Sacubitril/valsartan administration in patients with HFrEF significantly reduced the proportion of patients in NYHA class III from 40% to 17% (P<0.001) and improved ejection fraction.
Cohort (n=230)
Does sacubitril/valsartan improve clinical, biochemical, and echocardiographic parameters in patients with HFrEF?
Sacubitril/valsartan therapy in HFrEF patients is associated with significant reverse cardiac remodeling, biomarker reduction, and symptomatic improvement.
Absolute Event Rate: 17% vs 40%
p-value: p=<0.001
Background: Sacubitril/valsartan has been shown to be superior to enalapril in reducing the risks of death and hospitalization for heart failure (HF). However, knowledge of the impact on cardiac performance remains limited. We sought to evaluate the effects of sacubitril/valsartan on clinical, biochemical and echocardiographic parameters in patients with heart failure and reduced ejection fraction (HFrEF). Methods: Sacubitril/valsartan was administered to 205 HFrEF patients. Results: Among 230 patients (mean age 59 ± 10 years, 46% with ischemic heart disease) 205 (89%) completed the study. After a follow-up of 10.49 (2.93 ± 18.44) months, the percentage of patients in New York Heart Association (NYHA) class III changed from 40% to 17% (p < 0.001). Median N–Type natriuretic peptide (Nt-proBNP) decreased from 1865 ± 2318 to 1514 ± 2205 pg/mL, (p = 0.01). Furosemide dose reduced from 131.3 ± 154.5 to 120 ± 142.5 (p = 0.047). Ejection fraction (from 27± 5.9% to 30 ± 7.7% (p < 0.001) and E/A ratio (from 1.67 ± 1.21 to 1.42 ± 1.12 (p = 0.002)) improved. Moderate to severe mitral regurgitation (from 30.1% to 17.4%; p = 0.002) and tricuspid velocity decreased from 2.8 ± 0.55 m/s to 2.64 ± 0.59 m/s (p < 0.014). Conclusions: Sacubitril/valsartan induce “hemodynamic recovery” and, consistently with reduction in Nt-proBNP concentrations, improve NYHA class despite diuretic dose reduction.
Romano et al. (2019) conducted a cohort in Heart failure with reduced ejection fraction (HFrEF) (n=230). Sacubitril/valsartan was evaluated on Percentage of patients in NYHA class III (p=<0.001). Sacubitril/valsartan administration in patients with HFrEF significantly reduced the proportion of patients in NYHA class III from 40% to 17% (P<0.001) and improved ejection fraction.