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Acute pulmonary pressure change after transition to sacubitril/valsartan in patients with heart failure reduced ejection fraction

AIMS: Sacubitril/valsartan combines renin–angiotensin–aldosterone system inhibition with amplification of natriuretic peptides. In addition to well‐described effects, natriuretic peptides exert direct effects on pulmonary vasculature. The effect of sacubitril/valsartan on pulmonary artery pressure (...

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Autores principales: Tran, Jeffrey S., Havakuk, Ofer, McLeod, Jennifer M., Hwang, Jennifer, Kwong, Hoi Yan, Shavelle, David, Zile, Michael R., Elkayam, Uri, Fong, Michael W., Grazette, Luanda P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006690/
https://www.ncbi.nlm.nih.gov/pubmed/33522140
http://dx.doi.org/10.1002/ehf2.13225
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author Tran, Jeffrey S.
Havakuk, Ofer
McLeod, Jennifer M.
Hwang, Jennifer
Kwong, Hoi Yan
Shavelle, David
Zile, Michael R.
Elkayam, Uri
Fong, Michael W.
Grazette, Luanda P.
author_facet Tran, Jeffrey S.
Havakuk, Ofer
McLeod, Jennifer M.
Hwang, Jennifer
Kwong, Hoi Yan
Shavelle, David
Zile, Michael R.
Elkayam, Uri
Fong, Michael W.
Grazette, Luanda P.
author_sort Tran, Jeffrey S.
collection PubMed
description AIMS: Sacubitril/valsartan combines renin–angiotensin–aldosterone system inhibition with amplification of natriuretic peptides. In addition to well‐described effects, natriuretic peptides exert direct effects on pulmonary vasculature. The effect of sacubitril/valsartan on pulmonary artery pressure (PAP) has not been fully defined. METHODS AND RESULTS: This was a retrospective case‐series of PAP changes following transition from angiotensin‐converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) to sacubitril/valsartan in patients with heart failure reduced ejection fraction and a previously implanted CardioMEMS™ sensor. Pre‐sacubitril/valsartan and post‐sacubitril/valsartan PAPs were compared for each patient by examining averaged consecutive daily pressure readings from 1 to 5 days before and after sacubitril/valsartan exposure. PAP changes were also compared between patients based on elevated trans‐pulmonary gradients (trans‐pulmonary gradient ≥ 12 mmHg) at time of CardioMEMS™ sensor implantation. The cohort included 18 patients, 72% male, mean age 60.1 ± 13.6 years. There was a significant decrease in PAPs associated with transition from ACEI/ARB to sacubitril/valsartan. The median (interquartile range) pre‐treatment and post‐treatment change in mean, systolic and diastolic PAPs were −3.6 (−9.8, −0.7) mmHg (P < 0.001), −6.5 (−15.0, −2.0) mmHg (P = 0.001), and −2.5 (−5.7, −0.7) (P = 0.001), respectively. The decrease in PAPs was independent of trans‐pulmonary gradient (F(1,16) = 0.49, P = 0.49). CONCLUSIONS: In this retrospective case series, transition from ACEI/ARB to sacubitril/valsartan was associated with an early and significant decrease in PAPs.
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spelling pubmed-80066902021-04-01 Acute pulmonary pressure change after transition to sacubitril/valsartan in patients with heart failure reduced ejection fraction Tran, Jeffrey S. Havakuk, Ofer McLeod, Jennifer M. Hwang, Jennifer Kwong, Hoi Yan Shavelle, David Zile, Michael R. Elkayam, Uri Fong, Michael W. Grazette, Luanda P. ESC Heart Fail Short Communications AIMS: Sacubitril/valsartan combines renin–angiotensin–aldosterone system inhibition with amplification of natriuretic peptides. In addition to well‐described effects, natriuretic peptides exert direct effects on pulmonary vasculature. The effect of sacubitril/valsartan on pulmonary artery pressure (PAP) has not been fully defined. METHODS AND RESULTS: This was a retrospective case‐series of PAP changes following transition from angiotensin‐converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) to sacubitril/valsartan in patients with heart failure reduced ejection fraction and a previously implanted CardioMEMS™ sensor. Pre‐sacubitril/valsartan and post‐sacubitril/valsartan PAPs were compared for each patient by examining averaged consecutive daily pressure readings from 1 to 5 days before and after sacubitril/valsartan exposure. PAP changes were also compared between patients based on elevated trans‐pulmonary gradients (trans‐pulmonary gradient ≥ 12 mmHg) at time of CardioMEMS™ sensor implantation. The cohort included 18 patients, 72% male, mean age 60.1 ± 13.6 years. There was a significant decrease in PAPs associated with transition from ACEI/ARB to sacubitril/valsartan. The median (interquartile range) pre‐treatment and post‐treatment change in mean, systolic and diastolic PAPs were −3.6 (−9.8, −0.7) mmHg (P < 0.001), −6.5 (−15.0, −2.0) mmHg (P = 0.001), and −2.5 (−5.7, −0.7) (P = 0.001), respectively. The decrease in PAPs was independent of trans‐pulmonary gradient (F(1,16) = 0.49, P = 0.49). CONCLUSIONS: In this retrospective case series, transition from ACEI/ARB to sacubitril/valsartan was associated with an early and significant decrease in PAPs. John Wiley and Sons Inc. 2021-01-31 /pmc/articles/PMC8006690/ /pubmed/33522140 http://dx.doi.org/10.1002/ehf2.13225 Text en © 2021 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Short Communications
Tran, Jeffrey S.
Havakuk, Ofer
McLeod, Jennifer M.
Hwang, Jennifer
Kwong, Hoi Yan
Shavelle, David
Zile, Michael R.
Elkayam, Uri
Fong, Michael W.
Grazette, Luanda P.
Acute pulmonary pressure change after transition to sacubitril/valsartan in patients with heart failure reduced ejection fraction
title Acute pulmonary pressure change after transition to sacubitril/valsartan in patients with heart failure reduced ejection fraction
title_full Acute pulmonary pressure change after transition to sacubitril/valsartan in patients with heart failure reduced ejection fraction
title_fullStr Acute pulmonary pressure change after transition to sacubitril/valsartan in patients with heart failure reduced ejection fraction
title_full_unstemmed Acute pulmonary pressure change after transition to sacubitril/valsartan in patients with heart failure reduced ejection fraction
title_short Acute pulmonary pressure change after transition to sacubitril/valsartan in patients with heart failure reduced ejection fraction
title_sort acute pulmonary pressure change after transition to sacubitril/valsartan in patients with heart failure reduced ejection fraction
topic Short Communications
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006690/
https://www.ncbi.nlm.nih.gov/pubmed/33522140
http://dx.doi.org/10.1002/ehf2.13225
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