Impact of sacubitril/valsartan treatment on depression and anxiety in heart failure with reduced ejection fraction

Dereli, Seçkin; Kılınçel, Oğuzhan; Çerik, İdris Buğra; Kaya, Ahmet

doi:10.1080/00015385.2020.1730577

Cited by 13 publications

(10 citation statements)

References 44 publications

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“…15-21 Furthermore, it has been shown that there is a significant improvement in nutritional status and even depression and anxiety levels in patients in whom ACEI or ARB therapy is changed to ARNI. 22,23 An ongoing study is examining whether this effect of ARNI is valid in patients with post-MI left ventricular dysfunction. 24 Another trial, PARAGON-HF (Prospective Comparison of ARNI with ARB Global Outcomes in HF with Preserved Ejection Fraction), investigated the efficacy of ARNI in HF patients with preserved EF.…”

Section: Discussionmentioning

confidence: 99%

Effect of Sacubitril/Valsartan Combined with Dapagliflozin on Long-Term Cardiac Mortality in Heart Failure with Reduced Ejection Fraction

et al. 2021

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The angiotensin receptor–neprilysin inhibitor (ARNI) sacubitril/valsartan and sodium-glucose cotransporter-2 (SGLT-2) inhibitor dapagliflozin have been shown to reduce rehospitalization and cardiac mortality in patients with heart failure (HF) with reduced ejection fraction (HFrEF). We aimed to compare the long-term cardiac and all-cause mortality of ARNI and dapagliflozin combination therapy against ARNI monotherapy in patients with HFrEF. This retrospective study involved 244 patients with HF with New York Heart Association (NYHA) class II–IV symptoms and ejection fraction ≤40%. The patients were divided into 2 groups: ARNI monotherapy and ARNI+dapagliflozin. Median follow-up was 2.5 (.16–3.72) years. One hundred and seventy-five (71.7%) patients were male, and the mean age was 65.9 (SD, 10.2) years. Long-term cardiac mortality rates were significantly lower in the ARNI+dapagliflozin group (7.4%) than in the ARNI monotherapy group (19.5%) ( P = .01). Dapagliflozin [Hazard Ratio (HR) [95% Confidence Interval (CI)] = .29 [.10–.77]; P = .014] and left ventricular ejection fraction (LVEF) [HR (95% CI) = .89 (.85–.93); P < .001] were found to be independent predictors of cardiac mortality. Our study showed a significant reduction in cardiac mortality with ARNI and dapagliflozin combination therapy compared with ARNI monotherapy.

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Section: Discussionmentioning

confidence: 99%

Effect of Sacubitril/Valsartan Combined with Dapagliflozin on Long-Term Cardiac Mortality in Heart Failure with Reduced Ejection Fraction

et al. 2021

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“…Depression and anxiety are not systematically studied in patients with HF, but they are very important components of QoL [21,22]. Dereli et al [23] have demonstrated a significant positive effect of sacubitril/valsartan on different depression and anxiety parameters in patients with HF and a reduced LVEF. In this study, 43% of the patients had clinically significant depressive symptoms at baseline, and 38% of them also had moderate to severe anxiety, and these was related to poor QoL scores regardless of functional status.…”

Section: Discussionmentioning

confidence: 99%

Improvement in quality of life with sacubitril/ /valsartan in cardiac resynchronization non-responders: The RESINA (RESynchronization plus an Inhibitor of Neprilysin/Angiotensin) registry

et al. 2021

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Background: Clinical management of cardiac resynchronization therapy (CRT) nonresponders is difficult, and their prognosis is poor. The aim of the present study was to evaluate whether treatment with sacubitril/valsartan can improve quality of life (QoL) parameters in these patients. Methods: 35 non-responders to CRT were included (75 ± 7 years, 28% females, mean left ventricular ejection fraction 28 ± 8%, 54% non-ischemic cardiomyopathy) with maximally optimized drug therapy and New York Heart Association class II-III. They were all on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and were switched to sacubitril/valsartan. One week before and 6 months after initiation of the therapy they completed both the Minnesota Living with Heart Failure (MLWHF) and the 12-item Kansas City Cardiomyopathy Questionnaires (KCCQ-12). The primary 2 outcome was the effect of sacubitril/valsartan on the physical, clinical, social and emotional QoL parameters and number of hospitalizations. Results: The mean total scores of both questionnaires improved from baseline to the follow-up visit at 6-months (KCCQ 40 ± 10 to 47 ± 10; p < 0.001; MLWHF 40 ± 15 to 29 ± 15; p < 0.001). The best results were seen in the KCCQ total symptom domains (77% improvement), the MLWHF physical domain (81% improvement), and the MLWHF emotional domain (71% improvement). Two patients died during follow-up. The mean number of hospitalizations reduced significantly (1 ± 0.6 vs. 0.5 ± 0.8; p = 0.003) Conclusions: In CRT non-responders, sacubitril/valsartan significantly improved overall QoL, physical limitations and emotional domains and reduced the number of hospitalizations.

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“…The data presenting effects of ARNI on anxiety are sparse. The dual AT1/neprilysin blockade not only reduces the effect of Ang II but enhances the level of various peptides (ANP, bradykinin, substance P, enkephalins), which are considered to exert cardiovascular protection, 230,231 while some are believed to interfere with stress‐related conditions such as anxiety 136,239,240 . Well‐controlled prospective studies with angiotensin II/neprilysin inhibition focused on anxiety and depression are warranted.…”

Section: Discussionmentioning

confidence: 99%

“…In 115 symptomatic patients with systolic HF, the switch from an ACE inhibitor or ARB to sacubitril/valsartan resulted in the significant improvement of heart function along with a reduction of both depression and anxiety symptoms (Table 1). 136 5.3 | Lipid modifying agents…”

Section: Clinical Studymentioning

confidence: 99%

Cardiovascular therapeutics: A new potential for anxiety treatment?

Repova

Aziriova

Krajcirovicova

et al. 2022

Medicinal Research Reviews

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Besides the well-recognized risk factors, novel conditions increasing cardiovascular morbidity and mortality are emerging.Undesirable emotions and behavior such as anxiety and depression, appear to participate in worsening cardiovascular pathologies. On the other hand, deteriorating conditions of the heart and vasculature result in disturbed mental and emotional health. The pathophysiological background of this bidirectional

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Impact of sacubitril/valsartan treatment on depression and anxiety in heart failure with reduced ejection fraction

Cited by 13 publications

References 44 publications

Effect of Sacubitril/Valsartan Combined with Dapagliflozin on Long-Term Cardiac Mortality in Heart Failure with Reduced Ejection Fraction

Effect of Sacubitril/Valsartan Combined with Dapagliflozin on Long-Term Cardiac Mortality in Heart Failure with Reduced Ejection Fraction

Improvement in quality of life with sacubitril/ /valsartan in cardiac resynchronization non-responders: The RESINA (RESynchronization plus an Inhibitor of Neprilysin/Angiotensin) registry

Cardiovascular therapeutics: A new potential for anxiety treatment?

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