1
|
Barman HA, Dogan O, Tanyolaç S, Atıcı A, Arabaci HO, Ebeoglu AO, Özyıldırım S, Yiğit Z. Impact of Treatment With Sacubitril/Valsartan on Erectile Dysfunction in Patients With Heart Failure With Reduced Ejection Fraction. Am J Cardiol 2024; 212:1-5. [PMID: 37984637 DOI: 10.1016/j.amjcard.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 10/15/2023] [Accepted: 11/11/2023] [Indexed: 11/22/2023]
Abstract
Sacubitril/valsartan (S/V), an angiotensin receptor-neprilysin inhibitor, has been shown to reduce the risk of cardiovascular death or heart failure hospitalization and relieve symptoms in patients with chronic heart failure with reduced ejection fraction. The objective of this study was to assess the effects of S/V on erectile dysfunction in patients with heart failure with reduced ejection fraction (HFrEF). A prospective, open-label study was conducted with 59 male patients diagnosed with HFrEF and concomitant erectile dysfunction. Patients were treated with S/V for a duration of 1 month. The International Index of Erectile Function (IIEF) questionnaire was used to assess the severity of erectile dysfunction and sexual activities at baseline and follow-up visits. Other clinical parameters, including heart rate, were also monitored. After S/V treatment, a significant improvement was observed in sexual activities at the 1-month follow-up visit. The IIEF score showed a statistically significant increase, indicating a decrease in the severity of erectile dysfunction. However, it should be noted that the numerical increase in the IIEF score did not reach clinical significance. This study suggests that S/V treatment in patients with HFrEF may lead to improvements in sexual activities and a reduction in the severity of erectile dysfunction as measured by the IIEF score.
Collapse
Affiliation(s)
- Hasan Ali Barman
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Omer Dogan
- Department of Cardiology, Istinye State Hospital, Ministry of Health, Istanbul, Turkey.
| | - Selim Tanyolaç
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Adem Atıcı
- Department of Cardiology, Goztepe Training and Research Hospital, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Hidayet Ozan Arabaci
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Abdullah Omer Ebeoglu
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Serhan Özyıldırım
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Zerrin Yiğit
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| |
Collapse
|
2
|
Huang Y, Wu X, Li X, Liu Z, Li Y. Effect on the Quality of Life of Patients with Heart Failure and Reduced/Preserved Ejection Fraction Using Sacubitril/Valsartan. Arq Bras Cardiol 2023; 120:e20220611. [PMID: 37971045 PMCID: PMC10519244 DOI: 10.36660/abc.20220611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 05/15/2023] [Accepted: 06/14/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Heart failure (HF) management has markedly improved, but a clinically meaningful improvement in functional capacity and quality of life is perhaps more important for patients than living longer. OBJECTIVE This study aimed to review the improvement in quality of life with sacubitril/valsartan in patients with HF and reduced/preserved ejection fraction (EF) from prospective clinical trials. METHODS PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs) and prospective cohort studies published from inception to July 2021. A total of 6 clinical trials and 16854 patients with HF were included. The primary outcome was the change from baseline in KCCQ clinical summary score. The secondary outcomes were scores in other domains of KCCQ, the occurrence of serious adverse events (AEs), and overall mortality. P-values <0.05 were considered statistically significant. RESULTS Treatment of sacubitril/valsartan showed significantly higher KCCQ-CSS compared to the control (WMD=0.975, 95% CI: 0.885, 1.064, p<0.001; I2=94.8%, pheterogeneity<0.001). A significant decrease in the mortality rate was observed in the sacubitril/valsartan group compared to the control group (RR=0.895, 95%CI:0.831, 0.965, p=0.004; I2=43.6%, pheterogeneity=0.150). Nevertheless, no significant reduction in the occurrence of serious AEs was found among HF patients treated with sacubitril/valsartan compared to the control group (RR=0.950, 95%CI: 0.879, 1.027, p<0.001; I2=68.1%, pheterogeneity=0.024). CONCLUSIONS Our study demonstrated that sacubitril/valsartan might significantly improve the HRQL compared to other treatments according to the results in KCCQ-CSS and some subdomains in the KCCQ index during the follow-up in patients with HF.
