Bonatto Marcely Gimenes, Albanez Rodrigo, Salemi Vera Maria Cury, Moura Lídia Zytynski
Department of Cardiology, Heart Failure and Heart Transplantation Section of Santa Casa de Misericórdia Hospital, Curitiba, Paraná, Brazil.
Department of Cardiology, Pontifical Catholic University of Paraná, Curitiba, Brazil.
ESC Heart Fail. 2020 Jun;7(3):1186-1189. doi: 10.1002/ehf2.12713. Epub 2020 Apr 17.
The use of sacubitril/valsartan significantly reduces death or hospitalization in patients with ejection fraction < 40%. There is no study evaluating this drug effects in non-compaction cardiomyopathy (NCCM) individuals. The aim of this article is to report a case of a patient with NCCM initially refractory to gold standard treatment and afterwards treated with sacubitril/valsartan and its improvements. This is a case report of a 48-year-old woman, presenting with NCCM heart failure, who had received standard guideline-directed medical therapy for 18 months without any improvement in clinical and echocardiographic parameters. After that period, sacubitril/valsartan was initiated. After 18 months of refractory usage of guideline-directed medical therapy, sacubitril/valsartan was started, and significant change in functional class (III to I) and important ventricular remodelling were achieved with an improvement of 29% in the ejection fraction, reduction of 7 mm in ventricular diastolic diameter, and mild to none mitral valve functional regurgitation. In this case report, sacubitril/valsartan use was associated with improvement of echocardiographic and clinical parameters in a patient with NCCM.
沙库巴曲缬沙坦的使用显著降低了射血分数<40%的患者的死亡或住院风险。尚无研究评估该药物对心肌致密化不全（NCCM）患者的疗效。本文旨在报告1例NCCM患者，该患者最初对金标准治疗无效，随后接受沙库巴曲缬沙坦治疗并取得改善。这是1例48岁女性NCCM心力衰竭患者的病例报告，该患者接受标准指南指导的药物治疗18个月，临床和超声心动图参数均无改善。在此期间后，开始使用沙库巴曲缬沙坦。在对指南指导的药物治疗进行18个月的难治性使用后，开始使用沙库巴曲缬沙坦，功能分级（从III级改善到I级）出现显著变化，心室发生重要重塑，射血分数提高29%，心室舒张直径缩小7mm，二尖瓣功能性反流从轻度减轻至无反流。在本病例报告中，沙库巴曲缬沙坦的使用与1例NCCM患者的超声心动图和临床参数改善相关。
