Sacubitril/valsartan therapy for 30 days significantly improved the E/E' ratio by 35.9% (p=0.001) and peak oxygen uptake by 16.7% (p=0.001) in patients with HFrEF.
Does sacubitril/valsartan improve left ventricular diastolic parameters and functional capacity at 30 days in stable patients with symptomatic HFrEF?
Sacubitril/valsartan therapy is associated with early (30-day) improvements in left ventricular diastolic function and functional capacity in patients with HFrEF.
valor p: p=0.001
Although sacubitril/valsartan has recently shown its long-term benefits on morbidity and mortality in symptomatic patients with chronic heart failure with reduced ejection fraction (HFrEF), its short-term effects on diastolic function remain uncertain. We sought to assess 30-day effects of sacubitril/valsartan on left ventricular (LV) diastolic paremeters determined by speckle tracking and tissue Doppler imaging (STI and TDI respectively) as well as their association with functional capacity change evaluated by peak oxygen uptake (VO2max) in stable patients with symptomatic HFrEF. A total of 35 patients (aged 61 ± 9 years) eligible for sacubitril/valsartan underwent a complete two-dimension (2D) echocardiographic study and a cardiopulmonary exercise test at baseline and 30 days after the initiation of therapy. Significant improvements in ratio of trans-mitral inflow early diastolic velocity E to mitral annulus early diastolic velocity E′ (ΔΕ//Ε′ = -35.9%, p = 0.001), peak early diastolic strain rate SRE (ΔSRE = +22.5%, p = 0.024) and ratio E/SRE (ΔE/SRE = -33.2%, p = 0.025) were observed after 1-month therapy. Compared with baseline, VO2max also increased significantly by 16.7 % (p = 0.001). Baseline E/SRE and ΔE/SRE were the strongest independent predictors of VO2max improvement (beta = -0.43, p = 0.004 and beta = 0.45, p = 0.021 respectively) in the multivariate analysis. Sacubitril/valsartan was associated with early improvement in LV diastolic function determined by TDI and 2D STI. Baseline E/SRE was stronger than standard echocardiographic parameters in predicting the early benefit of sacubitril/valsartan therapy.
Nakou et al. (Thu,) conducted a other in symptomatic heart failure with reduced ejection fraction (HFrEF) (n=35). Sacubitril/valsartan vs. Baseline was evaluated on Left ventricular diastolic parameters and functional capacity change (VO2max) (p=0.001). Sacubitril/valsartan therapy for 30 days significantly improved the E/E' ratio by 35.9% (p=0.001) and peak oxygen uptake by 16.7% (p=0.001) in patients with HFrEF.