Collapse
Affiliation(s)
- Yuanrui Huang
- Banan Hospital of Traditional Chinese MedicineDepartment of PharmacyChongqingChinaDepartment of Pharmacy, Banan Hospital of Traditional Chinese Medicine, Chongqing – China
| | - Xu Wu
- Banan Hospital of Traditional Chinese MedicineDepartment of GeriatricsChongqingChinaDepartment of Geriatrics, Banan Hospital of Traditional Chinese Medicine, Chongqing – China
| | - Xingyu Li
- Chongqing Hospital of Traditional Chinese MedicineDepartment of CardiologyChongqingChinaDepartment of Cardiology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing – China
| | - Zhengzhong Liu
- Banan Hospital of Traditional Chinese MedicineDepartment of CardiologyChongqingChinaDepartment of Cardiology, Banan Hospital of Traditional Chinese Medicine, Chongqing – China
| | - Yunyi Li
- Chongqing Hospital of Traditional Chinese MedicineDepartment of PharmacyChongqingChinaDepartment of Pharmacy, Chongqing Hospital of Traditional Chinese Medicine, Chongqing – China
| |
Collapse
|
3
|
A bibliometric analysis of research on heart failure comorbid with depression from 2002 to 2021. Heliyon 2023; 9:e13054. [PMID: 36755587 PMCID: PMC9900509 DOI: 10.1016/j.heliyon.2023.e13054] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/13/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
Heart failure (HF) with depression is a common comorbidity associated with worse clinical status and quality of life. Although there have been numerous high-quality studies and relevant reviews on HF comorbid with depression, few bibliometric analyses of this field have been reported. In order to understand the development process, research hotspots and future directions, this review analyzes the papers on HF comorbid with depression from January 2002 to December 2021 through CiteSpace and VOSviewer. Visual cooperative networks between countries, authors and institutions were conducted to understand the basic development status of HF comorbid with depression. Furthermore, we performed co-occurrence analysis, burst detection, and timeline analysis for keywords to understand this field's research directions and hotspots. Finally, a detailed review and analysis of the classical literature in this field were conducted based on co-citation analysis. This bibliometric analysis provides an overview of studies on HF comorbid with depression and emphasizes the research on comorbidity mechanisms and more effective interventions as a priority for future research.
Collapse
Key Words
- AHF, acute heart failure
- BDI, beck depression inventory
- Bibliometric analysis
- CAD, coronary artery disease
- CBT, cognitive-behavioral therapy
- CHF, chronic heart failure
- CVDs, cardiovascular diseases
- Depression
- HF, heart failure
- Heart failure
- MDD, major depression disorder
- PHQ-9, patient health questionnaire-9
- Research trends
- SCAD, stable coronary artery disease
- SSRIs, selective serotonin reuptake inhibitors
- US, United States
- WoSCC, web of science core collection
Collapse
|
4
|
Armentaro G, Condoleo V, Pelaia C, Cassano V, Miceli S, Maio R, Salzano A, Pelle MC, Perticone M, Succurro E, Arturi F, Andreozzi F, Sesti G, Sciacqua A. Short term effect of sacubitril/valsartan on comprehensive geriatric assessment in chronic heart failure: a real life analysis. Intern Emerg Med 2023; 18:113-125. [PMID: 36478322 DOI: 10.1007/s11739-022-03130-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/09/2022] [Indexed: 12/12/2022]
Abstract
Sacubitril/Valsartan (Sac-Val) has improved clinical prognosis in patients affected by heart failure (HF) with reduced ejection fraction (HFrEF). Comorbidities have a crucial impact on clinical presentation and prognosis in HF patients. Cognitive impairment (CoI) and Depression are a very common comorbidity in patients with HF and is widely recognized as a specific determinant of chronic disability, and HF patients with poor physical functional performance in Short physical performance battery (SPPB) showed a worse prognosis. The aim of the present study was to evaluate the potential effects of Sac-Val on functional, humoral, and cognitive aspects, evaluated by performing comprehensive geriatric assessment (CGA), in a cohort of elderly HFrEF. We studied 61 patients (51 men and 10 women, mean age 76.4 ± 5.1 years) suffering from HFrEF. After 6 months follow-up, we observed a significant improvement in humoral and functional parameters of CGA, renal function, NTpro-BNP levels and echocardiographic parameters. In the whole population, multivariate analysis shows that changes of Cardiac Index, NT-proBNP and Respiratory rate contributed for 26.0%, 9.7% and 4.8% to GDS variability, respectively, and the whole model accounted for a 41.1% of GDS variation; moreover changes of Global longitudinal strain, estimated glomerular filtration rate, Cardiac Index and BMI contributed for 23.9%, 11.7%, 5.4% and 4.0% to SPPB variability, respectively, and the whole model accounted for a 45% of SPPB variation. This represents the first real-world study carried out in an elderly population suffering from chronic HFrEF with numerous comorbidities, in which treatment with Sac-Val for 6 months induced important improvements in clinical, humoral, hemodynamic, and functional outcomes, without adverse effects on cognitive performance.
