Baseline left ventricular ejection fraction predicts the magnitude of improvement in patients taking sacubitril/valsartan.

Cardiology journal Pub Date : 2025-01-01 Epub Date: 2025-05-22 DOI:10.5603/cj.104310

José-Manuel Rubio-Campal, Carlos Rodriguez Lopez, Carla Lázaro Rivera, Francisco de Asís Díaz Cortegana, Loreto Bravo Calero, Cristina Aguilera Agudo, José María Romero-Otero, José Tuñón Fernández

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Abstract

Background: Sacubitril/valsartan (S/V) improve left ventricular ejection fraction (LVEF) in heart failure patients, but the magnitude of improvement may depend on baseline values.

Methods: We analyzed whether baseline LVEF can predict its improvement in patients with LVEF ≤ 45% receiving S/V. Patients were divided into 4 groups (G) according to baseline LVEF (G1: ≤ 20%; G2: 21-30%; G3: 31-40%; G4: 41-45%).

Results: We included 256 patients (age 73 ± 12 years; 73% male; 174 ischemic cardiomyopathy [CM], 82 nonischemic CM) and assessed LVEF at S/V initiation and at 6 and 12 months of therapy. Baseline LVEF (%) values (overall 30.9 ± 8.6) were: G1: 17.3 ± 3.3; G2: 27.5 ± 2.4; G3: 35.5 ± 2; G4: 44.4 ± 1. LVEF increased in 62% of patients, reaching 34.3 ± 10.4% and 35.5 ± 11.2% at 6 and 12 months, respectively (p < 0.001). A significantly higher absolute LVEF increase was found in Groups 3 (7.2 ± 4.3) and 4 (4.2 ± 3.05) than in Groups 1 (0.6 ± 1.5) and 2 (3.5 ± 1.5), in women (5.9 ± 4.4 vs. 4.1 ± 4.5; p < 0.001), with high S/V doses (7.4 ± 4.7 vs. 4.3 ± 4.4; p < 0.001), and in nonischemic CM (6.3 ± 4.9 vs. 3.8 ± 4.2; p < 0.001). On multivariate analysis, female sex (OR 2.18; 95% CI [1.06-4.48]; p = 0.034), high dose (OR 3.38; 95% CI [1.10-10.34]; p = 0.033), and baseline LVEF > 30% (OR 8.62; 95% CI [4.69-15.82]; p = 0.001) were significant predictors of LVEF improvement.

Conclusions: LVEF improvement with S/V depends on baseline values, sex, and dose.

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基线左室射血分数预测服用苏比里尔/缬沙坦的患者改善程度。

背景：Sacubitril/缬沙坦（S/V）可改善心力衰竭患者的左心室射血分数（LVEF），但改善的程度可能取决于基线值。方法：我们分析基线LVEF是否可以预测LVEF≤45%接受S/V治疗的患者的改善。根据基线LVEF分为4组(G) (G1:≤20%；G2: 21 - 30%;G3: 31 - 40%;G4: 41 - 45%)。结果：我们纳入256例患者(年龄73±12岁；男性73%;174例缺血性心肌病（CM）， 82例非缺血性心肌病（CM），并在S/V开始和治疗6个月和12个月时评估LVEF。基线LVEF（%）值（总体30.9±8.6）为：G1: 17.3±3.3；G2: 27.5±2.4；G3: 35.5±2；G4: 44.4±1。62%的患者LVEF升高，6个月和12个月分别达到34.3±10.4%和35.5±11.2% （p < 0.001）。3组（7.2±4.3）和4组（4.2±3.05）的绝对LVEF增加明显高于1组（0.6±1.5）和2组（3.5±1.5），女性（5.9±4.4 vs 4.1±4.5）；p < 0.001)，高S/V剂量组(7.4±4.7 vs. 4.3±4.4；p < 0.001)，非缺血性CM组(6.3±4.9 vs 3.8±4.2；P < 0.001)。多因素分析，女性(OR 2.18；95% ci [1.06-4.48]；p = 0.034)，高剂量组(OR 3.38；95% ci [1.10-10.34]；p = 0.033)，基线LVEF >为30% (OR 8.62；95% ci [4.69-15.82]；p = 0.001)是LVEF改善的显著预测因子。结论：S/V对LVEF的改善取决于基线值、性别和剂量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Cardiology journal

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