OBJECTIVE To evaluate the clinical efficacy of Shenfu Qiangxin Drink (SFQXD) in patients with heart failure with preserved ejection fraction (HFpEF) using speckle tracking imaging (STI) combined with novel myocardial fibrosis biomarkers.

METHODS A total of 108 HFpEF patients were computer-randomized into a conventional group (n=54) and a treatment group (n=54). The conventional group completed 49 cases, and the treatment group completed 48 cases. The conventional group received conventional Western medicine intervention combined with Shenfu Qiangxin Drink placebo granules, while the treatment group received conventional Western medicine intervention combined with Shenfu Qiangxin Drink granules. The treatment course for both groups was 12 weeks. Before and after treatment, the following parameters were observed in the two groups of patients: echocardiographic indicators left atrial anterior-posterior diameter (LAD), interventricular septum diastole (IVSd), left ventricular posterior wall thickness (LVPWT), left ventricular end-diastolic diameter (LVDd), ratio of early diastolic peak flow velocity to late diastolic peak flow velocity at the mitral valve orifice (E/A), left ventricular ejection fraction (LVEF), left ventricular strain rate systolic peak strain rate (SRs), early diastolic strain rate (SRe), late diastolic strain rate (SRa), global longitudinal strain (GLS), novel myocardial fibrosis indicators Galectin-3 (Gal-3), soluble growth-stimulated expressed gene 2 protein (sST2), 6-minute walking distance (6MWD), and changes in traditional Chinese medicine (TCM) syndrome scores. The TCM clinical efficacy in the two groups was evaluated.

RESULTS After treatment, E/A, SRe, SRa, and 6MWD were significantly increased in both groups, while SRs, GLS, sST2, Gal-3, and total TCM syndrome scores were significantly decreased (P < 0.05, P < 0.01). E/A, SRe, SRa, and 6MWD were significantly higher in the treatment group than in the conventional group, while SRs, GLS, sST2, Gal-3, and total TCM syndrome scores were significantly lower in the treatment group than in the conventional group (P < 0.05, P < 0.01). The effective rate in the treatment group was significantly higher than that in the conventional group (P < 0.01).

CONCLUSION Shenfu Qiangxin Drink combined with conventional Western medicine treatment can effectively improve the clinical efficacy in patients with HFpEF, and its therapeutic mechanism may be related to improving myocardial strain and inhibiting myocardial fibrosis.