Pere Pericas1,2, Caterina Mas-Lladó3,4, Maria Francisca Ramis-Barceló3,4, Isabel Valadrón3,4, Marta Noris Mora3,4, Lucía Pasamar Márquez3,4, Rosa González Colino3,4, José Francisco Forteza Albertí3,4, Vicente Peral Disdier3,4, Xavier Rossello3,4,5. 1. Cardiology Department, Hospital Universitari Son Espases, Carretera de Valldemossa, 79, 07120, Palma, Balearic Islands, Spain. papericas@hotmail.com. 2. Grupo de investigación de Fisiopatología y Terapéutica Cardiovascular, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain. papericas@hotmail.com. 3. Cardiology Department, Hospital Universitari Son Espases, Carretera de Valldemossa, 79, 07120, Palma, Balearic Islands, Spain. 4. Grupo de investigación de Fisiopatología y Terapéutica Cardiovascular, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Spain. 5. Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
Abstract
INTRODUCTION: Sacubitril/valsartan (S-V) has been shown to reduce clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF). This benefit has been mostly attributed to an improvement in systolic function. AIM: This study aimed to evaluate longitudinal changes in several echocardiographic parameters of diastolic function in a cohort of patients with HFrEF receiving S-V. METHODS: Echocardiographic parameters of consecutive patients receiving S-V, such as diastolic dysfunction (DD) grade and other individual diastolic and systolic function parameters, were prospectively collected at baseline and at 6-month follow-up. New York Heart Association (NYHA) functional class was also recorded. RESULTS: 65 patients (73.9% males; 61.5 ± 13 years) with HFrEF in NYHA class II-IV were evaluated. There was a significant reduction in DD grade after treatment with maximal tolerated doses (p < 0.001). Patients with advanced DD showed the most significant improvements: 75% and 60% of patients with initial grade 3 and 2, respectively, had better grade after 6 months of S-V. Moreover, there was a reduction in E/e' ratio (p = 0.004), left atrial longitudinal strain (p = 0.002), and an improvement of left ventricle ejection fraction (p < 0.001) and NYHA functional class (p = 0.001). Among those subjects who improved their functional class, a higher percentage improved their DD grade (39.3%, p = 0.025) in comparison with those not improving their NYHA class (25%, p = 0.434). CONCLUSIONS: In addition to an improvement in systolic function parameters, patients with HFrEF receiving S-V improved their diastolic function. This echocardiographic improvement is particularly relevant in those patients with better NYHA class at 6-month follow-up.
INTRODUCTION:Sacubitril/valsartan (S-V) has been shown to reduce clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF). This benefit has been mostly attributed to an improvement in systolic function. AIM: This study aimed to evaluate longitudinal changes in several echocardiographic parameters of diastolic function in a cohort of patients with HFrEF receiving S-V. METHODS: Echocardiographic parameters of consecutive patients receiving S-V, such as diastolic dysfunction (DD) grade and other individual diastolic and systolic function parameters, were prospectively collected at baseline and at 6-month follow-up. New York Heart Association (NYHA) functional class was also recorded. RESULTS: 65 patients (73.9% males; 61.5 ± 13 years) with HFrEF in NYHA class II-IV were evaluated. There was a significant reduction in DD grade after treatment with maximal tolerated doses (p < 0.001). Patients with advanced DD showed the most significant improvements: 75% and 60% of patients with initial grade 3 and 2, respectively, had better grade after 6 months of S-V. Moreover, there was a reduction in E/e' ratio (p = 0.004), left atrial longitudinal strain (p = 0.002), and an improvement of left ventricle ejection fraction (p < 0.001) and NYHA functional class (p = 0.001). Among those subjects who improved their functional class, a higher percentage improved their DD grade (39.3%, p = 0.025) in comparison with those not improving their NYHA class (25%, p = 0.434). CONCLUSIONS: In addition to an improvement in systolic function parameters, patients with HFrEF receiving S-V improved their diastolic function. This echocardiographic improvement is particularly relevant in those patients with better NYHA class at 6-month follow-up.
Entities:
Keywords:
Diastolic function; Heart failure; Sacubitril–valsartan; Systolic function
Authors: Luis López; Xavier Rossello; Dora Romaguera; Ángel M Alonso-Gómez; Estefanía Toledo; Elena Fortuny; Marta Noris; Caterina Mas-Lladó; Miquel Fiol; Raul Ramallal; Lucas Tojal-Sierra; Alvaro Alonso; Carlos Fernandez-Palomeque Journal: Front Cardiovasc Med Date: 2022-06-21
Authors: Jakub Benko; Matej Samoš; Tomáš Bolek; Dana Prídavková; Jakub Jurica; Martin Jozef Péč; Peter Galajda; Marián Mokáň Journal: J Diabetes Res Date: 2022-03-07 Impact factor: 4.011