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

BACKGROUND: 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. OBJECTIVE: To evaluate the impact of adjunctive QLQX therapy with Sac/Val on quantitative myocardial motion, cardiac function, and hemodynamic parameters in patients with ESRD. METHODS: 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. RESULTS: 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). CONCLUSION: 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.