Correale Michele, Mallardi Adriana, Mazzeo Pietro, Tricarico Lucia, Diella Claudia, Romano Valentina, Ferraretti Armando, Leopizzi Alessandra, Merolla Giuseppina, Di Biase Matteo, Brunetti Natale Daniele
Ospedali Riuniti University Hospital, Foggia, Italy.
Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
Int J Cardiol Heart Vasc. 2020 Feb 25;27:100486. doi: 10.1016/j.ijcha.2020.100486. eCollection 2020 Apr.
Previous studies and case-series showed improvement in left ventricular (LV) function and reverse remodeling after sacubitril/valsartan therapy in real-world studies. We therefore aimed to evaluate whether also right ventricular (RV) function may improve after sacubitril/valsartan therapy.
Sixty consecutive patients with chronic heart failure and NYHA class II-III were followed up for 12 months after therapy with sacubitril/valsartan. Left and (RV) function was assessed at baseline and after 12 months of therapy.
At 12-month control, therapy with sacubitril/valsartan was associated with a significant improvement in a series of echo parameters: LVEF (p < 0.05), LV end-systolic volume (p < 0.01), left atrium area (p < 0.05).Right ventricular echo parameters were also improved after sacubitril/valsartan therapy: PAsP (31.0 ± 12.8 vs 34.7 ± 12.5 mmHg, p < 0.05), TAPSE (17.8 ± 3.9 vs 16.5 ± 4.0 mm, p < 0.001); mean PAsP reduction was 3.7 ± 11.4 mmHg (-6.3 ± 37.7%), mean TAPSE increase 1.3 ± 2.5 mm (+9.5 ± 15.7%).Indexed (%) improvement in PAsP (r 0.33, p < 0.01) and TAPSE (r -0.42, p < 0.01) values were proportional to baseline levels. Improvement in PAsP and TAPSE were independent of left ventricular improvements except for PAsP and end-systolic volumes (r 0.44, p < 0.01).
In a real world scenario, sacubitril/valsartan was associated with an improved RV function.
既往研究和病例系列显示,在真实世界研究中,沙库巴曲缬沙坦治疗后左心室(LV)功能改善且发生逆向重构。因此,我们旨在评估沙库巴曲缬沙坦治疗后右心室(RV)功能是否也会改善。
连续纳入60例慢性心力衰竭且纽约心脏协会(NYHA)心功能II-III级的患者,在接受沙库巴曲缬沙坦治疗后随访12个月。在基线期和治疗12个月后评估左心室和右心室功能。
在12个月的对照期,沙库巴曲缬沙坦治疗与一系列超声心动图参数的显著改善相关:左心室射血分数(LVEF)(p<0.05)、左心室收缩末期容积(p<0.01)、左心房面积(p<0.05)。沙库巴曲缬沙坦治疗后右心室超声心动图参数也得到改善:肺动脉收缩压(PAsP)(31.0±12.8 vs 34.7±12.5 mmHg,p<0.05)、三尖瓣环平面收缩期位移(TAPSE)(17.8±3.9 vs 16.5±4.0 mm,p<0.001);PAsP平均降低3.7±11.4 mmHg(-6.3±37.7%),TAPSE平均增加1.3±2.5 mm(+9.5±15.7%)。PAsP(r 0.33,p<0.01)和TAPSE(r -0.42,p<0.01)值的指数化(%)改善与基线水平成比例。除PAsP和收缩末期容积外(r 0.44,p<0.01),PAsP和TAPSE的改善与左心室改善无关。
在真实世界中,沙库巴曲缬沙坦与右心室功能改善相关。