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. 2024 Mar 28;76(1):41.
doi: 10.1186/s43044-024-00468-4.

Unlocking the potential of sacubitril/valsartan therapy in improving ECG and echocardiographic parameters in heart failure patients with reduced ejection fraction (HErEF)

Lamyaa Elsayed Allam  1 , Ahmed Aly Abdelmotteleb  2 , Hayam Mohamed Eldamanhoury  2 , Hassan Shehata Hassan  2
Affiliations

Unlocking the potential of sacubitril/valsartan therapy in improving ECG and echocardiographic parameters in heart failure patients with reduced ejection fraction (HErEF)

Lamyaa Elsayed Allam et al. Egypt Heart J. .

Abstract

Background: Sacubitril/valsartan therapy has been found to reduce hospitalizations, improve echocardiogram parameters, and improve mortality in HFrEF. The objective is to assess S/V therapy effect on electrocardiogram indices and how those parameters related to echocardiographic parameters.

Results: From June 2022 until June 2023, this prospective study enrolled 100 patients (mean age 56.1, 8.2, 78% male) with non-ischemic dilated cardiomyopathy (NIDCM) used PARADIGM-HF criteria: NYHA Class II, III, or IV HF; ejection fraction EF ≤ 40%; and hospitalization for HF within previous 12 months. Before starting S/V therapy, an echo and ECG were performed, as well as 6 months following the optimal dose and if LVEF was improved by more than 5%, they were termed notable S/V treatment responders. Aside from improving echo parameters, ECG parameters improved significantly. The QRS width was reduced from 123.7 ± 20.3 to 117.1 ± 18.8 ms (p 0.00), and QTc interval was reduced from 425.4 ± 32.8 to 421.4 ± 32.3 ms (p = 0.012). QRS width was significantly reduced in patients with LBBB, RBBB, and IVCD based on QRS morphology. QRS width (r = - 0.243, p = 0.016) and QTc (r = - 0.252, p = 0.012) had a negative connection with LVEF.

Conclusion: S/V therapy, in addition to improving echo parameters and NYHA class, improves QRS width and corrected QTc interval on ECG in HFrEF patients. This is an indication of reverse electrical LV remodeling and can be used as an auxiliary prediction for tracking therapy outcomes.

Keywords: ECG; Echocardiography; Heart failure; Reduced ejection fraction; Sacubitril/valsartan combination.

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Conflict of interest statement

All authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Pearson correlation coefficient (r) and p-value (p) between QRS width change and LV ejection fraction after S/V therapy in HErEF patients
Fig. 2
Fig. 2
Pearson correlation coefficient (r) and p-value (p) between corrected QT interval change and LV ejection fraction after S/V therapy in HErEF patients
See this image and copyright information in PMC

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