Artery Research

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Volume 16, Issue C, December 2016, Pages 80 - 80

13.3 SACUBITRIL/VALSARTAN THERAPY IS ASSOCIATED WITH DECREASE OF ARTERIAL ELASTANCE IN STABLE PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION

Authors
Zhanna Kobalava, Svetlana Villevalde, Olga Lukina, Evgenii Tyukhmenev
Peoples’ Friendship University of Russia, Moscow, Russia
Available Online 24 November 2016.
DOI
10.1016/j.artres.2016.10.112How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Objective: Angiotensin receptor-neprilysin inhibition with LCZ696 is a novel approach for the treatment of heart failure with reduced ejection fraction (HFrEF). The aim of the study was to assess the effects of valsartan/sacubitril on parameters of ventricular-arterial coupling and left ventricular (LV) work efficiency in patients with stable HFrEF.

Methods: In the open-label follow-up to PARADIGM HF study 18 patients with stable HFrEF (16 male, 69±9 years (MSD), arterial hypertension 83%, previous myocardial infarction 89%, diabetes mellitus 39%, LVEF 324%) were enrolled. 2-dimentional echocardiography was performed to assess arterial (Ea) and end-systolic LV elastance (Ees) baseline and after 6 month LCZ696 therapy. VAC was assessed as the ratio Ea/Ees. Wilcoxon test was considered significant if p<0.05.

Results: Baseline brachial BP decreased from 137.1±22.0/83.4±11.8 to 120.5±13.5/75.1±9.3 mmHg (Δ −16.6±14.2/−8.3±10.3 mmHg, p<0.05). LCZ696 therapy was associated with significant decrease of VAC (2.10±0.55 vs 1.68±0.32, p<0.05), Ea (2.11±1.04 vs 1.66±0.6 mmHg/ml/m2 (Δ −0,70 (−0.26%)), p<0.05), arterial peripheral resistance (0.029±0.016 vs 0.027±0.011 mmHg/ml/min, p<0.05), increase of stroke volume (63±24 vs 78±26 ml, p<0.05). Ees remained unchanged (1.11±0.42 vs 1.01±0.52 mmHg/ml/m2, p>0.05). LCZ696 therapy was associated with potential energy decrease (8049±2846 vs 5037±2492 mmHg*ml/m2, p<0.05),stroke work/pressure-volume area index (LV work efficiency) increase (0.48±0.09 vs 0.63±0.05, p<0.05). There was no statistically significant correlation between decrease of Ea and brachial BP decrease.

Conclusion: LCZ696 therapy was associated with BP-independent improvement in VAC related with decrease of Ea rather than Ees changes and associated with decrease of arterial peripheral resistance and improvement of LV work efficiency

References

1.2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC), European Heart Journal. http://dx.doi.org/10.1093/eurheartj/ehw128.
2.2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure, Circulation, Vol. 134, 2016.
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Journal
Artery Research
Volume-Issue
16 - C
Pages
80 - 80
Publication Date
2016/11/24
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2016.10.112How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Zhanna Kobalava
AU  - Svetlana Villevalde
AU  - Olga Lukina
AU  - Evgenii Tyukhmenev
PY  - 2016
DA  - 2016/11/24
TI  - 13.3 SACUBITRIL/VALSARTAN THERAPY IS ASSOCIATED WITH DECREASE OF ARTERIAL ELASTANCE IN STABLE PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION
JO  - Artery Research
SP  - 80
EP  - 80
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.10.112
DO  - 10.1016/j.artres.2016.10.112
ID  - Kobalava2016
ER  -