Key result
In a real-world registry of patients with chronic heart failure, 12 months of sacubitril/valsartan therapy significantly improved right ventricular function, increasing TAPSE from 16.5 mm to 17.8 mm.
Why the study?
Sacubitril/valsartan improves left ventricular function and reverse remodeling, but whether right ventricular function also improves was unknown.
Does sacubitril/valsartan improve right ventricular function in patients with chronic heart failure with reduced ejection fraction?
Observational (n=60)
Does sacubitril/valsartan improve right ventricular function in patients with chronic heart failure with reduced ejection fraction?
Absolute Event Rate: 17.8% vs 16.5%
p-value: p=<0.001
In a real-world cohort of patients with HFrEF, sacubitril/valsartan therapy was associated with significant improvements in right ventricular function (TAPSE and PAsP) that were proportional to baseline dysfunction.
Sacubitril/valsartan was associated with RV function gains in this observational cohort; leaves open clinical benefit pending randomized confirmation.
Previous studies and case-series showed improvement in left ventricular (LV) function and reverse remodeling after sacubitril/valsartan therapy in real-world studies. We therefore aimed to evaluate whether also right ventricular (RV) function may improve after sacubitril/valsartan therapy. Sixty consecutive patients with chronic heart failure and NYHA class II-III were followed up for 12 months after therapy with sacubitril/valsartan. Left and (RV) function was assessed at baseline and after 12 months of therapy. At 12-month control, therapy with sacubitril/valsartan was associated with a significant improvement in a series of echo parameters: LVEF (p < 0.05), LV end-systolic volume (p < 0.01), left atrium area (p < 0.05). Right ventricular echo parameters were also improved after sacubitril/valsartan therapy: PAsP (31.0 ± 12.8 vs 34.7 ± 12.5 mmHg, p < 0.05), TAPSE (17.8 ± 3.9 vs 16.5 ± 4.0 mm, p < 0.001); mean PAsP reduction was 3.7 ± 11.4 mmHg (-6.3 ± 37.7%), mean TAPSE increase 1.3 ± 2.5 mm (+9.5 ± 15.7%). Indexed (%) improvement in PAsP (r 0.33, p < 0.01) and TAPSE (r −0.42, p < 0.01) values were proportional to baseline levels. Improvement in PAsP and TAPSE were independent of left ventricular improvements except for PAsP and end-systolic volumes (r 0.44, p < 0.01). In a real world scenario, sacubitril/valsartan was associated with an improved RV function.
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Correale et al. (2020) conducted an observational in Chronic heart failure with reduced ejection fraction (HFrEF) (n=60). Sacubitril/valsartan vs. Baseline was evaluated on Tricuspid annular plane systolic excursion (TAPSE) (p=<0.001). In a real-world registry of patients with chronic heart failure, 12 months of sacubitril/valsartan therapy significantly improved right ventricular function, increasing TAPSE from 16.5 mm to 17.8 mm.
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