OBJECTIVE To observe the effects of Shenzhu Xinkang Decoction on left ventricular diastolic function and epicardial adipose tissue (EAT) thickness in patients with heart failure with preserved ejection fraction (HFpEF), and to evaluate its clinical efficacy.

METHODS A total of 105 patients with HFpEF who received treatment at Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine from September 2023 to March 2025 were randomly divided into a control group (n=52) and an observation group (n=53). The control group was treated with dapagliflozin tablets plus sacubitril valsartan tablets, while the observation group received oral administration of Shenzhu Xinkang Decoction in addition to the treatment given to the control group. The treatment course for both groups was 16 weeks. Before and after treatment, the following parameters were assessed in both groups: left ventricular diastolic function parameters mitral inflow early diastolic peak velocity (E), mitral inflow late diastolic peak velocity (A), E/A ratio, tissue Doppler mitral annular early diastolic peak velocity (e'), E/e' ratio, left atrial volume (LAV), and left atrial volume index (LAVI), EAT, TCM syndrome scores and efficacy, cardiac morphology parameters left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular posterior wall thickness (LVPWT), serum myocardial injury parameters N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, serum inflammatory factors high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α) levels, and changes in safety parameters.

RESULTS After treatment, E, e', and E/A levels significantly increased in both groups (P<0.05, P<0.01), while A, E/e', LVEDD, LVESD, LAV, and LAVI levels significantly decreased (P<0.05, P<0.01). The observation group showed better results than the control group in terms of E, e', E/A, A, E/e', and LAVI (P<0.05, P<0.01). EAT, NT-proBNP, hs-CRP, IL-6, and TNF-α levels significantly decreased in both groups (P<0.05, P<0.01), while IL-10 levels significantly increased (P<0.01). The observation group showed better improvement in EAT, NT-proBNP, hs-CRP, and TNF-α than the control group (P<0.05, P<0.01). Both groups showed significant improvement in TCM syndrome scores (P<0.05), with the observation group demonstrating better outcomes than the control group (P<0.05). The total effective rate of TCM clinical efficacy in the observation group was better than that in the control group (P<0.05). In terms of safety, there was no statistically significant difference between the two groups (P>0.05).

CONCLUSION Shenzhu Xinkang Decoction can significantly improve left ventricular diastolic function and reduce EAT thickness in patients with HFpEF, demonstrating good clinical efficacy and safety.