Abstract: Objective: To evaluate the clinical efficacy of recombinant human brain natriuretic peptide(rhBNP) combined with Sacubitril/Valsartan in the sequential treatment of heart failure caused by pulmonary hypertension due to pulmonary heart disease. Methods: The clinical data of 170 patients with heart failure caused by secondary pulmonary hypertension complicated with pulmonary heart disease were collected.The patients were divided into the observation group and control group according to the treatment methods(85 cases in each group).The control group was treated with Sacubitril/Valsartan,while the observation group was treated with rhBNP combined with Sacubitril/Valsartan sequentially.The treatment course in two groups was 6 months.The clinical efficacy and improvement of symptoms and signs were compared between two groups.The pulmonary function indicatorsforced expiratory volume in one second(FEV1),percentage of FEV1 to forced vital capacity(FEV1/FVC),mean pulmonary artery pressure,cardiac function indicatorsleft ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD) and serum myocardium markerswhole blood N-terminal pro-brain natriuretic peptide(NT-proBNP),angiotensin-converting enzyme 2(ACE2) and cardiac troponin I(cTnI) before and after treatment were compared between two groups. Results: The total effective rate of treatment in the observation group was 91.76% (78/85),which was significantly higher than that in control group75.29%(64/85)(P<0.01).The disappearance time of symptoms and signs such as cough,edema,cyanosis and rales,and recovery time of sputum in the observation group were significantly shorter than those in control group(P<0.01).After treatment,the FEV1,FEV1/FVC and LVEF in the observation group were significantly higher than those in control group(P<0.01),the mean pulmonary artery pressure,LVESD and LVEDD were significantly lower than those in control group(P<0.01),the levels of myocardial injury markers NT-proBNP and ACE2 were significantly higher than those in control group,and the cTnI was significantly lower than that in control group(P<0.01).The incidence of adverse reactions in the observation group was 7.06%(6/85),which was lower than 17.65%(15/85) in the control group(P<0.05). Conclusions: The sequential treatment of rhBNP combined with Sacubitril/Valsartan for heart failure caused by secondary pulmonary hypertension complicated with pulmonary heart disease has a significant clinical effect.It can effectively improve the cardiac function,reduce the myocardial damage and lower the pulmonary artery pressure,and is safe and reliable.It is worthy of further clinical promotion.