YAO Dan, ZHENG Ju, PANG Chong, WU Yanming, YOU Hua. Effect of sacubitril/valsartan on echocardiographic parameters in patients with chronic heart failure with reduced ejection fraction[J]. Journal of Clinical Medicine in Practice, 2021, 25(7): 81-84, 88. DOI: 10.7619/jcmp.20210125
Citation: YAO Dan, ZHENG Ju, PANG Chong, WU Yanming, YOU Hua. Effect of sacubitril/valsartan on echocardiographic parameters in patients with chronic heart failure with reduced ejection fraction[J]. Journal of Clinical Medicine in Practice, 2021, 25(7): 81-84, 88. DOI: 10.7619/jcmp.20210125

Effect of sacubitril/valsartan on echocardiographic parameters in patients with chronic heart failure with reduced ejection fraction

More Information
  • Received Date: January 06, 2021
  • Available Online: April 20, 2021
  • Published Date: April 14, 2021
  •   Objective  To evaluate the effect of sacubatre/valsartan on echocardiographic parameters in patients with chronic heart failure with reduced ejection fraction (HFrEF).
      Methods  Totally 50 patients with chronic HFrEF from July 2018 to December 2020 were selected as study objects. All the patients were conducted with clinical examination and assessment of echocardiography and color Doppler ultrasound before starting to use sacubitril/valsartan, and the same examinations were repeated at 3 months. The cardiac function was evaluated by New York Heart Association (NYHA) classification.
      Results  In the course of study, 7 patients were excluded due to the intolerance of sacubitril/valsartan treatment, and finally 43 patients completed the study. There were significant differences in left ventricular ejection fraction (LVEF), left ventricular end systolic volume (LVESV), left ventricular end diastolic diameter (LVEDD), integral velocity time (IVT) and right ventricular systolic pressure before and after treatment in 43 patients (P < 0.01). After treatment, 19 cases (response group) had response to ultrasound and 24 cases (non-response group) had no response to ultrasound. There were significant differences in left ventricular end diastolic volume (LVEDV), LVESV, LVEDD and mitral regurgitation ratio between the two groups (P < 0.05 or P < 0.01). No effects on left ventricular diastolic function or right ventricular parameters were observed in cases with sacubitril-valsartan response.
      Conclusion  In patients with HFrEF, sacubitril/valsartan can significantly improve left ventricular systolic remodeling, and responders show mild left ventricular remodeling and lower mitral regurgitation ratio.
  • [1]
    BENJAMIN E J, BLAHA M J, CHIUVE S E, et al. Heart disease and stroke statistics-2017 update: a report from the American heart association[J]. Circulation, 2017, 135(10): e146-e603. http://med.wanfangdata.com.cn/Paper/Detail?id=PeriodicalPaper_f5c16bf3c37ae3bef6774f9164fe762e
    [2]
    中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会, 中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志, 2018, 46(10): 760-789. doi: 10.3760/cma.j.issn.0253-3758.2018.10.004
    [3]
    PONIKOWSKI P, VOORS A A, ANKER S D, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC[J]. Eur J Heart Fail, 2016, 18(8): 891-975. doi: 10.1002/ejhf.592
    [4]
    JHUND P S, MCMURRAY J J. The neprilysin pathway in heart failure: a review and guide on the use of sacubitril/valsartan[J]. Heart, 2016, 102(17): 1342-1347. doi: 10.1136/heartjnl-2014-306775
    [5]
    KING J B, BRESS A P, REESE A D, et al. Neprilysin inhibition in heart failure with reduced ejection fraction: a clinical review[J]. Pharmacotherapy, 2015, 35(9): 823-837. doi: 10.1002/phar.1629
    [6]
    邱爽, 杨波, 平海芹, 等. 血管紧张素受体脑啡肽酶抑制剂在心力衰竭中的研究进展[J]. 中国循环杂志, 2015, 30(11): 1131-1133. doi: 10.3969/j.issn.1000-3614.2015.11.024
    [7]
    MCMURRAY J J, PACKER M, DESAI A S, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure[J]. N Engl J Med, 2014, 371(11): 993-1004. doi: 10.1056/NEJMoa1409077
