Different aspects of pharmacological heart failure treatment

The effect of initiating sacubitril/valsartan (sac/val) therapy during hospitalization for acute heart failure (AHF) on left ventricular (LV) remodelling remains unclear.Dr Tanaka and co-workers from Japan, aimed to assess the impact of Sac/Val on LV remodelling in patients in whom sacubitril/valsartan (Sac/Val) was initiated during AHF hospitalization.The authors used data from Program of Angiotensin-Neprilysin Inhibition in Admitted Patients with Worsening Heart Failure (PREMIER) study, which investigated the impact of initiating Sac/Val during hospitalization for AHF on echocardiographic parameters over an 8-week period, in comparison with the standard renin-angiotensin system inhibitor therapy. 1 The study group concluded that in patients stabilized after hospitalization for AHF, Sac/Val may significantly improve some functional and structural parameters of the left ventricle, particularly in those with an LVEF 40% is controversial. 3,4Dr Maeder and colleagues from Switzerland, assessed the relationship between BB therapy at discharge and 1-year mortality according to LVEF in a large contemporary ACS cohort (n = 7820).The authors found that among patients with LVEF 40%, mortality was lower in patients with BB compared to those without (5.9% vs. 14%; P 40%, mortality did not differ between patients with and without BB (2.1% vs. 2.6%; P = 0.3).A statistically significant interaction between BB therapy and LVEF stratum was identified.