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Zheng J, Wu Q, Li Q, Tang M, He J, Qiu Z, Xie L, Chen L. Benefits of sacubitril/valsartan use in patients with chronic heart failure after cardiac valve surgery: a single-center retrospective study. J Cardiothorac Surg 2023; 18:138. [PMID: 37041595 PMCID: PMC10091567 DOI: 10.1186/s13019-023-02252-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 04/03/2023] [Indexed: 04/13/2023] Open
Abstract
OBJECTIVES To evaluate the efficacy of sacubitril/valsartan for the treatment of patients with chronic heart failure (CHF) after cardiac valve surgery (CVS). METHODS Data were collected from 259 patients who underwent CVS due to valvular heart disease and were admitted to the hospital with CHF from January 2018 to December 2020. The patients were divided into Group A (treatment with sacubitril/valsartan) and Group B (treatment without sacubitril/valsartan). The duration of treatment and follow-up was 6 months. The two groups' prior and clinical characteristics, post-treatment data, mortality, and follow-up data were analysed. RESULTS The effective rate of Group A was higher than that of Group B (82.56% versus 65.52%, P < 0.05). The left ventricular ejection fraction (LVEF, %) was improved in both groups. The final value minus the initial value was (11.14 ± 10.16 versus 7.15 ± 11.18, P = 0.004). The left ventricular end-diastolic/-systolic diameter (LVEDD/LVESD, mm) in Group A decreased more than in Group B. The final value minus the initial value was (-3.58 ± 9.21 versus - 0.27 ± 14.44, P = 0.026; -4.21 ± 8.15 versus - 1.14 ± 12.12, P = 0.016, respectively). Both groups decreased the N-terminal prohormone of B-type natriuretic peptide (NT-proBNP, pg/ml). The final value minus initial value was [-902.0(-2226.0, -269.5) versus - 535.0(-1738, -7.0), P = 0.029]. The systolic and diastolic blood pressure (SBP/DBP, mmHg) in Group A decreased more than in Group B. The final value minus the initial value was (-13.13 ± 23.98 versus - 1.81 ± 10.89, P < 0.001; -8.28 ± 17.79 versus - 2.37 ± 11.41, P = 0.005, respectively). Liver and renal insufficiency, hyperkalaemia, symptomatic hypotension, angioedema, and acute heart failure had no statistical differences between the two groups. CONCLUSIONS Sacubitril/valsartan can effectively improve the cardiac function of patients with CHF after CVS by increasing LVEF and reducing LVEDD, LVESD, NT-proBNP, and BP, with good safety.
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Affiliation(s)
- Jian Zheng
- Department of Pharmacy, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, P. R. China
| | - Qingsong Wu
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Xinquan Road 29, 350001, Fuzhou, Fujian, P. R. China
- Key Laboratory of Cardio-Thoracic SurgeryFujian Medical University), Fujian Province University, Fujian Medical University), Fuzhou, Fujian, P. R. China
| | - Qianzhen Li
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Xinquan Road 29, 350001, Fuzhou, Fujian, P. R. China
| | - Mirong Tang
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Xinquan Road 29, 350001, Fuzhou, Fujian, P. R. China
| | - Jian He
- Fujian Medical University, Fuzhou, Fujian, P. R. China
| | - Zhihuang Qiu
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Xinquan Road 29, 350001, Fuzhou, Fujian, P. R. China
- Key Laboratory of Cardio-Thoracic SurgeryFujian Medical University), Fujian Province University, Fujian Medical University), Fuzhou, Fujian, P. R. China
| | - Linfeng Xie
- Fujian Medical University, Fuzhou, Fujian, P. R. China
| | - Liangwan Chen
- Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Xinquan Road 29, 350001, Fuzhou, Fujian, P. R. China.
- Key Laboratory of Cardio-Thoracic SurgeryFujian Medical University), Fujian Province University, Fujian Medical University), Fuzhou, Fujian, P. R. China.
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Ragab MAA, Korany MA, Galal SM, Ahmed AR. Diode array detection for stability assessment and evaluation of degradation kinetics of newly introduced sacubitril in its supramolecular complex (LCZ696) with valsartan. J LIQ CHROMATOGR R T 2018. [DOI: 10.1080/10826076.2017.1415213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Marwa A. A. Ragab
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt
| | - Mohamed A. Korany
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt
| | - Shereen M. Galal
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt
| | - Aya R. Ahmed
- Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, University of Alexandria, Alexandria, Egypt
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Ragab MA, Galal SM, Korany MA, Ahmed AR. First derivative emission spectrofluorimetric method for the determination of LCZ696, a newly approved FDA supramolecular complex of valsartan and sacubitril in tablets. LUMINESCENCE 2017; 32:1417-1425. [DOI: 10.1002/bio.3339] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 03/24/2017] [Accepted: 03/29/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Marwa A.A. Ragab
- Faculty of Pharmacy, Department of Pharmaceutical Analytical Chemistry; University of Alexandria, El-Messalah; Alexandria Egypt
| | - Shereen M. Galal
- Faculty of Pharmacy, Department of Pharmaceutical Analytical Chemistry; University of Alexandria, El-Messalah; Alexandria Egypt
| | - Mohamed A. Korany
- Faculty of Pharmacy, Department of Pharmaceutical Analytical Chemistry; University of Alexandria, El-Messalah; Alexandria Egypt
| | - Aya R. Ahmed
- Faculty of Pharmacy, Department of Pharmaceutical Analytical Chemistry; University of Alexandria, El-Messalah; Alexandria Egypt
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Abstract
Hypertension (HTN) is a well-known health problem associated with considerable morbidity and mortality and it is an important risk factor for the development of heart failure (HF). These findings support the need for optimizing the antihypertensive strategies to prevent the progression to HF. Interestingly, the progression from HTN to HF, among other things, may be a consequence of inappropriate over-activation of the renin-angiotensin-aldosterone system (RAAS), sympathetic nervous system (SNS), and the natriuretic peptide system (NPS). In the present review, we will discuss the pathophysiological aspects of the progression from HTN to HF with reduced ejection fraction (HFrEF) and we will focus on the evolution of different pharmacological therapies which are reported to be effective in reducing BP and improving HF outcomes, paying particular attention to the recent trials that have demonstrated the efficacy of the combined therapy of RAAS blockade and Neprilysin (NEP) inhibitor in lowering BP and mediating several beneficial actions within cardiovascular tissues, such as avoiding the worsening of HF.
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