Impact of Sacubitril-Valsartan Treatment on Diastolic Function in Patients with Heart Failure and Reduced Ejection Fraction
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.
| Errataetall: |
CommentIn: High Blood Press Cardiovasc Prev. 2021 Jul;28(4):331-332. - PMID 33905096 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension - 28(2021), 2 vom: 18. März, Seite 167-175 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Pericas, Pere [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 06.04.2021 Date Revised 04.12.2021 published: Print-Electronic CommentIn: High Blood Press Cardiovasc Prev. 2021 Jul;28(4):331-332. - PMID 33905096 Citation Status MEDLINE |
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| doi: |
10.1007/s40292-021-00437-x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM321587928 |
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| 245 | 1 | 0 | |a Impact of Sacubitril-Valsartan Treatment on Diastolic Function in Patients with Heart Failure and Reduced Ejection Fraction |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: High Blood Press Cardiovasc Prev. 2021 Jul;28(4):331-332. - PMID 33905096 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Diastolic function | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Sacubitril–valsartan | |
| 650 | 4 | |a Systolic function | |
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| 650 | 7 | |a Protease Inhibitors |2 NLM | |
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| 650 | 7 | |a Valsartan |2 NLM | |
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| 650 | 7 | |a Neprilysin |2 NLM | |
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| 700 | 1 | |a Rossello, Xavier |e verfasserin |4 aut | |
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