Influence of sacubitril/valsartan on hibernating myocardium in patients with chronic heart failure with reduced ejection fraction

Abstract

Funding Acknowledgements Type of funding sources: None. Background Myocardial viability particularly hibernating myocardium is one of the critical parameters for the assessment of the long-term prognosis of patients with ischemic etiology heart disease. Purpose of the study was to evaluate the influence of angiotensin receptor neprilysin inhibitor - sacubitril/valsartan on hibernating myocardium in patients with ischemic etiology chronic heart failure with reduced ejection fraction. Material and Methods One hundred and twenty patients with chronic heart failure with reduced ejection fraction (EF<40%) were enrolled in the study (mean age 58.2±14.6 years, male=53%). Patients were divided into two groups by sixty. Group I patients were assigned sacubitril/valsartan while Group II were assigned valsartan in addition to the standard treatment. Hibernating myocardium were assessed with echocardiography with dopamine test. All statistical analysis were assessed using STATA software. Results Ejection fraction and the wall motion score has been improved in both groups from baseline (P<0.05), however when we compared two groups, sacubitril/valsartan group tended to have more positive effect on ejection fraction (from 32.2±8.2% to 43.6±12.4% vs. from 31.7±8.0% to 37.2±10.3%, P<0.05) and the wall motion score (from 2.34±0.5 to 1.92±0.4 vs. 2.36±0.6 to 2.15±0.45, P<0.05) compared to valsartan group. Diastolic and systolic wall thickness has been improved in both groups from baseline (P<0.05), however there were not statistically significant changes between groups (P>0.05). When we analyzed by gender there were not significant changes between male and female (P<0.05). Conclusion Sacubitril/valsartan improves myocardial viability in patients with ischemic etiology chronic heart failure with reduced ejection fraction. Further studies with large amount of patients are required to clarify exact mechanisms.

Contemporary view on chronic limb ischemia

“…After interventions on the vessels of the lower extremities, patients are recommended to take aspirin (level of evidence IA) [6]. According to some researchers [7], clopidogrel should be used instead of aspirin as an antiplatelet agent in the treatment of patients with CILC, in particular in cases of intolerance to acetylsalicylic acid (level of evidence IIB).…”

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