Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan
Abstract Aims The angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan reduces mortality and hospitalizations in patients with heart failure and reduced ejection fraction (HFrEF). Favourable effects on haemodynamic and functional parameters have been observed in patients with HFrEF...
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| Format: | Article |
| Language: | English |
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Wiley
2020-06-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.12656 |
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| author | Simone Mazzetti Chiara Scifo Raffaele Abete Davide Margonato Margherita Chioffi Jessica Rossi Matteo Pisani Giovanni Passafaro Massimiliano Grillo Daniele Poggio Andrea Mortara |
| author_facet | Simone Mazzetti Chiara Scifo Raffaele Abete Davide Margonato Margherita Chioffi Jessica Rossi Matteo Pisani Giovanni Passafaro Massimiliano Grillo Daniele Poggio Andrea Mortara |
| author_sort | Simone Mazzetti |
| collection | DOAJ |
| description | Abstract Aims The angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan reduces mortality and hospitalizations in patients with heart failure and reduced ejection fraction (HFrEF). Favourable effects on haemodynamic and functional parameters have been observed in patients with HFrEF undergoing ARNI therapy, using standard transthoracic echocardiography. Global longitudinal strain (GLS) assessment uses a semi‐automatic procedure to provide a reliable and repeatable method that improves the detection of early changes of contractile function. We aimed to assess the effects of ARNI on GLS and myocardial mechanics in patients with HFrEF. Methods and results Thirty patients with New York Heart Association class II–III HFrEF were treated with ARNI and monitored using standard echocardiographic examination and GLS measurements at baseline, 3 months, and 6 months. ARNI therapy resulted in a significant reduction of ventricular volumes and a significant increase in left ventricular ejection fraction at 6 months but not 3 months by standard transthoracic echocardiography (left ventricular ejection fraction from 28 ± 8% at baseline to 34 ± 12% at 6 months, P < 0.001). Non‐significant differences in the size of the left atrium, right ventricular function, and pulmonary pressures were found at 6 months. By using GLS, there was a progressive improvement of all strain parameters by 3 months. The improvement showed a progressive trend over time and maintained significance at 6 months: GLS 4ch −7.2 ± 4.8% at baseline vs. −7.5 ± 3.9% at 3 months (P = 0.025) and − 9.2 ± 5.2% at 6 months (P = 0.0001); AVG GLS −6.9 ± 4.3 at baseline vs. −7.9 ± 4.2 at 3 months (P = 0.04) and − 8.8 ± 4.4 at 6 months (P = 0.035); GLS endo 8.2 ± 4.8 at baseline vs. −9.0 ± 4.8 at 3 months (P = 0.05) and − 10.1 ± 5.1 at 6 months (P = 0.001). Conclusions Sacubitril/valsartan induces an early benefit on left ventricular remodelling, which is captured by myocardial strain and not by standard echocardiography. Strain method represents a practical tool to assess early and minimal variations of left ventricular systolic function. |
| format | Article |
| id | doaj-art-710528c298ae41f3828206a06ed053c1 |
| institution | Kabale University |
| issn | 2055-5822 |
| language | English |
| publishDate | 2020-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj-art-710528c298ae41f3828206a06ed053c12025-02-03T10:25:46ZengWileyESC Heart Failure2055-58222020-06-017396497210.1002/ehf2.12656Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartanSimone Mazzetti0Chiara Scifo1Raffaele Abete2Davide Margonato3Margherita Chioffi4Jessica Rossi5Matteo Pisani6Giovanni Passafaro7Massimiliano Grillo8Daniele Poggio9Andrea Mortara10Department of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyDepartment of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyDepartment of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyDepartment of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyDepartment of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyDepartment of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyDepartment of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyDepartment of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyDepartment of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyDepartment of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyDepartment of Clinical Cardiology Policlinico di Monza Via Amati, 111 20900 Monza MB ItalyAbstract Aims The angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan reduces mortality and hospitalizations in patients with heart failure and reduced ejection fraction (HFrEF). Favourable effects on haemodynamic and functional parameters have been observed in patients with HFrEF undergoing ARNI therapy, using standard transthoracic echocardiography. Global longitudinal strain (GLS) assessment uses a semi‐automatic procedure to provide a reliable and repeatable method that improves the detection of early changes of contractile function. We aimed to assess the effects of ARNI on GLS and myocardial mechanics in patients with HFrEF. Methods and results Thirty patients with New York Heart Association class II–III HFrEF were treated with ARNI and monitored using standard echocardiographic examination and GLS measurements at baseline, 3 months, and 6 months. ARNI therapy resulted in a significant reduction of ventricular volumes and a significant increase in left ventricular ejection fraction at 6 months but not 3 months by standard transthoracic echocardiography (left ventricular ejection fraction from 28 ± 8% at baseline to 34 ± 12% at 6 months, P < 0.001). Non‐significant differences in the size of the left atrium, right ventricular function, and pulmonary pressures were found at 6 months. By using GLS, there was a progressive improvement of all strain parameters by 3 months. The improvement showed a progressive trend over time and maintained significance at 6 months: GLS 4ch −7.2 ± 4.8% at baseline vs. −7.5 ± 3.9% at 3 months (P = 0.025) and − 9.2 ± 5.2% at 6 months (P = 0.0001); AVG GLS −6.9 ± 4.3 at baseline vs. −7.9 ± 4.2 at 3 months (P = 0.04) and − 8.8 ± 4.4 at 6 months (P = 0.035); GLS endo 8.2 ± 4.8 at baseline vs. −9.0 ± 4.8 at 3 months (P = 0.05) and − 10.1 ± 5.1 at 6 months (P = 0.001). Conclusions Sacubitril/valsartan induces an early benefit on left ventricular remodelling, which is captured by myocardial strain and not by standard echocardiography. Strain method represents a practical tool to assess early and minimal variations of left ventricular systolic function.https://doi.org/10.1002/ehf2.12656Heart failureHeart failure with reduced ejection fractionAngiotensin receptor neprilysin inhibitorGlobal longitudinal strainRenin–angiotensin–aldosterone systemNeprilysin |
| spellingShingle | Simone Mazzetti Chiara Scifo Raffaele Abete Davide Margonato Margherita Chioffi Jessica Rossi Matteo Pisani Giovanni Passafaro Massimiliano Grillo Daniele Poggio Andrea Mortara Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan ESC Heart Failure Heart failure Heart failure with reduced ejection fraction Angiotensin receptor neprilysin inhibitor Global longitudinal strain Renin–angiotensin–aldosterone system Neprilysin |
| title | Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan |
| title_full | Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan |
| title_fullStr | Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan |
| title_full_unstemmed | Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan |
| title_short | Short‐term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril/valsartan |
| title_sort | short term echocardiographic evaluation by global longitudinal strain in patients with heart failure treated with sacubitril valsartan |
| topic | Heart failure Heart failure with reduced ejection fraction Angiotensin receptor neprilysin inhibitor Global longitudinal strain Renin–angiotensin–aldosterone system Neprilysin |
| url | https://doi.org/10.1002/ehf2.12656 |
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