The association of vascular access flow with sacubitril/valsartan and left ventricular ejection fraction in hemodialysis patients with heart failure with reduced ejection fraction.
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引用次数: 0
Abstract
Background: Sacubitril/valsartan improves heart function in maintenance hemodialysis (HD) patients with heart failure with a reduced ejection fraction of <40% (HFrEF). However, the effect of sacubitril/valsartan on vascular access flow (Qa) in this population is still unclear.
Methods: Hemodialysis patients with HFrEF were enrolled and divided into sacubitril/valsartan and non-sacubitril/valsartan treatment groups and received echocardiographic and Qa measurements at baseline and after 12 months. We compared the changes in Qa (△Qa) and echocardiographic parameters after 12 months. Correlations between △Qa and echocardiographic parameters were also examined. Multiple linear regression analysis was performed to predict △Qa.
Results: Thirty-three HD patients with HFrEF were enrolled. Sixteen patients received sacubitril/valsartan treatment. Their mean Qa significantly increased from 633.8 to 948.8 mL/min (P < .001). There was no significant change in Qa for the non-sacubitril/valsartan treatment group (from 637.7 to 621.8 mL/min; P = .436). The change in left ventricular ejection fraction (△LVEF) differed significantly between the sacubitril/valsartan and conventional treatment groups (13.63 ± 11.35% and 1.59 ± 6.99%, respectively; P = .001). The △Qa was significantly correlated with △LVEF (rs = 0.929; P < .001) and with the change in interventricular septum thickness in diastole (△IVSd, rs = -0.736; P = .001) in the sacubitril/valsartan group. The △Qa was predicted as -44.034 + 15.868 × △LVEF-25.072 × △IVSd + 145.964 × A (A = 1 for sacubitril/valsartan use and A = 0 for non-sacubitril/valsartan treatment) mL/min (R2 = 0.909).
Conclusion: In HD patients with HFrEF, treatment with sacubitril/valsartan is associated with improvement in LVEF and Qa over 12 months.
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About the Journal
Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.
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