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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...

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Autores principales: Valentim Gonçalves, António, Pereira-da-Silva, Tiago, Galrinho, Ana, Rio, Pedro, Moura Branco, Luísa, Soares, Rui, Feliciano, Joana, Ilhão Moreira, Rita, Cruz Ferreira, Rui
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
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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.
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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
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