Long-Term Effects of Sacubitril-Valsartan on Cardiac Remodeling: A Parallel Echocardiographic Study of Left and Right Heart Adaptive Response
Articolo
Data di Pubblicazione:
2023
Citazione:
Long-Term Effects of Sacubitril-Valsartan on Cardiac Remodeling: A Parallel Echocardiographic Study of Left and Right Heart Adaptive Response / F. Valli, F. Bursi, G. Santangelo, F. Toriello, A. Faggiano, I. Rusconi, A.M. Vella, S. Carugo, M. Guazzi. - In: JOURNAL OF CLINICAL MEDICINE. - ISSN 2077-0383. - 12:7(2023), pp. 2659.1-2659.13. [10.3390/jcm12072659]
Abstract:
Sacubitril/Valsartan (S/V) carries potential anti-remodeling properties, however long-term effects and biventricular adaptive response are poorly described. 76 HFrEF patients who underwent progressive uptitration of S/V, completed the annual scheduled follow-up. After a median follow-up of 11 (8-13) months, left ventricular (LV) reverse remodeling (RR) is defined as (1) absolute increase in LV ejection fraction (EF) ≥ 10% or LVEF ≥ 50% at follow-up and (2) decrease in indexed LV end-diastolic diameter (LVEDDi) of at least 10% or indexed LVEDDi ≤ 33 mm/m2, occurred in 27.6%. Non-ischemic etiology, shorter duration of HF, and absence of a history of AF were independently associated with LVRR (p < 0.05). TAPSE and TAPSE/PASP, a non-invasive index of right ventricular (RV) coupling to the pulmonary circulation, significantly improved at follow-up (0.45 vs. 0.56, p = 0.02). 41% of patients with baseline RV dysfunction obtained favorable RV remodeling despite only a moderate correlation between RV and LV function was observed (r = 0.478, p = 0.002). Our data point to a potential long-term reverse global remodeling effect by S/V, especially in patients who start S/V at an early stage of the disease, and focus our attention on a possible direct effect of the drug in synergistic hemodynamics between RV and pulmonary circulation.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Sacubitril/Valsartan; global adaptive response; heart failure with reduced ejection fraction; right heart function
Elenco autori:
F. Valli, F. Bursi, G. Santangelo, F. Toriello, A. Faggiano, I. Rusconi, A.M. Vella, S. Carugo, M. Guazzi
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