The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”

Romano, Giuseppe; Vitale, Giuseppe; Ajello, Laura; Agnese, Valentina; Bellavia, Diego; Caccamo, Giuseppa; Corrado, Egle; Gesaro, Gabriele Di; Falletta, Calogero; Franca, Eluisa La; Minà, Chiara; Storniolo, Salvatore Antonio; Sarullo, Filippo M.; Clemenza, Francesco

doi:10.3390/jcm8122165

Cited by 33 publications

(30 citation statements)

References 24 publications

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“…Several retrospective studies reported similar results for LV reverse remodelling, which was observed in the early phase after ARNI treatment initiation. [17][18][19] In the present study, we observed significant improvements in LV function parameters in patients with HFrEF treated with ARNI, which is consistent with previous reports. Relevant echocardiographic parameters, including LV-EF, indexed LV volume, LAVI, mitral E/e′ ratio, PASP, and the severity of MR demonstrated concordant trends towards improvement.…”

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confidence: 93%

Reverse remodelling by sacubitril/valsartan predicts the prognosis in heart failure with reduced ejection fraction

et al. 2021

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Aims Despite well-established benefits of sacubitril/valsartan for cardiac reverse remodelling and the prognosis of patients with heart failure with reduced ejection fraction (HFrEF), there are some patients with limited therapeutic response, even with optimal therapy. We assessed the treatment response to sacubitril/valsartan in patients with HFrEF, focusing on the association between reverse remodelling and the prognosis. Methods and results Using a retrospective cohort of consecutive patients with HFrEF treated with sacubitril/valsartan, we compared the time trajectory of cardiac function in 415 patients (1258 echocardiograms), according to the occurrence of cardiovascular death and hospitalization for HF during a median follow-up of 19.1 (interquartile range, 10.9-27.6) months. A higher sacubitril/valsartan dose was associated with a better prognosis, whereas advanced age, diabetes, left ventricular (LV) hypertrophy, left atrial enlargement, and pulmonary hypertension were associated with a worse prognosis. Patients without an event (n = 337; 81.2%) showed LV reverse remodelling (LV ejection fraction ≥45% or LV end-systolic volume reduction by 15% from baseline), which was typically observed within 6 months of sacubitril/valsartan treatment. Reverse remodelling achievement was significantly associated with a better prognosis. However, patients without reverse remodelling had a worse prognosis, as poor as that in patients with HFrEF not treated with sacubitril/valsartan. Conclusions In patients with HFrEF treated with sacubitril/valsartan, LV reverse remodelling reflects the treatment response and predicts the prognosis, whereas a lack of reverse remodelling indicates the lack of treatment benefits. Prediction and assessment of reverse remodelling may facilitate the selection of patients with greater benefits by sacubitril/valsartan.

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confidence: 93%

Reverse remodelling by sacubitril/valsartan predicts the prognosis in heart failure with reduced ejection fraction

et al. 2021

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“…Our study showed a significant improvement in patient’s quality of life, symptoms and functional status demonstrated by the reduction in the percentage of patients in NYHA class III and an increasing number of patients in NYHA class I and II at follow-up. Those results are aligning with previous studies, Romano et al [ 28 ] and other authors found a significant improvement in NYHA class after different interventions in patients with HFrEF [ 29 ]. The NYHA classification is the most commonly used system to describe the impact of heart failure on a patient's daily activities [ 30 ] and is recommended in all guidelines [ 10 , 15 ] as a useful tool to assess the functional limitations due to HF.…”

Section: Discussionsupporting

confidence: 93%

Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

León-Justel

Garcia-Polavieja

Álvarez-Ríos

et al. 2021

Health Qual Life Outcomes

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Background Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF). Methods This is a before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost-analysis was also performed on these data. Results Admission rates significantly decreased by 19.8% after the intervention (from 30.2 to 10.4), the total hospital admissions were reduced by 32 (from 78 to 46) and the total length of stay was reduced by 7 days (from 15 to 9 days). The rate of ED visits was reduced by 44% (from 64 to 20). Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was € 72,769 per patient (from € 201,189 to € 128,420) and €139,717.65 for the whole group over 1 year. Conclusions A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care-associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

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“…Our study showed a signi cant improvement in patient's quality of life, symptoms and functional status demonstrated by the reduction in the percentage of patients in NYHA class III and an increasing number of patients in NYHA class I and II at follow-up. Those results are aligning with previous studies, Romano et al [28] and other authors found a signi cant improvement in NYHA class after different interventions in patients with HFrEF [29] .…”

Section: Discussionsupporting

confidence: 93%

Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost.

Justel

Garcia-Polavieja

Ríos

et al. 2021

Preprint

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BACKGROUND Heart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF with a reduced left ventricular ejection fraction (HFrEF).METHODS This is a real-world, before and after interventional study, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before the intervention and again after the intervention. The primary objective was the rate of readmissions, due to a HF. Secondary outcome compared the rate of ED visits and quality of life improvement assessed by the number of patients who had reduced NYHA score. A cost- analysis was also performed on these data. RESULTS Admission rates significantly decreased by 65,6% after the intervention, the total hospital admissions were reduced by 41% and the total length of stay was reduced by 46%. The rate of ED visits was reduced by 55%. Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was €139,717.65 for the whole group over 1 year.CONCLUSIONS A personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care- associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

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The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The “Hemodynamic Recovery”

Cited by 33 publications

References 24 publications

Reverse remodelling by sacubitril/valsartan predicts the prognosis in heart failure with reduced ejection fraction

Reverse remodelling by sacubitril/valsartan predicts the prognosis in heart failure with reduced ejection fraction

Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost

Biomarkers-based personalized follow-up in chronic heart failure improves patient’s outcomes and reduces care associate cost.

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