Heart failure with reduced ejection fraction developed from valvular surgery: Risk factors and therapeutic effects of sacubitril valsartan

IF 2.5 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

IJC Heart and Vasculature Pub Date : 2025-02-25 DOI:10.1016/j.ijcha.2025.101634

Chen Yuqian , Hu Qinghua , Luo Fanyan , Huang Lingjin , Chen Xuliang , Zhang Chengliang

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引用次数: 0

Abstract

Objective

To investigate the risk factors for heart failure developed from cardiac valvular surgery and the efficacy of sacubitril valsartan (ARNI).

Methods

Clinical data from patients with left ventricular ejection fraction (LVEF) ≥ 50 % who consecutively underwent cardiac valvular (mitral/aortic valve) surgery in 2021 were collected. Pre − and intra − operative variables were analyzed to explore risk factors for HFrEF (LVEF ≤ 40 %). Post − operative HFrEF patients were split into ARNI − treated (n = 15) and non-ARNI − treated (n = 15) groups. Follow − up echocardiography data were compared to assess ARNI’s efficacy.

Results

Among 420 patients undergoing valve surgery (117 aortic, 133 mitral, 170 double-valve), 34 (8.1 %) developed HFrEF, showing significantly higher in-hospital mortality than non-HFrEF patients (8.82 % vs 0.52 %). Multivariate analysis identified preoperative left ventricular diameter as an independent HFrEF risk factor. During follow-up, 70 % of HFrEF patients achieved LVEF > 50 % within 6 months, Repeated-measures F test demonstrated significantly greater LVEF improvement (P = 0.036) and LVEDD reduction (P = 0.014) in the ARNI group versus non-ARNI group.

Conclusions

About 8 % of patients with LVEF ≥ 50 % developed HFrEF after cardiac valvular surgery, and large left ventricular diameter was an independent risk factor. Sacubitril valsartan is very effective in improving left ventricular remodeling and LVEF in such cohort.

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来源期刊

IJC Heart and Vasculature Medicine-Cardiology and Cardiovascular Medicine

CiteScore

4.90

自引率

10.30%

发文量

216

审稿时长

56 days

期刊介绍： IJC Heart & Vasculature is an online-only, open-access journal dedicated to publishing original articles and reviews (also Editorials and Letters to the Editor) which report on structural and functional cardiovascular pathology, with an emphasis on imaging and disease pathophysiology. Articles must be authentic, educational, clinically relevant, and original in their content and scientific approach. IJC Heart & Vasculature requires the highest standards of scientific integrity in order to promote reliable, reproducible and verifiable research findings. All authors are advised to consult the Principles of Ethical Publishing in the International Journal of Cardiology before submitting a manuscript. Submission of a manuscript to this journal gives the publisher the right to publish that paper if it is accepted. Manuscripts may be edited to improve clarity and expression.