Reverse Remodeling and Functional Improvement of Left Ventricle in Patients with Chronic Heart Failure Treated with Sacubitril/Valsartan: Comparison between Non-Ischemic and Ischemic Etiology.
Roberto CeminSimona CasablancaLuisa FocoElisabeth SchoepfAndrea ErlicherRenato Di GaetanoDavide ErmacoraPublished in: Journal of clinical medicine (2023)
Sacubitril/valsartan (SV) has been demonstrated to reduce cardiovascular mortality, hospitalization for heart failure and to induce reverse ventricular remodeling. The present study was designed to confirm the effects of SV in a selected population of patients with HFrEF and to evaluate the different responses between patients with an ischemic or a non-ischemic etiology. A total of 79 patients with indication of SV were recruited prospectively during a timelapse of 4 years. SV was overall associated to a reduction of end-diastolic and end-systolic volume, of NT-proBNP levels, furosemide dosage and NYHA functional class, together with an increase in EF. These changes were more evident in patients with non-ischemic dilated cardiomyopathy, who showed a significant improvement in ventricular volumes, ejection fraction, TAPSE and blood levels of NT-proBNP. Kaplan-Meier curves confirmed a greater benefit in terms of ejection-fraction improvement in non-ischemic patients compared to the ischemic group. The results of the present study confirm the positive effect of SV on NYHA functional class, NT- proBNP, left ventricular volumes and EF in HFrEF patients, showing evidence of association of SV with ventricular remodeling in patients with dilated cardiomyopathy of non-ischemic etiology compared to the ischemic group.
Keyphrases
- ejection fraction
- aortic stenosis
- left ventricular
- heart failure
- ischemia reperfusion injury
- cerebral ischemia
- blood pressure
- end stage renal disease
- chronic kidney disease
- cardiac resynchronization therapy
- risk factors
- acute myocardial infarction
- type diabetes
- peritoneal dialysis
- cardiovascular disease
- left atrial
- brain injury
- coronary artery disease
- oxidative stress
- pulmonary hypertension
- pulmonary artery
- acute coronary syndrome
- subarachnoid hemorrhage
- congenital heart disease
- patient reported outcomes