    [8]
    MANGIAFICO S, COSTELLO-BOERRIGTER L C, ANDERSEN I A, et al. Neutral endopeptidase inhibition and the natriuretic peptide system: an evolving strategy in cardiovascular therapeutics[J]. Eur Heart J, 2013, 34(12): 886-893. doi: 10.1093/eurheartj/ehs262
    [9]
    KANG D H, PARK S J, SHIN S H, et al. Angiotensin receptor neprilysin inhibitor for functional mitral regurgitation[J]. Circulation, 2019, 139(11): 1354-1365. doi: 10.1161/CIRCULATIONAHA.118.037077
    [10]
    ALMUFLEH A, MARBACH J, CHIH S, et al. Ejection fraction improvement and reverse remodeling achieved with Sacubitril/Valsartan in heart failure with reduced ejection fraction patients[J]. Am J Cardiovasc Dis, 2017, 7(6): 108-113. http://www.ncbi.nlm.nih.gov/pubmed/29348971
    [11]
    CINTRON G, JOHNSON G, FRANCIS G, et al. Prognostic significance of serial changes in left ventricular ejection fraction in patients with congestive heart failure. The V-HeFT VA Cooperative Studies Group[J]. Circulation, 1993, 87(6 Suppl): VI17-VI23. http://www.ncbi.nlm.nih.gov/pubmed/8500235
    [12]
    PITZALIS M V, IACOVIELLO M, ROMITO R, et al. Ventricular asynchrony predicts a better outcome in patients with chronic heart failure receiving cardiac resynchronization therapy[J]. J Am Coll Cardiol, 2005, 45(1): 65-69. doi: 10.1016/j.jacc.2004.09.058
    [13]
    NAGUEH S F, SMISETH O A, APPLETON C P, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American society of echocardiography and the European association of cardiovascular imaging[J]. Eur Heart J Cardiovasc Imaging, 2016, 17(12): 1321-1360. doi: 10.1093/ehjci/jew082
    [14]
    YANCY C W, JESSUP M, BOZKURT B, et al. 2017 ACC/AHA/HFSA focused update of the 2013 ACCF/AHA guideline for the management of heart failure: a report of the American college of cardiology/American heart association task force on clinical practice guidelines and the heart failure society of America[J]. Circulation, 2017, 136(6): e137-e161. http://www.sciencedirect.com/science/article/pii/S0735109717370870
    [15]
    MCMURRAY J J, PACKER M, DESAI A S, et al. Dual angiotensin receptor and neprilysin inhibition as an alternative to angiotensin-converting enzyme inhibition in patients with chronic systolic heart failure: rationale for and design of the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial (PARADIGM-HF)[J]. Eur J Heart Fail, 2013, 15(9): 1062-1073. doi: 10.1093/eurjhf/hft052
    [16]
    GU J, NOE A, CHANDRA P, et al. Pharmacokinetics and pharmacodynamics of LCZ696, a novel dual-acting angiotensin receptor-neprilysin inhibitor (ARNi)[J]. J Clin Pharmacol, 2010, 50(4): 401-414. doi: 10.1177/0091270009343932
    [17]
    PACKER M, CALIFF R M, KONSTAM M A, et al. Comparison of omapatrilat and enalapril in patients with chronic heart failure: the Omapatrilat Versus Enalapril Randomized Trial of Utility in Reducing Events (OVERTURE)[J]. Circulation, 2002, 106(8): 920-926. doi: 10.1161/01.CIR.0000029801.86489.50
    [18]
    FONAROW G C, HERNANDEZ A F, SOLOMON S D, et al. Potential mortality reduction with optimal implementation of angiotensin receptor neprilysin inhibitor therapy in heart failure[J]. JAMA Cardiol, 2016, 1(6): 714-717. doi: 10.1001/jamacardio.2016.1724
    [19]
    KRUM H. Prospective Comparison of ARNi with ACE-I to Determine Impact on Global Mortality and Morbidity in Heart Failure (PARADIGM-HF): paragon of a study or further investigation paramount[J]. Circulation, 2015, 131(1): 11-12. doi: 10.1161/CIRCULATIONAHA.114.013887
    [20]
    VARDENY O, CLAGGETT B, PACKER M, et al. Efficacy of sacubitril/valsartan vs. enalapril at lower than target doses in heart failure with reduced ejection fraction: the PARADIGM-HF trial[J]. Eur J Heart Fail, 2016, 18(10): 1228-1234. doi: 10.1002/ejhf.580

Catalog

    Article views (415) PDF downloads (20) Cited by()

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return