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Influence of sacubitril/valsartan on exercise tolerance, left ventricular mass index and diastolic function in patients with HFpEF and left ventricular hypertrophy
Journal: Russian Cardiology Bulletin. 2023;18(3): 67‑75
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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
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.
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.
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.
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.
Authors:
Received:
23.05.2023
Accepted:
28.06.2023
List of references:
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