The comparative effects of sacubitril/valsartan versus enalapril on pulmonary hypertension due to heart failure with a reduced ejection fraction.

The purpose of this study was to investigate the effects of sacubitril/valsartan on right ventricular (RV) function in patients with pulmonary hypertension (PH) due to heart failure with reduced ejection fraction (HFrEF). We prospectively enrolled patients with HFrEF-induced PH admitted to the Department of Cardiology between August 2018 and December 2019. Patients were randomized to receive oral treatment with sacubitril/valsartan or enalapril. Epidemiological data were recorded before treatment. Echocardiography was performed at admission and 6 months of follow-up, and all parameters were compared. Major adverse cardiac events (MACEs) were compared between baseline and 6 months follow-up. There were no significant differences in the baseline characteristics between the two groups. After 6 months of treatment, both treatment groups improved the following parameters from baseline (mean ± SD): left atrium, left ventricle, the left ventricular ejection function (LVEF), RV systolic function (the tricuspid annular plane systolic excursion [TAPSE], the systolic pulmonary artery pressure [sPAP], and TAPSE/sPAP). After 6 months, sacubitril/valsartan improved significantly the following parameters compared with enalapril (all p < 0.05): LVEF (47.07 ± 6.93% vs. 43.47 ± 7.95%); TAPSE (15.33 ± 1.31 vs. 14.78 ± 1.36 mm); sPAP (36.76 ± 14.32 vs. 42.26 ± 12.07 mmHg); and TAPSE/sPAP ratio (0.50 ± 0.23 vs. 0.39 ± 0.14), respectively. There was no difference in readmissions due to recurrent heart failure. Sacubitril/valsartan seems to provide more beneficial effects among patients with HFrEF-induced PH to improve RV function, along with a decrease in pulmonary pressure.

[Clinical evaluation of implant anchorage with segmental arch technique on the elongated teeth and tilted teeth].

PURPOSE: To evaluate the clinical efficiency of implant anchorage combined with segmental arch technique. METHODS: Segmental arch technique of the micro-implant and adjacent teeth was used, ideal space for the superstructure of the implant was gained. RESULTS: The implant anchorage with segmental arch technique methods decreased the therapeutic process efficiency and made enough space for superstructure of the implant. CONCLUSIONS: Implant anchorage with segmental arch technique can undertake the vertical anchorage force efficiently, depress the molar safely and make enough space for superstructure of implants.