Impact of Sacubitril-Valsartan Treatment on Diastolic Function in Patients with Heart Failure and Reduced Ejection Fraction.
High Blood Press Cardiovasc Prev
; 28(2): 167-175, 2021 Mar.
Article
in En
| MEDLINE
| ID: mdl-33599965
INTRODUCTION: Sacubitril/valsartan (S-V) has been shown to reduce clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF). This benefit has been mostly attributed to an improvement in systolic function. AIM: This study aimed to evaluate longitudinal changes in several echocardiographic parameters of diastolic function in a cohort of patients with HFrEF receiving S-V. METHODS: Echocardiographic parameters of consecutive patients receiving S-V, such as diastolic dysfunction (DD) grade and other individual diastolic and systolic function parameters, were prospectively collected at baseline and at 6-month follow-up. New York Heart Association (NYHA) functional class was also recorded. RESULTS: 65 patients (73.9% males; 61.5 ± 13 years) with HFrEF in NYHA class II-IV were evaluated. There was a significant reduction in DD grade after treatment with maximal tolerated doses (p < 0.001). Patients with advanced DD showed the most significant improvements: 75% and 60% of patients with initial grade 3 and 2, respectively, had better grade after 6 months of S-V. Moreover, there was a reduction in E/e' ratio (p = 0.004), left atrial longitudinal strain (p = 0.002), and an improvement of left ventricle ejection fraction (p < 0.001) and NYHA functional class (p = 0.001). Among those subjects who improved their functional class, a higher percentage improved their DD grade (39.3%, p = 0.025) in comparison with those not improving their NYHA class (25%, p = 0.434). CONCLUSIONS: In addition to an improvement in systolic function parameters, patients with HFrEF receiving S-V improved their diastolic function. This echocardiographic improvement is particularly relevant in those patients with better NYHA class at 6-month follow-up.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Protease Inhibitors
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Stroke Volume
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Tetrazoles
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Neprilysin
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Ventricular Function, Left
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Angiotensin II Type 1 Receptor Blockers
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Aminobutyrates
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Heart Failure
Type of study:
Observational_studies
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Risk_factors_studies
Limits:
Aged
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Female
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Humans
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Male
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Middle aged
Language:
En
Journal:
High Blood Press Cardiovasc Prev
Year:
2021
Document type:
Article
Affiliation country:
Country of publication: