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Gvozdeva A.D.

Chazov National Medical Research Center for Cardiology

Sobolevskaya M.S.

Chazov National Medical Research Center for Cardiology

Sharf T.V.

Chazov National Medical Research Center for Cardiology

Kuznetsova T.V.

Chazov National Medical Research Center for Cardiology

Masenko V.P.

Chazov National Medical Research Center for Cardiology

Ageev F.T.

Chazov National Medical Research Center for Cardiology

Ovchinnikov A.G.

Chazov National Medical Research Center for Cardiology

Influence of sacubitril/valsartan on exercise tolerance, left ventricular mass index and diastolic function in patients with HFpEF and left ventricular hypertrophy

Authors:

Gvozdeva A.D., Sobolevskaya M.S., Sharf T.V., Kuznetsova T.V., Masenko V.P., Ageev F.T., Ovchinnikov A.G.

More about the authors

Journal: Russian Cardiology Bulletin. 2023;18(3): 67‑75

DOI: 10.17116/Cardiobulletin20231803167

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Table of contents

INFLUENCE OF SACUBITRIL/VALSARTAN ON EXERCISE TOLERANCE, LEFT VENTRICULAR MASS INDEX AND DIASTOLIC FUNCTION IN PATIENTS WITH HFPEF AND LEFT VENTRICULAR HYPERTROPHY
INFLUENCE OF SACUBITRIL/VALSARTAN ON EXERCISE TOLERANCE, LEFT VENTRICULAR MASS INDEX AND DIASTOLIC FUNCTION IN PATIENTS WITH HFPEF AND LEFT VENTRICULAR HYPERTROPHY

To cite this article:

Gvozdeva AD, Sobolevskaya MS, Sharf TV, Kuznetsova TV, Masenko VP, Ageev FT, Ovchinnikov AG. Influence of sacubitril/valsartan on exercise tolerance, left ventricular mass index and diastolic function in patients with HFpEF and left ventricular hypertrophy. Russian Cardiology Bulletin. 2023;18(3):67‑75. (In Russ.)
https://doi.org/10.17116/Cardiobulletin20231803167

 
 
Подписка 2025-2 (Russian Cardiology Bulletin)
 
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OBJECTIVE

To assess the effect of neprilysin/angiotensin receptor inhibitor (sacubitril/valsartan, S/V) on exercise capacity, left ventricular (LV) mass index and diastolic function, serum NT-proBNP in patients with chronic HFpEF and concentric LV hypertrophy.

MATERIAL AND METHODS

A prospective single-center trial enrolled 45 patients with chronic HFpEF NYHA class II―III, moderate/severe hypertensive concentric LV hypertrophy (LV mass index ≥132 g/m2 for men or ≥109 g/m2 for women) and increased LV filling pressures at rest and/or during exercise. All participants were randomly assigned in an open-label fashion to receive S/V 50–200 mg daily or to the control group (individualized therapy including ACE inhibitors or ARBs) with a ratio of 2:1 for 6 months. At baseline and after 6 months, all participants underwent echocardiography at rest and during exercise, a 6-minute walk test and laboratory testing.

RESULTS

In the S/V group, 6MWD increased by 20 m (95% CI 12—28), quality of life improved (Minnesota Questionnaire) by 5 points (95% CI –8— –2), left ventricular mass index decreased by 17 g/m2 (95% CI –21— –13), indexed left atrial volume decreased by 2.8 ml/m2 (95% CI –9.2— –0.8), E/e′ ratio decreased by 1.8 (95% CI –3.2— –0.02) and serum NT-proBNP decreased by 26% (95% CI –53— –2%; p<0.05) after 6 months compared to the control group.

CONCLUSION

Treatment with S/V was associated with improvement in exercise capacity and reduction of LV hypertrophy and LV filling pressure, improved diastolic reserve and decrease of serum NT-proBNP in patients with HFpEF and advanced LV hypertrophy.

Keywords:

neprilysin inhibitor
natriuretic peptide
heart failure with preserved ejection fraction

Authors:

Gvozdeva A.D.

Chazov National Medical Research Center for Cardiology

Sobolevskaya M.S.

Chazov National Medical Research Center for Cardiology

Sharf T.V.

Chazov National Medical Research Center for Cardiology

Kuznetsova T.V.

Chazov National Medical Research Center for Cardiology

Masenko V.P.

Chazov National Medical Research Center for Cardiology

Ageev F.T.

Chazov National Medical Research Center for Cardiology

Ovchinnikov A.G.

Chazov National Medical Research Center for Cardiology

Received:

23.05.2023

Accepted:

28.06.2023

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