The effect of sacubitril / valsartan on the occurrence of ventricular arrhythmia and the risk of sudden cardiac death in patients with chronic heart failure with reduced left ventricular ejection fraction. Expert opinion of the Heart Rhythm and Heart Failure Sections of the Polish Cardiac Society

Grabowski, Marcin; Ozierański, Krzysztof; Balsam, Paweł; Dąbrowski, Rafał; Farkowski, Michał M.; Gackowski, Andrzej; Jędrzejczyk-Patej, Ewa; Kalarus, Zbigniew; Leszek, Przemysław; Nessler, Jadwiga; Sterliński, Maciej; Opolski, Grzegorz; Przybylski, Andrzej

doi:10.33963/kp.14972

Cited by 9 publications

(10 citation statements)

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“…There are few real-world data about the clinical performance of sacubitril/valsartan among patients with heart failure and implantable cardioverter defibrillators [2][3][4]. Therefore little is known about the effect of sacubitril/valsartan on device-detected arrhythmias, both ventricular and atrial [2][3][4][5][6][7][8], and there are no reliable data on ICD electrical parameters among patients with heart failure on sacubitril/valsartan treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Sacubitril/valsartan therapy demonstrated superiority in reducing the risks of death and hospitalization for heart failure (HF) among patients with reduced ejection fraction (HFrEF) when compared to guideline recommended doses of enalapril; however, no information about the mechanism leading to sudden cardiac death (SCD) was provided in the randomized control trial [1]. There are few and contrasting real-world data about the incidence of device detected tachyarrhythmias in HFrEF patients with implantable cardioverter defibrillators (ICD) treated with sacubitril/valsartan [2][3][4], and its possible direct antiarrhythmic effect is still debated [5][6][7][8][9][10]. Moreover, there are no clinical data about the effect of sacubitril/valsartan therapy on measured ICD electrical parameters, such as atrial/ventricular electrograms sensing and pacing threshold.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Sacubitril/Valsartan on Device Detected Arrhythmias and Electrical Parameters among Dilated Cardiomyopathy Patients with Reduced Ejection Fraction and Implantable Cardioverter Defibrillator

Russo

Bottino

Rago

et al. 2020

JCM

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Sacubitril/valsartan therapy reduces sudden cardiac death (SCD) among patients with reduced ejection fraction (HFrEF) when compared to guidelines recommended doses of enalapril, however the mechanism is still not clear. There are few, contrasting results about the effect of sacubitril/valsartan on arrhythmias in the clinical context of dilated cardiomyopathy (DCM) and there are no clinical data about its effect on measured implantable cardioverter defibrillator (ICD) electrical parameters, such as atrial/ventricular electrograms sensing and pacing threshold. We conducted a 12 month follow-up observational study in 167 ischemic and nonischemic DCM patients (mean age 68.1 ± 11.6 years; 85% male), with dual-chamber ICD on sacubitril/valsartan treatment, to evaluate the incidence of device detected tachyarrhythmia events, both atrial and ventricular, and the change in measured ICD electrical parameters. We collected data on clinical, electrocardiographic and echocardiographic parameters to find a possible electro-mechanical correlation within results. Our results show that DCM patients with reduced ejection fraction and ICD on sacubitril/valsartan treatment experienced a reduction in both atrial and ventricular arrhythmias incidence and an improvement in ICD electrical atrial parameters. The findings might be explained by the electro-mechanical cardiac reverse remodeling induced by sacubitril/valsartan therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effect of Sacubitril/Valsartan on Device Detected Arrhythmias and Electrical Parameters among Dilated Cardiomyopathy Patients with Reduced Ejection Fraction and Implantable Cardioverter Defibrillator

Russo

Bottino

Rago

et al. 2020

JCM

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“…As well known, ARNI is commonly used in clinical treatment of heart failure. For instance, its effect on VAs prevention has been widely reported [27,28,29], but not SGLT2i.…”

Section: Discussionmentioning

confidence: 99%

Cardioprotection of Sodium–Glucose Cotransporter 2 Inhibition in Rats With Isoproterenol-Induced Cardiomyopathy

