Do the remodeling effects of sacubitril/valsartan treatment depend upon heart failure duration?

Alessandra Villani, Silvia Ravaro, Paolo Cerea, Sergio Caravita, Francesca Ciambellotti, Giovanna Branzi, Carlotta Munforti, Gianfranco Parati, Gabriella Malfatto

Research output: Contribution to journalArticlepeer-review

Abstract

AIMS: The angiotensin receptor and neprilysin inhibitor (ARNI) sacubitril/valsartan (LCZ696) is recommended for the treatment of patients with heart failure in New York Heart Association (NYHA) class II-III and left ventricular ejection fraction (LVEF) 35% or less. We examined the effects of sacubitril/valsartan on cardiac remodeling and their correlation with heart failure duration in patients enrolled in our heart failure clinic from March 2017 to December 2019. METHODS: Echocardiographic and clinical/laboratory data were collected at baseline and at 6-month and 12-month follow-up visits in 69 patients (age 67 ± 12 years, disease duration 8.4 ± 5.8 years, 93% men). RESULTS: At both time points, mean NYHA class, NT-proBNP level, LVEF, LV end-systolic volume, and estimated systolic pulmonary pressure significantly (P < 0.05) improved versus baseline, as did the proportion of patients with diastolic dysfunction grade 3 or functional mitral regurgitation grade 3-4. In the subgroup with mean disease duration less than 8.5 years (n = 40), there was a significant improvement in all variables at both time points; in this group, a recovery of right ventricular function was also seen at the 12-month follow-up. On the contrary, patients with heart failure duration of at least 8.5 years (n = 29) showed only a slight improvement in LVEF and mitral regurgitation at 12 months. There were no significant changes in renal function and/or potassium levels in all patients. CONCLUSION: In patients with a relatively short disease duration, sacubitril/valsartan was associated with a strong favorable remodeling of the left ventricle and improvement in pulmonary circulation.

Original languageEnglish
Pages (from-to)682-687
Number of pages6
JournalJournal of cardiovascular medicine (Hagerstown, Md.)
Volume21
Issue number9
DOIs
Publication statusPublished - Sep 1 2020

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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