Mapelli M, Mantegazza V, Ferrari C, Cimino R, Maragna R, Pontone G, Pepi M, Agostoni P. Dramatic disease regression in a case of HFrEF with end-stage renal failure treated with sacubitril/valsartan and SGLT2i.
ESC Heart Fail 2023;
10:2099-2106. [PMID:
36907832 PMCID:
PMC10192298 DOI:
10.1002/ehf2.14344]
[Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/12/2023] [Accepted: 02/19/2023] [Indexed: 03/14/2023] Open
Abstract
The amount of evidence for guideline-directed new heart failure (HFrEF) disease-modifying drugs in the context of chronic kidney disease (CKD) is relatively modest, especially in end-stage CKD. We report a case of dramatic reverse remodelling and disease regression in a naïve HFrEF young woman on haemodialysis treated with sacubitril/valsartan and SGLT2i. At 10-month follow-up, the patient normalized left ventricle and atrial volumes and improved ejection fraction to the normal range, assessed both by echocardiography and cardiac magnetic resonance. Cardiac biomarkers and exercise performance improved consensually. The haemodialysis protocol and the loop diuretic dose were unchanged within the whole period.
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