Wang

Wei

et al. 2021

Preprint

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Background: Sodium-glucose cotransporter 2 inhibitor (SGLT2i) has been reported to improve glycaemic control in patients with type 2 diabetes. The aim of this study was to investigate the effect of SGLT2i Dapagliflozin (Dapa) on cardiomyopathy induced by isoproterenol (ISO) and its potential mechanism.Methods: Fifty male Sprague Dawley rats were randomly assigned to Control (n = 10) and ISO (2.5 mg/kg/day)-treated groups (n = 40). After 2 weeks, 28 survived rats with obvious left ventricular dysfunction in ISO group were randomized into three groups for medication including ARNI (angiotensin receptor neprilysin inhibitor, 68 mg/kg/day, n = 9), Dapa (3 mg/kg/day, n = 9) and ISO (saline, n = 10) for 4 weeks. After that, electrical programmed stimulation (EPS) was performed in all groups for the evaluation of the susceptibility of ventricular arrhythmias (VAs). Echocardiography was used to evaluate cardiac function. Results: Echocardiography revealed significant left ventricular (LV) dysfunction in rats with ISO treatment for 2 weeks compared to the control group. Dapa administration for 4 weeks reduced the cumulative risk of death, myocardial fibrosis, plasma angiotensin II level and its functional receptor AT1R protein expression in the heart, and proinflammatory cytokines levels in the cardiac tissue of ISO-treated rats. It also improved cardiac function and inhibited oxidative stress when compared to the ISO group. These effects were similar to ARNI. However, Dapa showed a greater efficacy than ARNI in reducing left ventricular end-diastolic volume, lowing heart rate and VAs, and decreasing body weight and plasma glucose in ISO-treated rats. Conclusion: Dapa effectively improved the myocardial remodelling and oxidative stress like ARNI in ISO-induced cardiomyopathy in rats, but Dapa may be more effectively in decreasing VAs, and improving cardiac function when compared to ARNI. The mechanisms by which Dapa exerts protective effects on cardiomyopathy may be related to its antioxidant capacity and hypoglycemic action.

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“…По данным литературы BNP имеет большое значение в диагностике и лечении ХСН, а также в оценке прогноза заболевания [13][14][15][16][17]. Было показано, что комбинация сакубитрил/валсартан положительно влияет на уровень BNP в организме [18][19][20][21].…”

Section: Discussionunclassified

Comparative efficacy of medication and cardiac resynchronization therapy in patients with heart failure with reduced ejection fraction

Эюбова

2021

Russ J Cardiol

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Aim. To compare the effectiveness of standard conservative therapy for heart failure (HF) with the inclusion of sacubitril/valsartan combination and device therapy.Material and methods. The study included 64 patients from 38 to 73 years old (45 men and 19 women; mean age, 59,5±0,9 years) hospitalized in Baku (Azerbaijan) hospital due to NYHA class II-IV HF. The patients were divided into the experimental (group 1) and control (group 2) groups. The experimental group included 33 patients who took sacubitril/valsartan twice a day in combination with other drugs for standard HF therapy. The control group included 31 patients after cardiac resynchronization therapy. We compared clinical and hemodynamic parameters (including 6-minute walk test and echocardiography data) before and 6 months after treatment, as well as blood concentration of brain natriuretic peptide (BNP). In addition, Kaplan-Meier survival curves were analyzed.Results. As a result of 6-month therapy, clinical condition of patients in both groups was improved. In the experimental group, some parameters were significantly better than in the control one. So, the differences regarded distance in 6-minute walk test (pu=0,002), changes in HF class (pu=0,017), LV ESD (pu=0,006), LV EDD (pu=0,001) and blood BNP concentrations (pu<0,001).Conclusion. The use of sacubitril/valsartan combination as part of standard HF therapy was accompanied by a significant improvement in the clinical, hemodynamic and biochemical parameters of patients with HF compared with device therapy.

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The effect of sacubitril / valsartan on the occurrence of ventricular arrhythmia and the risk of sudden cardiac death in patients with chronic heart failure with reduced left ventricular ejection fraction. Expert opinion of the Heart Rhythm and Heart Failure Sections of the Polish Cardiac Society

Cited by 9 publications

References 0 publications

The Effect of Sacubitril/Valsartan on Device Detected Arrhythmias and Electrical Parameters among Dilated Cardiomyopathy Patients with Reduced Ejection Fraction and Implantable Cardioverter Defibrillator

The Effect of Sacubitril/Valsartan on Device Detected Arrhythmias and Electrical Parameters among Dilated Cardiomyopathy Patients with Reduced Ejection Fraction and Implantable Cardioverter Defibrillator

Cardioprotection of Sodium–Glucose Cotransporter 2 Inhibition in Rats With Isoproterenol-Induced Cardiomyopathy

Comparative efficacy of medication and cardiac resynchronization therapy in patients with heart failure with reduced ejection fraction

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