Sacubitril/valsartan on right ventricular-pulmonary artery coupling and albumin-bilirubin score in heart failure in Chinese patients with reduced ejection fraction
Abstract Objective Impaired right ventricular (RV)-pulmonary arterial (PA) coupling, calculated by measuring the tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP), can be used as an early indicator of right ventricular dysfunction (RVD) in patients with...
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BMC
2025-01-01
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| Series: | Journal of Cardiothoracic Surgery |
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| Online Access: | https://doi.org/10.1186/s13019-024-03224-6 |
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| author | Yanan Shi Chuanyu Gao Yu Xu Fang Yuan |
| author_facet | Yanan Shi Chuanyu Gao Yu Xu Fang Yuan |
| author_sort | Yanan Shi |
| collection | DOAJ |
| description | Abstract Objective Impaired right ventricular (RV)-pulmonary arterial (PA) coupling, calculated by measuring the tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP), can be used as an early indicator of right ventricular dysfunction (RVD) in patients with heart failure with a reduced ejection fraction (HFrEF). Patients suffering from HFrEF experience improvements in left ventricular (LV) function through the administration of sacubitril/valsartan therapy. In addition, the albumin-bilirubin (ALBI) score was associated with the fluid overload status and adverse clinical outcomes in patients with heart failure. This study aimed to assess whether angiotensin receptor-neprilysin inhibitor (ARNI) affects the TAPSE /PASP in patients with HFrEF, and whether there is a correlation between changes in the ALBI score and ARNI treatment. Methods A retrospective observational study was conducted on 305 patients with HFrEF and RVD who were hospitalized between June 2020 and December 2021. One year after treatment, laboratory test results, ALBI score, transthoracic echocardiography (TTE), New York Heart Association classification, Minnesota Living with Heart Failure Questionnaire scores and changes in relevant variables were reevaluated. Results Compared to before sacubitril/valsartan treatment, the ALBI was found to be significantly reduced after one year of follow-up (-2.42 ± 0.37 vs. -2.51 ± 0.32, p < 0.001). Additionally, A significant improvement was demonstrated in the following echocardiography parameters assessing RV function after 1 year of treatment with sacubitril/valsartan: TAPSE (15 ± 1 vs. 18 ± 2 mm, p < 0.001), PASP (45 ± 8 vs. 40 ± 9 mmHg, p < 0.001), pulmonary artery diastolic pressure (PADP) (22 ± 4 vs. 19 ± 4 mmHg, p < 0.001), RV-PA coupling (0.35 ± 0.08 vs. 0.48 ± 0.12, p < 0.001), and RV s’(8.7 ± 2.2 vs. 9.5 ± 2.6 cm/s, p < 0.001). Multivariate analysis showed that the improvement of RV-PA coupling was associated with baseline PASP (r: -0.45, p < 0.001) and PADP (r: -0.45, p < 0.001). Conclusions Sacubitril/valsartan improves RV-PA conjugation in patients with RVD and HFrEF, and has a positive impact on the ALBI score by improving liver function in patients with HFrEF. |
| format | Article |
| id | doaj-art-e8076e1abca143b986a77b9730d49b6f |
| institution | Kabale University |
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| series | Journal of Cardiothoracic Surgery |
| spelling | doaj-art-e8076e1abca143b986a77b9730d49b6f2025-01-26T12:51:50ZengBMCJournal of Cardiothoracic Surgery1749-80902025-01-012011810.1186/s13019-024-03224-6Sacubitril/valsartan on right ventricular-pulmonary artery coupling and albumin-bilirubin score in heart failure in Chinese patients with reduced ejection fractionYanan Shi0Chuanyu Gao1Yu Xu2Fang Yuan3Department of Cardiology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Fuwai Central China Cardiovascular Hospital, Heart Center of Henan Provincial People’s HospitalDepartment of Cardiology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Fuwai Central China Cardiovascular Hospital, Heart Center of Henan Provincial People’s HospitalDepartment of Cardiology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Fuwai Central China Cardiovascular Hospital, Heart Center of Henan Provincial People’s HospitalDepartment of Cardiology, Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Fuwai