The Results of the Use of Angiotensin Receptor Inhibitors and Neprilisin in Secondary Functional Mitral Regurgitation in Outpatient Practice

Ryazanov, A S; Сергеевич, Рязанов Алексей; Капитонов, К. И.; Иванович, Капитонов Константин; Makarovskaya, M.V.; Владимировна, Макаровская Мария; Kudryavtsev, A. A.; Афанасьевич, Кудрявцев Алексей

doi:10.15690/vramn1462

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…The E/e' index is defined as the ratio of the maximum early diastolic inflow of the left ventricle E to the maximum rate of early diastolic excursion of the mitral annulus e' ( 11 ). The average value of the E/e' index >15 at rest has significant diagnostic value for increased LV filling pressure ( 12 ).…”

Section: Methodsmentioning

confidence: 99%

Angiotensin receptor-neprilysin inhibitors and cardiac remodeling

Ryazanov

Ших

Makarovskaya³

et al. 2023

Braz J Med Biol Res

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The aim of this study was to determine how sacubitril/valsartan compared with valsartan in an outpatient setting affects left ventricular remodeling in heart failure with reduced ejection fraction and functional (or secondary) mitral regurgitation (SMR) due to the effect of dual inhibition of the renin-angiotensin system and neprilysin. The outpatient study included 90 patients with chronic SMR who were followed up for 12 months. They received sacubitril/valsartan or valsartan instead of the more commonly used angiotensin-converting enzyme inhibitor enalapril for heart failure, in addition to standard medical therapy for heart failure. The difference in NT-proBNP change between groups was the primary endpoint. Changes in effective regurgitation orifice area, left ventricular ejection fraction, left ventricular end-systolic and end-diastolic volume indices, left atrial volume index, E/e' index, and exercise tolerance on the 6-minute walk test were secondary endpoints. In the treatment efficacy analysis, NT-proBNP levels decreased significantly by 37% in the sacubitril/valsartan group and by 11% in the valsartan group (P<0.001). Ejection fraction and exercise tolerance (increase in walking distance in the 6-min test) increased in the sacubitril/valsartan group (P<0.05). Also, in this group, the effective area of the regurgitation orifice, the left atrial volume index, the E/e' index, and the indices of the end-systolic and end-diastolic volume of the left ventricle (P<0.05) decreased more pronouncedly. Compared with valsartan, treatment with sacubitril/valsartan led to a significant improvement in cardiac remodeling in patients with SMR and heart failure with reduced ejection fraction.

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Section: Methodsmentioning

confidence: 99%

Angiotensin receptor-neprilysin inhibitors and cardiac remodeling

Ryazanov

Ших

Makarovskaya³

et al. 2023

Braz J Med Biol Res

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Efficacy of sacubitril/valsartan versus valsartan in patients with arterial hypertension

Ryazanov,

Melnikova,

Makarovskaya

et al. 2024

Arter. gipertenz.

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Objective. To identify the effectiveness of sacubitril/valsartan versus valsartan in reducing blood pressure (BP) in patients with arterial hypertension (HTN) 1–2 degree.Design and methods. The study included 105 patients, among them 90 were included in the effectiveness analysis and were observed for 12 months in an outpatient setting. In accordance with the protocol, 90 patients completed the study, 44 of them received sacubitril/ valsartan (97/103 mg), 46 received valsartan (160 mg). The dynamics of clinical BP in mm Hg and rates of achieving target BP levels in treatment groups were assessed.Results. Systolic after 12 months decreased more significantly in sacubitril/valsartan group versus valsartan: by 14,68 ± 9,33 vs 6,17 ± 4,81 mmHg (p = 0,007). The rate of achieving target BP was higher in the sacubitril/valsartan group (61,41 % vs 34,8 %, p < 0,01).Conclusions. Among patients with 1–2 degree HTN, sacubitril/valsartan reduced blood pressure to a greater extent than valsartan alone and was not inferior to the latter in terms of safety criteria.

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The Effect of Angiotensin Receptor and Neprilysin Inhibitors on Quality of Life in Patients with Heart Failure with Reduced Ejection Fraction and Functional Mitral Regurgitation

Ryazanov

Ших

Kechina³

et al. 2023

Racionalʹnaâ farmakoterapiâ v kardiologii

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Aim. To compare the change in quality of life indicators and the main clinical and instrumental parameters in patients with chronic heart failure (CHF) and functional mitral regurgitation (FMR) under the influence of sacubitril/valsartan compared with valsartan in an outpatient practice.Material and Methods. The study included 90 patients with chronic FMR, who were observed for 12 months. They received sacubitril/valsartan or valsartan. Efficiency criteria were: the difference between groups in scores according to the Kansas questionnaire for patients with cardiomyopathy; MR degree parameters (change in effective regurgitation orifice area, vena contracta width, MR volume and MR fraction); indicators of the severity of myocardial remodeling (left ventricular EF; the level of N-terminal brain natriuretic propeptide), exercise tolerance based on a 6-minute walk test, a change in the functional class of heart failure according to NYHA.Results. In a treatment efficacy analysis, the Kansas City Cardiomyopathy Questionnaire–Overall Summary Score improved by 22.1 points in the sacubitril/valsartan group and by 4.5 points in the valsartan group (p<0.001). EF, exercise tolerance, and the number of patients transitioning from NYHA functional class III to II increased in the sacubitril/valsartan group (p<0.05). Also, in this group, the effective area of the regurgitation opening, the width of the vena contracta, the volume of regurgitation, the fraction of regurgitation, and the level of N-terminal brain natriuretic propeptide (p<0.05) decreased more pronouncedly (p<0.05).Conclusion. Compared with valsartan, treatment with sacubitril/valsartan leads to a significant improvement in the quality of life in patients with FMR and HF with reduced EF, which is largely associated with a change in NT-proBNP, echocardiographic characteristics of the severity of MR and the degree of myocardial remodeling.

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The Results of the Use of Angiotensin Receptor Inhibitors and Neprilisin in Secondary Functional Mitral Regurgitation in Outpatient Practice

Cited by 3 publications

References 9 publications

Angiotensin receptor-neprilysin inhibitors and cardiac remodeling

Angiotensin receptor-neprilysin inhibitors and cardiac remodeling

Efficacy of sacubitril/valsartan versus valsartan in patients with arterial hypertension

The Effect of Angiotensin Receptor and Neprilysin Inhibitors on Quality of Life in Patients with Heart Failure with Reduced Ejection Fraction and Functional Mitral Regurgitation

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