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Arch Cardiovasc Dis ; 117(6-7): 409-416, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38811278

RESUMEN

BACKGROUND: Sacubitril/valsartan has been demonstrated to significantly improve left ventricular performance and remodelling in patients with heart failure. However, its effects on the right ventricle in patients with chronic heart failure and sleep-disordered breathing (SDB) have not been studied. AIM: To investigate the impact of sacubitril/valsartan treatment on right ventricular function in patients with SDB. METHODS: This was a subanalysis of an observational prospective multicentre study involving 101 patients. At inclusion, patients were evaluated by echocardiography and nocturnal ventilatory polygraphy, which allowed patients to be divided into three groups: "central-SDB"; "obstructive-SDB"; and "no-SDB". RESULTS: After 3 months of sacubitril/valsartan therapy, a positive impact on right ventricular function was observed. In the general population, tricuspid annular plane systolic excursion increased by +1.32±4.74mm (P=0.024) and systolic pulmonary artery pressure decreased by -3.1±10.91mmHg (P=0.048). The central-SDB group experienced the greatest echocardiographic improvement, with a significant increase in tricuspid annular plane systolic excursion of +2.1±4.9mm (P=0.045) and a significant reduction in systolic pulmonary artery pressure of -8.4±9.7mmHg (P=0.001). CONCLUSIONS: Sacubitril/valsartan improved right ventricular function in patients with heart failure and SDB after only 3 months of treatment. The greatest improvement in right ventricular function was observed in the central-SDB group.


Asunto(s)
Aminobutiratos , Compuestos de Bifenilo , Combinación de Medicamentos , Insuficiencia Cardíaca , Recuperación de la Función , Valsartán , Función Ventricular Derecha , Humanos , Valsartán/uso terapéutico , Masculino , Femenino , Aminobutiratos/uso terapéutico , Aminobutiratos/efectos adversos , Función Ventricular Derecha/efectos de los fármacos , Estudios Prospectivos , Persona de Mediana Edad , Resultado del Tratamiento , Anciano , Insuficiencia Cardíaca/fisiopatología , Insuficiencia Cardíaca/tratamiento farmacológico , Insuficiencia Cardíaca/diagnóstico , Factores de Tiempo , Apnea Central del Sueño/fisiopatología , Apnea Central del Sueño/diagnóstico , Apnea Central del Sueño/tratamiento farmacológico , Bloqueadores del Receptor Tipo 1 de Angiotensina II/uso terapéutico , Bloqueadores del Receptor Tipo 1 de Angiotensina II/efectos adversos , Tetrazoles/uso terapéutico , Tetrazoles/efectos adversos , Inhibidores de Proteasas/uso terapéutico , Inhibidores de Proteasas/efectos adversos , Polisomnografía , Neprilisina/antagonistas & inhibidores , Enfermedad Crónica
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