Assessment of sacubitril/valsartan effects on left ventricular dynamics using 3D echocardiography and 3D strain in heart failure with reduced ejection fraction patients

Öz, Tuğba Kemaloğlu; Abdelnabi, Mahmoud; Fiore, Corrado; Cihan, Deniz; Babazade, Nigar; Naqvi, Syed Haseeb Raza; Omar, Bahadir; Dağdeviren, Bahadır

doi:10.23736/s2724-5683.21.05802-6

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…Finally, continuous research in pharmacology is providing us with drugs which may more specifically target and slow down myocardial fibrotic processes. Among them, it is worth mentioning sacubitril/valsartan 37 and sodium-glucose co-transporter 2 (SGLT2) inhibitors, 38 which in future clinical trials could be specifically tested with the aim of reducing fibrosis development and progression.…”

Section: Discussionmentioning

confidence: 99%

Myocardial fibrosis in asymptomatic patients undergoing surgery for mitral and aortic valve regurgitation

Fragasso¹,

Sanvito²,

Monaca³

et al. 2022

Journal of Cardiovascular Medicine

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BackgroundChronic heart valve regurgitation induces left ventricular (LV) volume overload, leading to the development of hypertrophy and progressive dilatation of the ventricle to maintain physiological cardiac output. In order to prevent potential irreversible LV structural changes, the identification of the best timing for treatment is pivotal.ObjectiveTo assess the presence and extent of fibrosis in myocardial tissue in asymptomatic patients with valvular heart disease (VHD) and preserved LV dimensions and function undergoing cardiac surgery.MethodsThirty-nine patients were enrolled. Sixteen patients were affected by aortic or mitral regurgitation: they were all asymptomatic, undergoing valve surgery according to VHD European Society of Cardiology guidelines. Twenty-three patients with end-stage nonischemic dilated cardiomyopathy (DCM) and severe LV dysfunction undergoing cardiac surgery for implantation of a durable left ventricular assist device (LVAD) served as controls. During surgery, VHD patients underwent three myocardial biopsies at the level of the septum, the lateral wall and LV apex, while in LVAD patients the coring of the apex of the LV was used. For both groups, the tissue samples were analyzed on one section corresponding to the apical area. All slides were stained with hematoxylin and eosin and Masson's trichrome staining and further digitalized. The degree of fibrosis was then calculated as a percentage of the total area.Results Of 39 patients, 23 met the inclusion criteria: 12 had mitral or aortic insufficiency with a preserved ejection fraction and 11 had idiopathic dilated cardiomyopathy. Quantitative analysis of apical sections revealed a myocardial fibrosis amount of 10 ± 6% in VHD patients, while in LVAD patients the mean apical myocardial fibrosis rate was 38 ± 9%. In VHD patients, fibrosis was also present in the lateral wall (9 ± 4%) and in the septum (9 ± 6%).ConclusionOur case series study highlights the presence of tissue remodeling with fibrosis in asymptomatic patients with VHD and preserved LV function. According to our results, myocardial fibrosis is present at an early stage of the disease, well before developing detectable LV dysfunction and symptoms. Since the relationship between the progressive magnitude of myocardial fibrosis and potential prognostic implications are not yet defined, further studies on this topic are warranted.

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Section: Discussionmentioning

confidence: 99%

Myocardial fibrosis in asymptomatic patients undergoing surgery for mitral and aortic valve regurgitation

Fragasso¹,

Sanvito²,

Monaca³

et al. 2022

Journal of Cardiovascular Medicine

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“…SV is the first US Food and Drug Administration (FDA)approved drug for the treatment of patients with chronic heart failure who have a reduced ejection fraction in NYHA classes II, III, or IV [6]. Many studies have demonstrated that SV significantly improves LVEF and left ventricular remodeling in patients with heart failure [7][8][9]. SV can also reduce re-hospitalization and mortality rates in patients with acute heart failure with reduced ejection fraction [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Sacubitril/Valsartan in Hemodialysis Patients with Chronic Heart Failure: A Retrospective Study at a Single Center

Yao,

Wang,

et al. 2024

Med Sci Monit

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Background Heart failure and end-stage renal disease often coexist, and management of heart failure can be challenging in patients during hemodialysis. Sacubitril-valsartan (SV) is the first drug to receive regulatory approval for use in patients with chronic heart failure with reduced ejection fraction (HFrEF) and New York Heart Association (NYHA) classification II, III, or IV. This study aimed to evaluate the efficacy and safety of SV for use in chronic heart failure patients on maintenance hemodialysis (MHD). Material/Methods From September 2021 to October 2022, 28 patients on MHD with chronic heart failure at the hemodialysis center of Shaanxi Second Provincial People’s Hospital were regularly followed. During the 12-week follow-up period, all patients were administered SV at doses of 100–400 mg per day. Biochemical indicators, echocardiographic parameters, life quality scores, and adverse events were evaluated. Results We enrolled 28 patients. Compared with the baseline levels, NYHA class III in these patients treated with SV was significantly decreased from 60.71% to 32.14% (P<0.05), left ventricular ejection fraction (LVEF) was significantly improved from 44.29±8.92% to 53.32±7.88% (P<0.001), the Physical Component Summary (PCS) score was significantly improved from 40.0±6.41 to 56.20±9.86 (P<0.001), and the Mental Component Summary (MCS) score was significantly improved from 39.99±6.14 to 52.59±11.0 (P<0.001). Conclusions We demonstrated that SV improved NYHA classification and LVEF values of patients on MHD with chronic heart failure and also improved their quality of life.

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Sacubitril/valsartan, left ventricular reverse remodeling and advanced echocardiographic imaging: is it a resolved conundrum?

Calvieri

Cataldi²

2022

Minerva Cardiol Angiol

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Assessment of sacubitril/valsartan effects on left ventricular dynamics using 3D echocardiography and 3D strain in heart failure with reduced ejection fraction patients

Cited by 4 publications

References 23 publications

Myocardial fibrosis in asymptomatic patients undergoing surgery for mitral and aortic valve regurgitation

Myocardial fibrosis in asymptomatic patients undergoing surgery for mitral and aortic valve regurgitation

Efficacy and Safety of Sacubitril/Valsartan in Hemodialysis Patients with Chronic Heart Failure: A Retrospective Study at a Single Center

Sacubitril/valsartan, left ventricular reverse remodeling and advanced echocardiographic imaging: is it a resolved conundrum?

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