Impact of Sacubitril–Valsartan Treatment on Diastolic Function and Right Ventricular Function in Patient with Heart Failure with Reduced Ejection Fraction

Abstract

Article informationBackground: It was proved that sacubitril-valsartan has a major role in ventricular remodeling resulting in improving ejection fraction and ventricular size.Although evaluating the diastolic function in those presenting with Heart failure and reduced ejection fraction [HFrEF] was neglected, the majority of patients with HFrEF also have diastolic dysfunction. The Aim of the work:In this study, we will focus on studying and explaining the impact of sacubitril-valsartan on diastolic dysfunction and RVD and explaining if the clinical improvement is attributed to improvement in diastolic function and right-side function. Patients and Methods: Our prospective study enrolled 60 HFrEF patients. All of the included patients were submitted for, ECG, and Standard 2D Doppler transthoracic echocardiography. The following parameters were collected; TAPSE [Tricuspid Annular Plane Systolic Excursion], FAC [fractional area change] 3Systolic pulmonary artery pressure [SPAP], Myocardial performance index [M P I]. Results: According to the percentage of improvement among the studied cases, the majority [80%] of class II cases improved and 20% had no change. Similarly, 82.1% of class III patients saw improvement in NYHA classification. Whereas all cases in class IV were improved [100%]. According to the change of systolic and diastolic blood pressure, the mean Systolic Blood Pressure [mmHg] of subjects before therapy with sacubitril-valsartan was 125.88 ±13.7 and it was 108.8± 11.3 of subjects following therapy with sacubitril -valsartan, and this was statistically substantial [P = 0.001]. The mean of Diastolic Blood Pressure [mmHg] of subjects before therapy with sacubitril -valsartan was 85.25 ± 8.9 and it was 74 ± 11.1 of subjects following therapy with sacubitril -valsartan, and this was statistically substantial [P = 0.001]. Conclusion:The measured parameters of right ventricular function such as TAPSE, MPI, and Fractional area change were all improved significantly indicating a positive effect for sacubitril-valsartan on the right ventricular function.