医学
射血分数
心脏病学
心力衰竭
内科学
沙库比林
沙库比林、缬沙坦
缬沙坦
血压
作者
António Valentim Gonçalves,A Galrinho,Tiago Pereira-da-Silva,Luísa Moura Branco,Pedro Rio,Ana Teresa Timóteo,João Abreu,Rui Soares,Joana Feliciano,Rita Ilhão Moreira,Rui Cruz Ferreira
出处
期刊:Journal of Cardiovascular Medicine
[Ovid Technologies (Wolters Kluwer)]
日期:2020-03-01
卷期号:21 (3): 223-230
被引量:19
标识
DOI:10.2459/jcm.0000000000000932
摘要
Aims Myocardial work is a new transthoracic echocardiogram (TTE) parameter that enhances the information provided through left ventricular (LV) global longitudinal strain (GLS). Nothing is known about the impact of sacubitril/valsartan (LCZ696) therapy on myocardial work parameters. The aim of this study was to evaluate the effects of LCZ696 on LV myocardial work in heart failure patients. Methods Prospective evaluation of chronic heart failure patients with LV ejection fraction of 40% or less despite optimized standard of care therapy, in which LCZ696 therapy was started and no other heart failure treatment was expected to change. TTE study was performed before and 6 months after LCZ696 therapy. A semiautomated analysis of LV GLS was made and myocardial work estimated using custom software of the GE Vivid E95 ultrasound system. Results Of the 42 patients, 35 (83.3%) completed the 6 months, follow-up, since 2 (4.8%) patients died and 5 (11.9%) discontinued treatment due to adverse events. Mean age was 58.6 ± 11.1 years. TTE data showed a significant reduction in LV dimensions and atrial volumes, as well as an improvement in LV ejection fraction (29.3 vs. 35.2%, P = 0.001) and GLS (−7.0 vs. −8.9%, P = 0.001). Myocardial work had a significant increase in global constructive work (720.2 vs. 900.6 mmHg%, P = 0.016) and global work efficiency (78.6 vs. 86.6%, P = 0.027), with a nonsignificant decrease in global wasted work (150.2 vs. 136.8 mmHg%, P = 0.441) at 6 months. Conclusion LCZ696 therapy was associated with signs of reverse remodelling by usual TTE parameters and LV myocardial work at 6 months, including an increase in global constructive work and work efficiency.
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