Collapse
Affiliation(s)
- Giuseppe Armentaro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Valentino Condoleo
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Corrado Pelaia
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Velia Cassano
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Raffaele Maio
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Andrea Salzano
- IRCSS SYNLAB SDN, Diagnostic and Nuclear Institute, Naples, Italy
| | - Maria Chiara Pelle
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Maria Perticone
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Elena Succurro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Franco Arturi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy
| | - Giorgio Sesti
- Department of Clinical and Molecular Medicine, University Rome-Sapienza, Rome, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, Italy.
| |
Collapse
|
5
|
Manolis TA, Manolis AA, Melita H, Manolis AS. Neuropsychiatric disorders in patients with heart failure: not to be ignored. Heart Fail Rev 2022:10.1007/s10741-022-10290-2. [DOI: 10.1007/s10741-022-10290-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
|
6
|
Tsukakoshi D, Yamamoto S, Takeda S, Furuhashi K, Sato M. Clinical Perspectives on Cardiac Rehabilitation After Heart Failure in Elderly Patients with Frailty: A Narrative Review. Ther Clin Risk Manag 2022; 18:1009-1028. [PMID: 36324527 PMCID: PMC9620837 DOI: 10.2147/tcrm.s350748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/11/2022] [Indexed: 01/25/2023] Open
Abstract
The purpose of this narrative review is to examine rehabilitation modalities for patients with heart failure and Frailty who require comprehensive intervention. Ischemic heart disease is the leading cause of death worldwide, accounting for 16% of global mortality. Due to population growing and aging, the total number of heart failure patients continues to rise, a condition known as the heart failure pandemic. Furthermore, frailty has been associated with an increased risk for heart failure and increased morbidity and mortality. The 2021 update of the 2017 ACC expert consensus decision pathway for optimization of HF treatment has become more concerning, citing frailty as one of the 10 most important issues associated with heart failure with reduced ejection fraction (HFrEF). Frailty and heart failure share common pathological mechanisms and are associated with poor clinical outcomes. Most studies of frailty in patients with heart failure primarily focus on physical frailty, and associations between psycho-psychological and social factors such as cognitive dysfunction and social isolation have also been reported. These results suggest that a more comprehensive assessment of frailty is important to determine the risk in patients with heart failure. Therefore, mechanisms of the three domains, including not only physical frailty but also cognitive, psychological, spiritual, and social aspects, should be understood. In addition to interventions in these three domains, nutritional and pharmacological interventions are also important and require tailor-made interventions for the widely varied conditions associated with heart failure and frailty. Although several studies have shown a relationship between frailty and prognosis in patients with heart failure, interventions to improve the prognosis have not yet been established. Further information is needed on frailty intervention by a multidisciplinary team to improve the prognosis.
Collapse
Affiliation(s)
- Daichi Tsukakoshi
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan,Correspondence: Shuhei Yamamoto, Department of Rehabilitation, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan, Tel +81-263-37-2836, Fax +81-263-37-2835, Email
| | - Shuhei Takeda
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Keisuke Furuhashi
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Masaaki Sato
- Division of Occupational Therapy, School of Health Sciences, Shinshu University, Matsumoto, Nagano, Japan
| |
Collapse
|
7
|
Mustafa NH, Jalil J, Zainalabidin S, Saleh MS, Asmadi AY, Kamisah Y. Molecular mechanisms of sacubitril/valsartan in cardiac remodeling. Front Pharmacol 2022; 13:892460. [PMID: 36003518 PMCID: PMC9393311 DOI: 10.3389/fphar.2022.892460] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/11/2022] [Indexed: 12/11/2022] Open
Abstract
Cardiovascular diseases have become a major clinical burden globally. Heart failure is one of the diseases that commonly emanates from progressive uncontrolled hypertension. This gives rise to the need for a new treatment for the disease. Sacubitril/valsartan is a new drug combination that has been approved for patients with heart failure. This review aims to detail the mechanism of action for sacubitril/valsartan in cardiac remodeling, a cellular and molecular process that occurs during the development of heart failure. Accumulating evidence has unveiled the cardioprotective effects of sacubitril/valsartan on cellular and molecular modulation in cardiac remodeling, with recent large-scale randomized clinical trials confirming its supremacy over other traditional heart failure treatments. However, its molecular mechanism of action in cardiac remodeling remains obscure. Therefore, comprehending the molecular mechanism of action of sacubitril/valsartan could help future research to study the drug’s potential therapy to reduce the severity of heart failure.
