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The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”

Background: Sacubitril/valsartan has been shown to be superior to enalapril in reducing the risks of death and hospitalization for heart failure (HF). However, knowledge of the impact on cardiac performance remains limited. We sought to evaluate the effects of sacubitril/valsartan on clinical, bioch...

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Autores principales: Romano, Giuseppe, Vitale, Giuseppe, Ajello, Laura, Agnese, Valentina, Bellavia, Diego, Caccamo, Giuseppa, Corrado, Egle, Di Gesaro, Gabriele, Falletta, Calogero, La Franca, Eluisa, Minà, Chiara, Storniolo, Salvatore Antonio, Sarullo, Filippo Maria, Clemenza, Francesco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947355/
https://www.ncbi.nlm.nih.gov/pubmed/31817815
http://dx.doi.org/10.3390/jcm8122165
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author Romano, Giuseppe
Vitale, Giuseppe
Ajello, Laura
Agnese, Valentina
Bellavia, Diego
Caccamo, Giuseppa
Corrado, Egle
Di Gesaro, Gabriele
Falletta, Calogero
La Franca, Eluisa
Minà, Chiara
Storniolo, Salvatore Antonio
Sarullo, Filippo Maria
Clemenza, Francesco
author_facet Romano, Giuseppe
Vitale, Giuseppe
Ajello, Laura
Agnese, Valentina
Bellavia, Diego
Caccamo, Giuseppa
Corrado, Egle
Di Gesaro, Gabriele
Falletta, Calogero
La Franca, Eluisa
Minà, Chiara
Storniolo, Salvatore Antonio
Sarullo, Filippo Maria
Clemenza, Francesco
author_sort Romano, Giuseppe
collection PubMed
description Background: Sacubitril/valsartan has been shown to be superior to enalapril in reducing the risks of death and hospitalization for heart failure (HF). However, knowledge of the impact on cardiac performance remains limited. We sought to evaluate the effects of sacubitril/valsartan on clinical, biochemical and echocardiographic parameters in patients with heart failure and reduced ejection fraction (HFrEF). Methods: Sacubitril/valsartan was administered to 205 HFrEF patients. Results: Among 230 patients (mean age 59 ± 10 years, 46% with ischemic heart disease) 205 (89%) completed the study. After a follow-up of 10.49 (2.93 ± 18.44) months, the percentage of patients in New York Heart Association (NYHA) class III changed from 40% to 17% (p < 0.001). Median N–Type natriuretic peptide (Nt-proBNP) decreased from 1865 ± 2318 to 1514 ± 2205 pg/mL, (p = 0.01). Furosemide dose reduced from 131.3 ± 154.5 to 120 ± 142.5 (p = 0.047). Ejection fraction (from 27± 5.9% to 30 ± 7.7% (p < 0.001) and E/A ratio (from 1.67 ± 1.21 to 1.42 ± 1.12 (p = 0.002)) improved. Moderate to severe mitral regurgitation (from 30.1% to 17.4%; p = 0.002) and tricuspid velocity decreased from 2.8 ± 0.55 m/s to 2.64 ± 0.59 m/s (p < 0.014). Conclusions: Sacubitril/valsartan induce “hemodynamic recovery” and, consistently with reduction in Nt-proBNP concentrations, improve NYHA class despite diuretic dose reduction.
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spelling pubmed-69473552020-01-13 The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery” Romano, Giuseppe Vitale, Giuseppe Ajello, Laura Agnese, Valentina Bellavia, Diego Caccamo, Giuseppa Corrado, Egle Di Gesaro, Gabriele Falletta, Calogero La Franca, Eluisa Minà, Chiara Storniolo, Salvatore Antonio Sarullo, Filippo Maria Clemenza, Francesco J Clin Med Article Background: Sacubitril/valsartan has been shown to be superior to enalapril in reducing the risks of death and hospitalization for heart failure (HF). However, knowledge of the impact on cardiac performance remains limited. We sought to evaluate the effects of sacubitril/valsartan on clinical, biochemical and echocardiographic parameters in patients with heart failure and reduced ejection fraction (HFrEF). Methods: Sacubitril/valsartan was administered to 205 HFrEF patients. Results: Among 230 patients (mean age 59 ± 10 years, 46% with ischemic heart disease) 205 (89%) completed the study. After a follow-up of 10.49 (2.93 ± 18.44) months, the percentage of patients in New York Heart Association (NYHA) class III changed from 40% to 17% (p < 0.001). Median N–Type natriuretic peptide (Nt-proBNP) decreased from 1865 ± 2318 to 1514 ± 2205 pg/mL, (p = 0.01). Furosemide dose reduced from 131.3 ± 154.5 to 120 ± 142.5 (p = 0.047). Ejection fraction (from 27± 5.9% to 30 ± 7.7% (p < 0.001) and E/A ratio (from 1.67 ± 1.21 to 1.42 ± 1.12 (p = 0.002)) improved. Moderate to severe mitral regurgitation (from 30.1% to 17.4%; p = 0.002) and tricuspid velocity decreased from 2.8 ± 0.55 m/s to 2.64 ± 0.59 m/s (p < 0.014). Conclusions: Sacubitril/valsartan induce “hemodynamic recovery” and, consistently with reduction in Nt-proBNP concentrations, improve NYHA class despite diuretic dose reduction. MDPI 2019-12-06 /pmc/articles/PMC6947355/ /pubmed/31817815 http://dx.doi.org/10.3390/jcm8122165 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
Romano, Giuseppe
Vitale, Giuseppe
Ajello, Laura
Agnese, Valentina
Bellavia, Diego
Caccamo, Giuseppa
Corrado, Egle
Di Gesaro, Gabriele
Falletta, Calogero
La Franca, Eluisa
Minà, Chiara
Storniolo, Salvatore Antonio
Sarullo, Filippo Maria
Clemenza, Francesco
The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”
title The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”
title_full The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”
title_fullStr The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”
title_full_unstemmed The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”
title_short The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”
title_sort effects of sacubitril/valsartan on clinical, biochemical and echocardiographic parameters in patients with heart failure with reduced ejection fraction: the “hemodynamic recovery”
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947355/
https://www.ncbi.nlm.nih.gov/pubmed/31817815
http://dx.doi.org/10.3390/jcm8122165
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