While sacubitril/valsartan (Sac/Val) and Qili Qiangxin (QLQX) granules have shown individual benefits in heart failure, their combined efficacy in ESRD patients remains poorly defined. To evaluate the impact of adjunctive QLQX therapy with Sac/Val on quantitative myocardial motion, cardiac function, and hemodynamic parameters in patients with ESRD. In this retrospective cohort study, 109 ESRD patients with heart failure with reduced ejection fraction (HFrEF) were enrolled. Patients were divided into a control group (n = 53, Sac/Val alone) and an observation group (n = 56, Sac/Val plus QLQX). Comprehensive 2D and 4D echocardiography, including speckle-tracking for global longitudinal strain (GLS), was performed after 3 months of treatment. Compared to the control group, the observation group demonstrated significantly higher left ventricular ejection fraction ( LVEF, 45.2 ± 5.8% vs. 40.5 ± 5.2%, t = 4.446, P<0.0001) and improved GLS (-17.1 ± 2.3% vs. -15.2 ± 2.1%, P = 0.018). Significant enhancements were also observed in peak systolic myocardial velocity, cardiac output, and left atrial emptying fraction (all P < 0.05). Furthermore, the observation group showed favorable shifts in diastolic indices (E/E’ ratio and isovolumic relaxation time) and right ventricular performance (TAPSE and Tei index) (P < 0.05). The combination of QLQX and Sac/Val is associated with modest but statistically significant improvements in biventricular systolic and diastolic function in ESRD patients. These findings suggest a potential synergistic effect on myocardial mechanics, providing a hypothesis-generating basis for larger prospective trials.