Cargando…
Antiarrhythmic Effect of Sacubitril-Valsartan: Cause or Consequence of Clinical Improvement?
Sacubitril/Valsartan (LCZ696) reduced sudden cardiac death in the PARADIGM-HF trial. However, the mechanism by which LCZ696 reduces ventricular arrhythmias remains unclear. The aim of this study was to compare electrocardiographic (ECG) parameters and mechanical dispersion index, assessed by left ve...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616876/ https://www.ncbi.nlm.nih.gov/pubmed/31216679 http://dx.doi.org/10.3390/jcm8060869 |
_version_ | 1783433562285932544 |
---|---|
author | Valentim Gonçalves, António Pereira-da-Silva, Tiago Galrinho, Ana Rio, Pedro Moura Branco, Luísa Soares, Rui Feliciano, Joana Ilhão Moreira, Rita Cruz Ferreira, Rui |
author_facet | Valentim Gonçalves, António Pereira-da-Silva, Tiago Galrinho, Ana Rio, Pedro Moura Branco, Luísa Soares, Rui Feliciano, Joana Ilhão Moreira, Rita Cruz Ferreira, Rui |
author_sort | Valentim Gonçalves, António |
collection | PubMed |
description | Sacubitril/Valsartan (LCZ696) reduced sudden cardiac death in the PARADIGM-HF trial. However, the mechanism by which LCZ696 reduces ventricular arrhythmias remains unclear. The aim of this study was to compare electrocardiographic (ECG) parameters and mechanical dispersion index, assessed by left ventricular (LV) global longitudinal strain (GLS), before and after LCZ696 therapy. We prospectively evaluated chronic Heart Failure (HF) patients with LV ejection fraction ≤40%, despite optimal medical and device therapy, in which LCZ696 therapy was started, while no additional HF treatment was expected to change. ECG and transthoracic echocardiographic data were gathered in the week before starting LCZ696 and at six months of therapy. A semiautomated analysis of LV GLS was performed and mechanical dispersion index was defined as the standard deviation from 16 time intervals corresponding to each LV segment. Of the 42 patients, 35 completed the six month follow-up, since two patients died and five discontinued treatment for adverse events. QTc interval (451.9 vs. 426.0 ms, p < 0.001), QRS duration (125.1 vs. 120.8 ms, p = 0.033) and mechanical dispersion index (88.4 vs. 78.1 ms, p = 0.036) were significantly reduced at six months. LCZ696 therapy is associated with a reduction in QTc interval, QRS duration and mechanical dispersion index as assessed by LV GLS. |
format | Online Article Text |
id | pubmed-6616876 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-66168762019-07-18 Antiarrhythmic Effect of Sacubitril-Valsartan: Cause or Consequence of Clinical Improvement? Valentim Gonçalves, António Pereira-da-Silva, Tiago Galrinho, Ana Rio, Pedro Moura Branco, Luísa Soares, Rui Feliciano, Joana Ilhão Moreira, Rita Cruz Ferreira, Rui J Clin Med Article Sacubitril/Valsartan (LCZ696) reduced sudden cardiac death in the PARADIGM-HF trial. However, the mechanism by which LCZ696 reduces ventricular arrhythmias remains unclear. The aim of this study was to compare electrocardiographic (ECG) parameters and mechanical dispersion index, assessed by left ventricular (LV) global longitudinal strain (GLS), before and after LCZ696 therapy. We prospectively evaluated chronic Heart Failure (HF) patients with LV ejection fraction ≤40%, despite optimal medical and device therapy, in which LCZ696 therapy was started, while no additional HF treatment was expected to change. ECG and transthoracic echocardiographic data were gathered in the week before starting LCZ696 and at six months of therapy. A semiautomated analysis of LV GLS was performed and mechanical dispersion index was defined as the standard deviation from 16 time intervals corresponding to each LV segment. Of the 42 patients, 35 completed the six month follow-up, since two patients died and five discontinued treatment for adverse events. QTc interval (451.9 vs. 426.0 ms, p < 0.001), QRS duration (125.1 vs. 120.8 ms, p = 0.033) and mechanical dispersion index (88.4 vs. 78.1 ms, p = 0.036) were significantly reduced at six months. LCZ696 therapy is associated with a reduction in QTc interval, QRS duration and mechanical dispersion index as assessed by LV GLS. MDPI 2019-06-18 /pmc/articles/PMC6616876/ /pubmed/31216679 http://dx.doi.org/10.3390/jcm8060869 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Valentim Gonçalves, António Pereira-da-Silva, Tiago Galrinho, Ana Rio, Pedro Moura Branco, Luísa Soares, Rui Feliciano, Joana Ilhão Moreira, Rita Cruz Ferreira, Rui Antiarrhythmic Effect of Sacubitril-Valsartan: Cause or Consequence of Clinical Improvement? |
title | Antiarrhythmic Effect of Sacubitril-Valsartan: Cause or Consequence of Clinical Improvement? |
title_full | Antiarrhythmic Effect of Sacubitril-Valsartan: Cause or Consequence of Clinical Improvement? |
title_fullStr | Antiarrhythmic Effect of Sacubitril-Valsartan: Cause or Consequence of Clinical Improvement? |
title_full_unstemmed | Antiarrhythmic Effect of Sacubitril-Valsartan: Cause or Consequence of Clinical Improvement? |
title_short | Antiarrhythmic Effect of Sacubitril-Valsartan: Cause or Consequence of Clinical Improvement? |
title_sort | antiarrhythmic effect of sacubitril-valsartan: cause or consequence of clinical improvement? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6616876/ https://www.ncbi.nlm.nih.gov/pubmed/31216679 http://dx.doi.org/10.3390/jcm8060869 |
work_keys_str_mv | AT valentimgoncalvesantonio antiarrhythmiceffectofsacubitrilvalsartancauseorconsequenceofclinicalimprovement AT pereiradasilvatiago antiarrhythmiceffectofsacubitrilvalsartancauseorconsequenceofclinicalimprovement AT galrinhoana antiarrhythmiceffectofsacubitrilvalsartancauseorconsequenceofclinicalimprovement AT riopedro antiarrhythmiceffectofsacubitrilvalsartancauseorconsequenceofclinicalimprovement AT mourabrancoluisa antiarrhythmiceffectofsacubitrilvalsartancauseorconsequenceofclinicalimprovement AT soaresrui antiarrhythmiceffectofsacubitrilvalsartancauseorconsequenceofclinicalimprovement AT felicianojoana antiarrhythmiceffectofsacubitrilvalsartancauseorconsequenceofclinicalimprovement AT ilhaomoreirarita antiarrhythmiceffectofsacubitrilvalsartancauseorconsequenceofclinicalimprovement AT cruzferreirarui antiarrhythmiceffectofsacubitrilvalsartancauseorconsequenceofclinicalimprovement |