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Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan

AIMS: The angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan reduces mortality and hospitalizations in patients with heart failure and reduced ejection fraction (HFrEF). Favourable effects on haemodynamic and functional parameters have been observed in patients with HFrEF undergoi...

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Autores principales: Mazzetti, Simone, Scifo, Chiara, Abete, Raffaele, Margonato, Davide, Chioffi, Margherita, Rossi, Jessica, Pisani, Matteo, Passafaro, Giovanni, Grillo, Massimiliano, Poggio, Daniele, Mortara, Andrea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261528/
https://www.ncbi.nlm.nih.gov/pubmed/32233080
http://dx.doi.org/10.1002/ehf2.12656
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author Mazzetti, Simone
Scifo, Chiara
Abete, Raffaele
Margonato, Davide
Chioffi, Margherita
Rossi, Jessica
Pisani, Matteo
Passafaro, Giovanni
Grillo, Massimiliano
Poggio, Daniele
Mortara, Andrea
author_facet Mazzetti, Simone
Scifo, Chiara
Abete, Raffaele
Margonato, Davide
Chioffi, Margherita
Rossi, Jessica
Pisani, Matteo
Passafaro, Giovanni
Grillo, Massimiliano
Poggio, Daniele
Mortara, Andrea
author_sort Mazzetti, Simone
collection PubMed
description AIMS: The angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan reduces mortality and hospitalizations in patients with heart failure and reduced ejection fraction (HFrEF). Favourable effects on haemodynamic and functional parameters have been observed in patients with HFrEF undergoing ARNI therapy, using standard transthoracic echocardiography. Global longitudinal strain (GLS) assessment uses a semi‐automatic procedure to provide a reliable and repeatable method that improves the detection of early changes of contractile function. We aimed to assess the effects of ARNI on GLS and myocardial mechanics in patients with HFrEF. METHODS AND RESULTS: Thirty patients with New York Heart Association class II–III HFrEF were treated with ARNI and monitored using standard echocardiographic examination and GLS measurements at baseline, 3 months, and 6 months. ARNI therapy resulted in a significant reduction of ventricular volumes and a significant increase in left ventricular ejection fraction at 6 months but not 3 months by standard transthoracic echocardiography (left ventricular ejection fraction from 28 ± 8% at baseline to 34 ± 12% at 6 months, P < 0.001). Non‐significant differences in the size of the left atrium, right ventricular function, and pulmonary pressures were found at 6 months. By using GLS, there was a progressive improvement of all strain parameters by 3 months. The improvement showed a progressive trend over time and maintained significance at 6 months: GLS 4ch −7.2 ± 4.8% at baseline vs. −7.5 ± 3.9% at 3 months (P = 0.025) and − 9.2 ± 5.2% at 6 months (P = 0.0001); AVG GLS −6.9 ± 4.3 at baseline vs. −7.9 ± 4.2 at 3 months (P = 0.04) and − 8.8 ± 4.4 at 6 months (P = 0.035); GLS endo 8.2 ± 4.8 at baseline vs. −9.0 ± 4.8 at 3 months (P = 0.05) and − 10.1 ± 5.1 at 6 months (P = 0.001). CONCLUSIONS: Sacubitril/valsartan induces an early benefit on left ventricular remodelling, which is captured by myocardial strain and not by standard echocardiography. Strain method represents a practical tool to assess early and minimal variations of left ventricular systolic function.
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spelling pubmed-72615282020-06-01 Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan Mazzetti, Simone Scifo, Chiara Abete, Raffaele Margonato, Davide Chioffi, Margherita Rossi, Jessica Pisani, Matteo Passafaro, Giovanni Grillo, Massimiliano Poggio, Daniele Mortara, Andrea ESC Heart Fail Original Research Articles AIMS: The angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan reduces mortality and hospitalizations in patients with heart failure and reduced ejection fraction (HFrEF). Favourable effects on haemodynamic and functional parameters have been observed in patients with HFrEF undergoing ARNI therapy, using standard transthoracic echocardiography. Global longitudinal strain (GLS) assessment uses a semi‐automatic procedure to provide a reliable and repeatable method that improves the detection of early changes of contractile function. We aimed to assess the effects of ARNI on GLS and myocardial mechanics in patients with HFrEF. METHODS AND RESULTS: Thirty patients with New York Heart Association class II–III HFrEF were treated with ARNI and monitored using standard echocardiographic examination and GLS measurements at baseline, 3 months, and 6 months. ARNI therapy resulted in a significant reduction of ventricular volumes and a significant increase in left ventricular ejection fraction at 6 months but not 3 months by standard transthoracic echocardiography (left ventricular ejection fraction from 28 ± 8% at baseline to 34 ± 12% at 6 months, P < 0.001). Non‐significant differences in the size of the left atrium, right ventricular function, and pulmonary pressures were found at 6 months. By using GLS, there was a progressive improvement of all strain parameters by 3 months. The improvement showed a progressive trend over time and maintained significance at 6 months: GLS 4ch −7.2 ± 4.8% at baseline vs. −7.5 ± 3.9% at 3 months (P = 0.025) and − 9.2 ± 5.2% at 6 months (P = 0.0001); AVG GLS −6.9 ± 4.3 at baseline vs. −7.9 ± 4.2 at 3 months (P = 0.04) and − 8.8 ± 4.4 at 6 months (P = 0.035); GLS endo 8.2 ± 4.8 at baseline vs. −9.0 ± 4.8 at 3 months (P = 0.05) and − 10.1 ± 5.1 at 6 months (P = 0.001). CONCLUSIONS: Sacubitril/valsartan induces an early benefit on left ventricular remodelling, which is captured by myocardial strain and not by standard echocardiography. Strain method represents a practical tool to assess early and minimal variations of left ventricular systolic function. John Wiley and Sons Inc. 2020-03-31 /pmc/articles/PMC7261528/ /pubmed/32233080 http://dx.doi.org/10.1002/ehf2.12656 Text en © 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Articles
Mazzetti, Simone
Scifo, Chiara
Abete, Raffaele
Margonato, Davide
Chioffi, Margherita
Rossi, Jessica
Pisani, Matteo
Passafaro, Giovanni
Grillo, Massimiliano
Poggio, Daniele
Mortara, Andrea
Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan
title Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan
title_full Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan
title_fullStr Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan
title_full_unstemmed Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan
title_short Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan
title_sort short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan
topic Original Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261528/
https://www.ncbi.nlm.nih.gov/pubmed/32233080
http://dx.doi.org/10.1002/ehf2.12656
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