Collapse
Affiliation(s)
- Nor Hidayah Mustafa
- Centre for Drug and Herbal Research Development, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Juriyati Jalil
- Centre for Drug and Herbal Research Development, Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Satirah Zainalabidin
- Program of Biomedical Science, Centre of Applied and Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohammed S.M. Saleh
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ahmad Yusof Asmadi
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia, Kuala Lumpur, Malaysia
| | - Yusof Kamisah
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- *Correspondence: Yusof Kamisah, ,
| |
Collapse
|
8
|
Barman HA, Tanyolaç S, Dogan O, Bal E, Atıcı A, Özyıldırım S, Yiğit Z. Impact of Sacubitril/Valsartan on Lipid Parameters in Patients with Heart Failure with Reduced Ejection Fraction. Clin Drug Investig 2022; 42:533-540. [PMID: 35635714 DOI: 10.1007/s40261-022-01161-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor, has been shown to significantly reduce cardiovascular mortality, heart failure hospitalizations, and all-cause mortality in patients with heart failure with reduced ejection fraction. This study aims to investigate the long-term impact of the sacubitril/valsartan combination on lipid parameters in patients with heart failure with reduced ejection fraction. METHODS For this single-center retrospective cross-sectional study, data of patients using sacubitril/valsartan because of heart failure with reduced ejection fraction were collected. In addition to routine controls, the patients' lipid levels were measured at 3-month intervals. The parameters that were obtained over 3 years included total cholesterol, high-density lipoprotein cholesterol, triglyceride, and N-terminal pro-B-type natriuretic peptide levels. RESULTS A total of 192 patients with a functional capacity New York Heart Association II-V, and who were using sacubitril/valsartan because of heart failure with reduced ejection fraction, were included in this study. Independent of statin use, there was a decrease in total cholesterol levels (196.1 ± 44.8 mg/dL vs 161.5 ± 41.7 mg/dL, p < 0.001) and triglyceride levels (159.1 ± 10.4 mg/dL vs 121.4 ± 6.9 mg/dL, p < 0.001), and there was an improvement in high-density lipoprotein cholesterol levels (44.9 ± 1.9 mg/dL vs 48.2 ± 2.4 mg/dL, p < 0.001) when comparing baseline levels with third-year levels. CONCLUSIONS Sacubitril/valsartan in patients with heart failure with reduced ejection fraction, independent of statin use, may cause a decrease in total cholesterol and triglyceride levels and an improvement in high-density lipoprotein cholesterol levels.
Collapse
Affiliation(s)
- Hasan Ali Barman
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Haseki Street No:32, 34096, Fatih/İstanbul, Turkey
| | - Selim Tanyolaç
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Haseki Street No:32, 34096, Fatih/İstanbul, Turkey
| | - Omer Dogan
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Haseki Street No:32, 34096, Fatih/İstanbul, Turkey.
