Key result
Non-ischemic HFrEF linked to ~4-fold higher rate of LV improvement on sacubitril/valsartan vs ischemic.
Why the study?
The study was designed to confirm the effects of sacubitril/valsartan in HFrEF patients and evaluate whether response differed between ischemic and non-ischemic etiologies.
Does sacubitril/valsartan improve left ventricular reverse remodeling more in non-ischemic compared to ischemic HFrEF patients?
Cohort (n=79)
No
Does sacubitril/valsartan improve left ventricular reverse remodeling more in non-ischemic compared to ischemic HFrEF patients?
Hazard Ratio: 3.96 (95% CI 1.03–15.24)
p-value: p=0.045
Sacubitril/valsartan is associated with more pronounced reverse ventricular remodeling and ejection fraction improvement in HFrEF patients with a non-ischemic etiology compared to those with an ischemic etiology.
Etiology may influence LV recovery on sacubitril/valsartan in HFrEF; hypothesis-generating and requires randomized confirmation before guiding therapy.
Sacubitril/valsartan (SV) has been demonstrated to reduce cardiovascular mortality, hospitalization for heart failure and to induce reverse ventricular remodeling. The present study was designed to confirm the effects of SV in a selected population of patients with HFrEF and to evaluate the different responses between patients with an ischemic or a non-ischemic etiology. A total of 79 patients with indication of SV were recruited prospectively during a timelapse of 4 years. SV was overall associated to a reduction of end-diastolic and end-systolic volume, of NT-proBNP levels, furosemide dosage and NYHA functional class, together with an increase in EF. These changes were more evident in patients with non-ischemic dilated cardiomyopathy, who showed a significant improvement in ventricular volumes, ejection fraction, TAPSE and blood levels of NT-proBNP. Kaplan-Meier curves confirmed a greater benefit in terms of ejection-fraction improvement in non-ischemic patients compared to the ischemic group. The results of the present study confirm the positive effect of SV on NYHA functional class, NT- proBNP, left ventricular volumes and EF in HFrEF patients, showing evidence of association of SV with ventricular remodeling in patients with dilated cardiomyopathy of non-ischemic etiology compared to the ischemic group.
No takes yet. Share an insight, caveat, or question.
Cemin et al. (2023) conducted a cohort in Heart Failure with reduced Ejection Fraction (HFrEF) (n=79). Sacubitril/valsartan (non-ischemic etiology) vs. Sacubitril/valsartan (ischemic etiology) was evaluated on Functional LV improvement (EF increase > 10% baseline) (HR 3.96, 95% CI 1.03-15.24, p=0.045). In patients with HFrEF treated with sacubitril/valsartan, those with a non-ischemic etiology experienced a significantly greater rate of functional LV improvement compared to the ischemic group (HR 3.96, p=0.045).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: