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. 2021 Aug 16:12:733475.
doi: 10.3389/fphar.2021.733475. eCollection 2021.

Impact of Sacubitril/Valsartan on Clinical and Echocardiographic Parameters in Heart Failure Patients With Reduced Ejection Fraction: Data From a Real Life 2-year Follow-Up Study

Giuseppe Armentaro  1 , Graziella D'Arrigo  2 , Marcello Magurno  1 , Alfredo F Toscani  1 , Valentino Condoleo  1 , Sofia Miceli  1 , Velia Cassano  1 , Raffaele Maio  1 , Franco Arturi  1 , Giovanni Tripepi  2 , Giorgio Sesti  3 , Angela Sciacqua  1
Affiliations

Impact of Sacubitril/Valsartan on Clinical and Echocardiographic Parameters in Heart Failure Patients With Reduced Ejection Fraction: Data From a Real Life 2-year Follow-Up Study

Giuseppe Armentaro et al. Front Pharmacol. .

Abstract

Heart failure (HF) represents a widespread health problem characterized by high morbidity and mortality. Sacubitril/Valsartan (sac/val) has improved clinical prognosis in patients affected by HF with reduced ejection fraction (HFrEF). The aim of this study was to evaluate the effectiveness and durability of sac/val treatment on the clinical, hemodynamic and echocardiographic parameters, in real-life consecutive HFrEF outpatients, evaluated up to 2-years of follow-up. We collected 300 repeated observations over time in 60 patients suffering of HFrEF and symptomatic despite optimal drug therapy. Patients with left ventricular ejection fraction (LVEF) <35 and II-III NYHA functional class were considered. All patients underwent to clinical-instrumental and laboratory determinations and Minnesota Living with HF Questionnaire (MLHFQ) every 6 months until 24 months to evaluate possible clinical benefits and adverse events. During a 2-year follow-up period and through a 6-monthly control of the study variables both clinical, hemodynamic, biochemical and echocardiographic parameters significantly improved, in particular cardiac index (CI), both atrial and ventricular volumes and global longitudinal strain (GLS). Furthermore, there was a reduction of NT-proBNP levels and betterment of renal function and NYHA functional class, demonstrating the efficacy and durability of sac/val treatment. In a multiple linear mixed model the longitudinal evolutions of CI were associated to concomitant changes of GLS and E/e' ratio. Our study, contemplating the collection of 300 repeated observations in 60 patients, provides a complete and detailed demonstration of sac/val effects, showing effectiveness, safety and effect durability of the treatment every 6 months up to 2-years of follow-up with significant improvement of several clinical, hemodynamic and echocardiographic parameters in HFrEF outpatients.

Keywords: NT-proBNP; cardiac index; heart failure; left ventricular ejection fraction; sacubitril/valsartan.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
NTproBNP (pg/ml) median and interquartile range values at baseline and every 6 months, during the 24-months follow-up.
FIGURE 2
FIGURE 2
Mean values and standard deviation of the Cardiac Index (ml/min/m2) at baseline and every 6 months, during the 24-months follow-up.
See this image and copyright information in PMC

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