Add-on Sacubitril/Valsartan Therapy Induces Left Ventricular Remodeling in Non-responders to Cardiac Resynchronization Therapy to a Similar Extent as in Heart Failure Patients Without Resynchronization.
IF 3
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
引用次数: 0
Abstract
Introduction: Non-responders to cardiac resynchronization therapy (CRT-NR) have poor prognosis. Sacubitril/valsartan (SV) treatment improved the outcome of patients with heart failure with reduced left ventricular (LV) ejection fraction (HFrEF) in randomized trials with no data on the specific cohort of CRT-NRs. The aim of this study was to compare the echocardiographic and biomarker changes in CRT-NR patients treated with versus without SV, and in patients with HFrEF on SV therapy.
Methods: CRT-NR patients initiated on SV (group I), CRT-NR patients on angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB) (group II), and patients with HFrEF (without CRT) initiated on SV (group III) were identified in our heart failure (HF) registry. CRT-NR was defined as < 10% improvement in left ventricular ejection fraction (LV EF) 6 months after the implantation. Echocardiographic parameters and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels at baseline and at the end of follow-up were compared.
Results: A total of 275 patients (group I, 70; group II, 70; and group III, 135) were included. After a follow-up of 7.54 ± 1.8 months (mean ± standard deviation [SD]), LV EF (%) increased in group I (25.2 ± 5.7 versus 29.4% ± 6.7; p < 0.001) and in group III (26.6 ± 6.4 versus 29.9 ± 6.7; p < 0.001). LV end-systolic diameters (mm) decreased in group I (56.6 ± 9.0 versus 54.3 ± 8.7; p = 0.004) and in group III (55.9 ± 9.9 versus 54.3 ± 11.2; p = 0.021). The levels of NT-proBNP (pg/mL) decreased in group I (2058.86 [1041.07-4502.51] versus 1121.55 [545-2541]; p < 0.001) and in group III (2223.35 [1233.03-4795.96] versus 1123.09 [500.38-2651.27]; p < 0.001). The extent of improvement was similar in groups I and III (p > 0.05). No significant changes were detected in group II.
Conclusion: SV therapy induced similar improvements in echocardiographic parameters and in NT-proBNP levels in CRT-NR patients and in patients with HFrEF without resynchronization.
添加萨库比特利/缬沙坦疗法可诱导心脏再同步化疗法无反应者的左心室重塑，其程度与未接受再同步化治疗的心衰患者相似。
导言：对心脏再同步治疗（CRT-NR）无应答者预后不良。在随机试验中，沙奎利/缬沙坦（SV）治疗改善了左心室射血分数降低的心力衰竭（HFrEF）患者的预后，但没有关于 CRT-NR 特定人群的数据。本研究旨在比较接受与不接受 SV 治疗的 CRT-NR 患者以及接受 SV 治疗的 HFrEF 患者的超声心动图和生物标志物变化：我们的心力衰竭（HF）登记处确定了接受 SV 治疗的 CRT-NR 患者（I 组）、接受血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂（ACEi/ARB）治疗的 CRT-NR 患者（II 组）以及接受 SV 治疗的 HFrEF 患者（未接受 CRT）（III 组）。CRT-NR 被定义为 结果：共纳入 275 例患者（I 组 70 例；II 组 70 例；III 组 135 例）。随访 7.54 ± 1.8 个月（平均值 ± 标准差 [SD]）后，I 组 LV EF（%）增加（25.2 ± 5.7 对 29.4% ± 6.7；P 0.05）。结论：SV疗法对CRT-NR患者和未进行再同步化的HFrEF患者的超声心动图参数和NT-proBNP水平有相似的改善作用。
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来源期刊
Cardiology and Therapy
CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
5.30
自引率
0.00%
发文量
38
审稿时长
6 weeks
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Cardiology and Therapy is an international, open access, peer reviewed (single-blind), rapid-publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of cardiovascular therapies and interventions, including devices. Studies relating to diagnosis and diagnostics, pharmacoeconomics, public health, quality of life, as well as patient care, management and education are also encouraged.
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