Heart Failure Unit, Centro Cardiologico Monzino IRCCS, Milan, Italy.
Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy.
ESC Heart Fail. 2023 Jun;10(3):2099-2106. doi: 10.1002/ehf2.14344. Epub 2023 Mar 12.
The amount of evidence for guideline-directed new heart failure (HFrEF) disease-modifying drugs in the context of chronic kidney disease (CKD) is relatively modest, especially in end-stage CKD. We report a case of dramatic reverse remodelling and disease regression in a naïve HFrEF young woman on haemodialysis treated with sacubitril/valsartan and SGLT2i. At 10-month follow-up, the patient normalized left ventricle and atrial volumes and improved ejection fraction to the normal range, assessed both by echocardiography and cardiac magnetic resonance. Cardiac biomarkers and exercise performance improved consensually. The haemodialysis protocol and the loop diuretic dose were unchanged within the whole period.
在慢性肾脏病（CKD）背景下，指导心衰（HFrEF）疾病修饰药物的证据相对有限，尤其是在终末期 CKD 中。我们报告了一例在接受血液透析的、未经治疗的 HFrEF 年轻女性中，沙库巴曲缬沙坦和 SGLT2i 治疗后出现显著的逆向重构和疾病消退的病例。在 10 个月的随访中，患者通过超声心动图和心脏磁共振评估，左心室和心房容积正常化，射血分数恢复至正常范围。心脏生物标志物和运动表现也一致改善。整个期间，血液透析方案和袢利尿剂剂量均未改变。
