Key result
Switching to sacubitril/valsartan significantly improved left ventricular reverse remodeling parameters and quality of life at 3 months in patients with HFrEF (P<0.05).
Why the study?
To evaluate if switching from an ACEI or ARB to sacubitril/valsartan induces incremental LV reverse remodeling and improves quality of life in HFrEF.
Does switching to sacubitril/valsartan improve LV reverse remodeling and quality of life in patients with HFrEF?
Cohort (n=100)
Yes
Does switching to sacubitril/valsartan improve LV reverse remodeling and quality of life in patients with HFrEF?
p-value: p=<0.05
Switching from an ACEI or ARB to sacubitril/valsartan in HFrEF patients significantly improves echocardiographic parameters of reverse remodeling and quality of life at 3 months.
Switching to sacubitril/valsartan may improve remodeling and QOL in HFrEF; leaves open need for randomized trials before practice change.
Objective: To evaluate if switching therapy from an angiotensin converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) to sacubitril/valsartan induces incremental left ventricular (LV) reverse remodeling and the effect of switching on quality of life (QOL) in heart failure with reduced ejection fraction (HFrEF). Methodology: This prospective multicenter study included 100 patients with HFrEF. The patients were subdivided into two equal groups: Group one included patients who were switched to sacubitril/valsartan and group two included patients continued on ACEIs or ARBs as control group. The patients were subjected to medical history taking, clinical examination, heart failure related data, New York Heart Association (NYHA) functional classification, blood samples and chemistry, transthoracic echocardiography (TTE) and quality of life assessment. Results: There was marked improvement in all two dimensional (2D) echocardiography parameters, as left ventricular end-systolic volume (LVESVI), left ventricular end-diastolic volume index (LVEDVI) and left atrium volume index (LAVI) which significantly reduced after 3 months of therapy with significant improvement in LV function (P-value < 0.05). Moreover, mitral regurgitation (MR) severity significantly decreased (P-value < 0.05). Regarding quality of life, there was a significant improvement in QOL. KCCQ score was significantly improved after 3 months of treatment (P-value < 0.05). Conclusion: In HFrEF patients, sacubitril/valsartan significantly improves LV function; furthermore, it induces incremental LV reverse remodeling as well as improves QOL.
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Darwish et al. (2023) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=100). Sacubitril/valsartan vs. ACEIs or ARBs was evaluated on Left ventricular reverse remodeling (LVESVI, LVEDVI, LAVI, LV function) and quality of life (KCCQ score) (p=<0.05). Switching to sacubitril/valsartan significantly improved left ventricular reverse remodeling parameters and quality of life at 3 months in patients with HFrEF (P<0.05).
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