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Minerva Cardiology and Angiology 2022 August;70(4):431-8

DOI: 10.23736/S2724-5683.21.05802-6


lingua: Inglese

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 ABDELNABİ 3, 4, Corrado FIORE 5, Abdallah ALMAGHRABY 6, Deniz CİHAN 7, Nigar BABAZADE 8, Syed HASEEB RAZA NAQVİ 9, Bahadır OMAR 10, Bahadır DAĞDEVİREN 7

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

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