Preprint Article Version 1 This version is not peer-reviewed

The Effects of Sacubitril/Valsartan on Clinical, Bioumoral and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Reverse Remodeling”

Version 1 : Received: 31 October 2019 / Approved: 4 November 2019 / Online: 4 November 2019 (11:20:22 CET)

How to cite: Romano, G.; Vitale, G.; Ajello, L.; Agnese, V.; Bellavia, D.; Caccamo, G.; Corrado, E.; Di Gesaro, G.; Falletta, C.; Franca, E.L.; Minà, C.; Stornioloc, S.A.; Sarullo, F.M.; Clemenza, F. The Effects of Sacubitril/Valsartan on Clinical, Bioumoral and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Reverse Remodeling”. Preprints 2019, 2019110039 (doi: 10.20944/preprints201911.0039.v1). Romano, G.; Vitale, G.; Ajello, L.; Agnese, V.; Bellavia, D.; Caccamo, G.; Corrado, E.; Di Gesaro, G.; Falletta, C.; Franca, E.L.; Minà, C.; Stornioloc, S.A.; Sarullo, F.M.; Clemenza, F. The Effects of Sacubitril/Valsartan on Clinical, Bioumoral and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Reverse Remodeling”. Preprints 2019, 2019110039 (doi: 10.20944/preprints201911.0039.v1).

Abstract

Background: Sacubitril/valsartan has been shown to be superior to enalapril in reducing the risks of death and hospitalization for heart failure (HF). However the effect on cardiac performance remains unknown. We sought to evaluate the effects of sacubitril/valsartan on clinical, bioumoral and echocardiographic parameters in patients with HFrEF. Methods: Sacubitril/valsartan was administered to 205 HFrEF patients. Results: Among 230 patients (mean age 59 ± 10 years, 46% with ischemic heart disease) 205 (89%) completed the study. After a follow–up of 10.49 (2.93±18.44) months, the percentage of patients in NYHA class III changed from 40% to 17% (p<0.001). Median N–Type natriuretic peptide (Nt-proBNP) decreased from 1865 ± 2318 to 1514 ± 2205 pg/mL, (p=0.01). Furosemide dose reduced from 131.3 ± 154.5 to 120 ± 142.5 (p=0.047). Ejection fraction (from 27± 5.9% to 30 ± 7.7% (p<0.001) and E/A ratio (from 1.67 ± 1.21 to 1.42 ± 1.12 (p=0.002)) improved. Moderate to severe mitral regurgitation (from 30.1% to 17.4%; p=0.002) and tricuspid velocity decreased from 2.8 ± 0.55 m/sec to 2.64 ± 0.59 m/sec (p<0.014). CONCLUSIONS: Sacubitril/valsartan induce “hemodynamic reverse remodeling” and in association with Nt-proBNP concentrations lowering improve NYHA class despite a diuretic dose reduction.

Subject Areas

heart failure; Sacubitril/valsartan; Neprilysin inhibition; reduced ejection fraction; echocardiography; Nt-Pro-BNP; hemodynamic; remodeling

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