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Minerva Cardiology and Angiology 2021 Oct 29

DOI: 10.23736/S2724-5683.21.05802-6


language: English

Assessment of sacubitril/valsartan effects on left ventricular dynamics using 3D echocardiography and 3D strain in heart failure with reduced ejection fraction patients

Tuğba K. ÖZ 1, 2 , Mahmoud ABDELNABI 3, 4, Corrado FIORE 5, Abdallah ALMAGHRABY 6, Deniz CIHAN 7, Nigar BABAZADE 8, Syed HASEEB RAZA NAQVI 9, Bahadır OMAR 10, Bahadır DAĞDEVIREN 7

1 Cardiology Department, Faculty of Medicine, Istinye University, Istanbul, Turkey; 2 Cardiology Department, Liv Hospital Ulus, Istanbul, Turkey; 3 Clinical and Experimental Internal Medicine Department, Medical research Institute, Alexandria University, Alexandria, Egypt; 4 Internal Medicine Department, Texas Tech Health Science Center, Lubbock, TX, USA; 5 Cardiology Department, Citta di Lecce Hospital GVM Care and Research, Lecce, Italy; 6 Cardiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt; 7 Cardiology Department, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey; 8 Cardiology Department, Baku Health Clinic, Baku, Azerbaijan; 9 Cardiology Department, National Institute of Cardiovascular Diseases, Sindh, Pakistan; 10 Cardiology Department, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey


BACKGROUND: Three-dimensional (3D) echocardiography and 3D strain parameters have been used for a comprehensive quantitative assessment of left ventricular (LV) myocardial dynamics. So far, there are no data on sacubitril/valsartan effects on cardiac functions and LV reverse remodeling using 3D echocardiography. This study aimed to evaluate the effects of sacubitril/valsartan on the LV functions using two-dimensional (2D) echocardiography, 3D echocardiography, and the 3D strain parameters.
METHODS: A single-center prospective cohort study which included 100 heart failure with reduced ejection fraction (HFrEF) patients with guidelines-approved indications for sacubitril/valsartan treatment. Patients received a short course (3-month) of sacubitril/valsartan. 3-month follow-up 2D, 3D echocardiographic parameters, and 3D strain were compared to baseline parameters.
RESULTS: The results of the study revealed a significant improvement in left ventricular dynamic functions at 3-month follow-up with an improvement in left ventricular systolic function (mean left ventricular ejection fraction (LVEF) increased from 27.65 ± 4.98% to 32.89 ± 6.03%, P<0.001). Comparison of HFrEF patients with ischemic and non-ischemic etiologies showed that echocardiographic parameters significantly improved in both groups after 3 months of sacubitril/valsartan treatment. There was no statistically significant difference between both groups regarding echocardiographic parameters at baseline and 3-month follow-up.
CONCLUSIONS: In a single-center prospective observational cohort study evaluating the effects of short-term (3-month course) sacubitril/valsartan treatment on LV dynamics assessed by 3D echocardiography and 3D strain, sacubitril/valsartan was associated with a significant improvement of LV systolic functions and reverse remodeling effects in both ischemic and non-ischemic HFrEF patients.

KEY WORDS: Heart failure with reduced ejection fraction (HFrEF); Sacubitril/valsartan; 3D echocardiography; 3D stain; Ventricular remodeling

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