Central China Cardiovascular Hospital, Heart Center of Henan Provincial People’s HospitalAbstract Objective Impaired right ventricular (RV)-pulmonary arterial (PA) coupling, calculated by measuring the tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP), can be used as an early indicator of right ventricular dysfunction (RVD) in patients with heart failure with a reduced ejection fraction (HFrEF). Patients suffering from HFrEF experience improvements in left ventricular (LV) function through the administration of sacubitril/valsartan therapy. In addition, the albumin-bilirubin (ALBI) score was associated with the fluid overload status and adverse clinical outcomes in patients with heart failure. This study aimed to assess whether angiotensin receptor-neprilysin inhibitor (ARNI) affects the TAPSE /PASP in patients with HFrEF, and whether there is a correlation between changes in the ALBI score and ARNI treatment. Methods A retrospective observational study was conducted on 305 patients with HFrEF and RVD who were hospitalized between June 2020 and December 2021. One year after treatment, laboratory test results, ALBI score, transthoracic echocardiography (TTE), New York Heart Association classification, Minnesota Living with Heart Failure Questionnaire scores and changes in relevant variables were reevaluated. Results Compared to before sacubitril/valsartan treatment, the ALBI was found to be significantly reduced after one year of follow-up (-2.42 ± 0.37 vs. -2.51 ± 0.32, p < 0.001). Additionally, A significant improvement was demonstrated in the following echocardiography parameters assessing RV function after 1 year of treatment with sacubitril/valsartan: TAPSE (15 ± 1 vs. 18 ± 2 mm, p < 0.001), PASP (45 ± 8 vs. 40 ± 9 mmHg, p < 0.001), pulmonary artery diastolic pressure (PADP) (22 ± 4 vs. 19 ± 4 mmHg, p < 0.001), RV-PA coupling (0.35 ± 0.08 vs. 0.48 ± 0.12, p < 0.001), and RV s’(8.7 ± 2.2 vs. 9.5 ± 2.6 cm/s, p < 0.001). Multivariate analysis showed that the improvement of RV-PA coupling was associated with baseline PASP (r: -0.45, p < 0.001) and PADP (r: -0.45, p < 0.001). Conclusions Sacubitril/valsartan improves RV-PA conjugation in patients with RVD and HFrEF, and has a positive impact on the ALBI score by improving liver function in patients with HFrEF.https://doi.org/10.1186/s13019-024-03224-6Albumin-bilirubin (ALBI) scoreHeart failure with reduced ejection fractionRight ventricular pulmonary couplingRV-PA couplingSacubitril/valsartan |
| spellingShingle | Yanan Shi Chuanyu Gao Yu Xu Fang Yuan Sacubitril/valsartan on right ventricular-pulmonary artery coupling and albumin-bilirubin score in heart failure in Chinese patients with reduced ejection fraction Journal of Cardiothoracic Surgery Albumin-bilirubin (ALBI) score Heart failure with reduced ejection fraction Right ventricular pulmonary coupling RV-PA coupling Sacubitril/valsartan |
| title | Sacubitril/valsartan on right ventricular-pulmonary artery coupling and albumin-bilirubin score in heart failure in Chinese patients with reduced ejection fraction |
| title_full | Sacubitril/valsartan on right ventricular-pulmonary artery coupling and albumin-bilirubin score in heart failure in Chinese patients with reduced ejection fraction |
| title_fullStr | Sacubitril/valsartan on right ventricular-pulmonary artery coupling and albumin-bilirubin score in heart failure in Chinese patients with reduced ejection fraction |
| title_full_unstemmed | Sacubitril/valsartan on right ventricular-pulmonary artery coupling and albumin-bilirubin score in heart failure in Chinese patients with reduced ejection fraction |
| title_short | Sacubitril/valsartan on right ventricular-pulmonary artery coupling and albumin-bilirubin score in heart failure in Chinese patients with reduced ejection fraction |
| title_sort | sacubitril valsartan on right ventricular pulmonary artery coupling and albumin bilirubin score in heart failure in chinese patients with reduced ejection fraction |
| topic | Albumin-bilirubin (ALBI) score Heart failure with reduced ejection fraction Right ventricular pulmonary coupling RV-PA coupling Sacubitril/valsartan |
| url | https://doi.org/10.1186/s13019-024-03224-6 |
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