Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed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”

Giuseppe Romano
* ORCID logo ,
Giuseppe Vitale
ORCID logo ,
Laura Ajello
,
Valentina Agnese
,
Diego Bellavia
,
Giuseppa Caccamo
,
Egle Corrado
,
Gabriele Di Gesaro
,
Calogero Falletta
,
Eluisa La Franca
,
Chiara Minà
,
Salvatore Antonio Stornioloc
,
Filippo Maria Sarullo
,
Francesco Clemenza
Version 1 : Received: 31 October 2019 / Approved: 4 November 2019 / Online: 4 November 2019 (11:20:22 CET)

A peer-reviewed article of this Preprint also exists.

Romano, G.; Vitale, G.; Ajello, L.; Agnese, V.; Bellavia, D.; Caccamo, G.; Corrado, E.; Di Gesaro, G.; Falletta, C.; La Franca, E.; Minà, C.; Storniolo, S.A.; Sarullo, F.M.; Clemenza, F. The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”. J. Clin. Med. 2019, 8, 2165. Romano, G.; Vitale, G.; Ajello, L.; Agnese, V.; Bellavia, D.; Caccamo, G.; Corrado, E.; Di Gesaro, G.; Falletta, C.; La Franca, E.; Minà, C.; Storniolo, S.A.; Sarullo, F.M.; Clemenza, F. The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”. J. Clin. Med. 2019, 8, 2165.

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.

Keywords

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

Subject

Medicine and Pharmacology, Cardiac and Cardiovascular Systems

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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