Background: The clinical outcome of Sacubitril/Valsartan in reducing the incidence of death from cardiovascular causes or first hospitalization for worsening heart failure was demonstrated in PARADIGM-HF trial. These benefits may be related to effects on hemodynamics and cardiac remodeling.
Objectives: Evaluating the clinical and echocardiographic outcome of Sacubitril/Valsartan therapy in HFrEF patients.
Methods: Single center, prospective, cohort study of HFrEF patients who were treated with Sacubitril/Valsartan for a median duration of 6 months.
Results: Among 100 patients (median age, 56.5 years; 76% men), at 6 months, we conducted comparison analysis according to the dose of Sacubitril/Valsartan. About 29% patients were treated with 24/26 mg, 39% were treated with 49/51 mg and 32% with 97/103 mg. There was statistically significant improvement of LVEF with higher doses of Sacubitril/Valsartan (49/51 mg and 97/103 mg). The median baseline LVEF increased from a 30% to 32% with 24/26 mg dose (P=.120), 30% to 34% with 49/51 mg dose (P <0.001) and 31% to 39% with 97/103 mg dose (P <0.001). However, the decrease in LVEDV and LVESV after treatment was statistically significant even in small dose. LVEDV decreased from a baseline median 184 to 151 ml with 24/26 mg dose, P=0.13, 173 to 154 ml with 49/51 mg dose, P=.001 and 179 to 140 ml with 97/103 mg dose, P <0.001 and LVESV decreased from a baseline median 152 to 115 ml with 24/26 mg dose, P=.018, 122 to 110 ml with 49/51 mg dose, P=.001 and 130 to 85 ml with 97/103 mg dose P <0.001. Additionally, there was significant change in quality of life regardless the dose of Sacubitril/Valsartan.
Conclusions: Sacubitril/Valsartan had shown improvement quality of life and echocardiographic parameters at 6 months. More favorable effect are noted in patients who can tolerate higher dose of Sacubitril/Valsartan therapy. Clinical trial registration:URL: https://www.clinicaltrials.gov/ct2/show/NCT03816306