| | - Erdem Bal
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Haseki Street No:32, 34096, Fatih/İstanbul, Turkey
| | - Adem Atıcı
- Department of Cardiology, Faculty of Medicine, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Serhan Özyıldırım
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Haseki Street No:32, 34096, Fatih/İstanbul, Turkey
| | - Zerrin Yiğit
- Department of Cardiology, Institute of Cardiology, Istanbul University-Cerrahpaşa, Haseki Street No:32, 34096, Fatih/İstanbul, Turkey
| |
Collapse
|
9
|
Karabulut U, Keskin K, Karabulut D, Yiğit E, Yiğit Z. Effect of Sacubitril/Valsartan Combined with Dapagliflozin on Long-Term Cardiac Mortality in Heart Failure with Reduced Ejection Fraction. Angiology 2021; 73:350-356. [PMID: 34560822 DOI: 10.1177/00033197211047329] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The angiotensin receptor-neprilysin inhibitor (ARNI) sacubitril/valsartan and sodium-glucose cotransporter-2 (SGLT-2) inhibitor dapagliflozin have been shown to reduce rehospitalization and cardiac mortality in patients with heart failure (HF) with reduced ejection fraction (HFrEF). We aimed to compare the long-term cardiac and all-cause mortality of ARNI and dapagliflozin combination therapy against ARNI monotherapy in patients with HFrEF. This retrospective study involved 244 patients with HF with New York Heart Association (NYHA) class II-IV symptoms and ejection fraction ≤40%. The patients were divided into 2 groups: ARNI monotherapy and ARNI+dapagliflozin. Median follow-up was 2.5 (.16-3.72) years. One hundred and seventy-five (71.7%) patients were male, and the mean age was 65.9 (SD, 10.2) years. Long-term cardiac mortality rates were significantly lower in the ARNI+dapagliflozin group (7.4%) than in the ARNI monotherapy group (19.5%) (P = .01). Dapagliflozin [Hazard Ratio (HR) [95% Confidence Interval (CI)] = .29 [.10-.77]; P = .014] and left ventricular ejection fraction (LVEF) [HR (95% CI) = .89 (.85-.93); P < .001] were found to be independent predictors of cardiac mortality. Our study showed a significant reduction in cardiac mortality with ARNI and dapagliflozin combination therapy compared with ARNI monotherapy.
Collapse
Affiliation(s)
- Umut Karabulut
- Department of Cardiology, 64296Acıbadem International Hospital, Istanbul, Turkey
| | - Kudret Keskin
- Department of Cardiology, İstanbul Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Dilay Karabulut
- Department of Cardiology İstanbul, İstanbul Bakırköy Dr.Sadi Konuk Training and Research Hospital, İstanbul, Turkey
| | - Ece Yiğit
- Department of Internal Medicine, 218502İstanbul Pendik Medipol University Hospital, İstanbul, Turkey
| | - Zerrin Yiğit
- Department of Cardiology, İstanbul University, Cerrahpaşa Cardiology Institute, İstanbul, Turkey
| |
Collapse
|
10
|
Rubio Campal JM, Del Castillo H, Arroyo Rivera B, de Juan Bitriá C, Taibo Urquia M, Sánchez Borque P, Miracle Blanco Á, Bravo Calero L, Martí Sánchez D, Tuñón Fernández J. Improvement in quality of life with sacubitril/ /valsartan in cardiac resynchronization non-responders: The RESINA (RESynchronization plus an Inhibitor of Neprilysin/Angiotensin) registry. Cardiol J 2021; 28:402-410. [PMID: 33634846 DOI: 10.5603/cj.a2021.0009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/20/2021] [Accepted: 01/15/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Clinical management of cardiac resynchronization therapy (CRT) non-responders is difficult, and their prognosis is poor. The aim of the present study was to evaluate whether treatment with sacubitril/valsartan can improve quality of life (QoL) parameters in these patients. METHODS Thirty five non-responders to CRT were included (75 ± 7 years, 28% females, mean left ventricular ejection fraction 28 ± 8%, 54% non-ischemic cardiomyopathy) with maximally optimized drug therapy and New York Heart Association class II-III. They were all on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and were switched to sacubitril/valsartan. One week before and 6 months after initiation of the therapy they completed both the Minnesota Living with Heart Failure (MLWHF) and the 12-item Kansas City Cardiomyopathy Questionnaires (KCCQ-12). The primary outcome was the effect of sacubitril/valsartan on the physical, clinical, social and emotional QoL parameters and number of hospitalizations. RESULTS The mean total scores of both questionnaires improved from baseline to the follow-up visit at 6-months (KCCQ-12 40 ± 10 to 47 ± 10; p < 0.001; MLWHF 40 ± 15 to 29 ± 15; p < 0.001). The best results were seen in the KCCQ-12 total symptom domains (77% improvement), the MLWHF physical domain (81% improvement), and the MLWHF emotional domain (71% improvement). Two patients died during follow-up. The mean number of hospitalizations reduced significantly (1 ± 0.6 vs. 0.5 ± 0.8; p = 0.003) CONCLUSIONS: In CRT non-responders, sacubitril/valsartan significantly improved overall QoL, physical limitations and emotional domains and reduced the number of hospitalizations.
Collapse
|