Gioia Margherita Ilaria, Parisi Giuseppe, Grande Dario, Albanese Miriam, Alcidi Gianmarco, Correale Michele, Brunetti Natale Daniele, Ciccone Marco Matteo, Iacoviello Massimo
Cardiology Unit, Perrino Hospital, 72100 Brindisi, Italy.
School of Cardiology, University of Bari, 70124 Bari, Italy.
J Clin Med. 2022 Jun 26;11(13):3683. doi: 10.3390/jcm11133683.
Sacubitril/valsartan plays a key role in improving left ventricular remodeling and prognosis in patients with heart failure with a reduced ejection fraction (HFrEF). Moreover, some data support its role in preserving renal function. In order to better clarify the effects of sacubitril/valsartan in cardiorenal syndrome, this study evaluated its effects on the renal resistance index (RRI).
A group of patients with HFrEF was enrolled. The RRI was assessed with renal echo-color Doppler at enrollment and again after at least six months of sacubitril/valsartan treatment. In a subgroup of patients, the RRI was also evaluated at least six months before enrollment. The variations in echocardiographic parameters reflecting the left and right ventricular function, as well as creatinine and the estimated glomerular filtration rate, were also evaluated.
After treatment with sacubitril/valsartan, significant improvements in the left ventricular ejection fraction, and a decrease in the left atrial and ventricular volumes were observed. The RRI also showed a significant decrease. No relationship was found between the improvements in the parameters reflecting cardiac function and changes in the RRI.
Treatment with sacubitril/valsartan is associated with improvements in both left ventricular function and renal perfusion, through decreasing the renal resistance. These data help to clarify the effects of the drug on cardiorenal syndrome progression.
沙库巴曲缬沙坦在改善射血分数降低的心力衰竭（HFrEF）患者的左心室重构和预后方面发挥着关键作用。此外，一些数据支持其在保护肾功能方面的作用。为了更好地阐明沙库巴曲缬沙坦在心肾综合征中的作用，本研究评估了其对肾阻力指数（RRI）的影响。
招募一组HFrEF患者。在入组时以及接受沙库巴曲缬沙坦治疗至少六个月后，采用肾脏超声彩色多普勒评估RRI。在一组亚组患者中，还在入组前至少六个月评估RRI。还评估了反映左、右心室功能的超声心动图参数以及肌酐和估计肾小球滤过率的变化。
接受沙库巴曲缬沙坦治疗后，观察到左心室射血分数显著改善，左心房和心室容积减小。RRI也显著降低。在反映心脏功能的参数改善与RRI变化之间未发现相关性。
沙库巴曲缬沙坦治疗可通过降低肾阻力，改善左心室功能和肾灌注。这些数据有助于阐明该药物在心肾综合征进展中的作用。
