PMID- 31817815 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20200928 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 8 IP - 12 DP - 2019 Dec 6 TI - The Effects of Sacubitril/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The "Hemodynamic Recovery". LID - 10.3390/jcm8122165 [doi] LID - 2165 AB - BACKGROUND: Sacubitril/valsartan has been shown to be superior to enalapril in reducing the risks of death and hospitalization for heart failure (HF). However, knowledge of the impact on cardiac performance remains limited. We sought to evaluate the effects of sacubitril/valsartan on clinical, biochemical and echocardiographic parameters in patients with heart failure and reduced ejection fraction (HFrEF). METHODS: Sacubitril/valsartan was administered to 205 HFrEF patients. RESULTS: Among 230 patients (mean age 59 +/- 10 years, 46% with ischemic heart disease) 205 (89%) completed the study. After a follow-up of 10.49 (2.93 +/- 18.44) months, the percentage of patients in New York Heart Association (NYHA) class III changed from 40% to 17% (p < 0.001). Median N-Type natriuretic peptide (Nt-proBNP) decreased from 1865 +/- 2318 to 1514 +/- 2205 pg/mL, (p = 0.01). Furosemide dose reduced from 131.3 +/- 154.5 to 120 +/- 142.5 (p = 0.047). Ejection fraction (from 27+/- 5.9% to 30 +/- 7.7% (p < 0.001) and E/A ratio (from 1.67 +/- 1.21 to 1.42 +/- 1.12 (p = 0.002)) improved. Moderate to severe mitral regurgitation (from 30.1% to 17.4%; p = 0.002) and tricuspid velocity decreased from 2.8 +/- 0.55 m/sec to 2.64 +/- 0.59 m/sec (p < 0.014). CONCLUSIONS: Sacubitril/valsartan induce "hemodynamic recovery" and, consistently with reduction in Nt-proBNP concentrations, improve NYHA class despite diuretic dose reduction. FAU - Romano, Giuseppe AU - Romano G AD - Cardiology Unit and Research Office, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy. FAU - Vitale, Giuseppe AU - Vitale G AD - Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, via Messina Marine, 197, 90123 Palermo, Italy. FAU - Ajello, Laura AU - Ajello L AD - Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, via Messina Marine, 197, 90123 Palermo, Italy. FAU - Agnese, Valentina AU - Agnese V AD - Cardiology Unit and Research Office, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy. FAU - Bellavia, Diego AU - Bellavia D AD - Cardiology Unit and Research Office, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy. FAU - Caccamo, Giuseppa AU - Caccamo G AD - Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, via Messina Marine, 197, 90123 Palermo, Italy. FAU - Corrado, Egle AU - Corrado E FAU - Di Gesaro, Gabriele AU - Di Gesaro G AD - Cardiology Unit and Research Office, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy. FAU - Falletta, Calogero AU - Falletta C AD - Cardiology Unit and Research Office, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy. FAU - La Franca, Eluisa AU - La Franca E AD - Cardiology Unit and Research Office, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy. FAU - Mina, Chiara AU - Mina C AD - Cardiology Unit and Research Office, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy. FAU - Storniolo, Salvatore Antonio AU - Storniolo SA FAU - Sarullo, Filippo Maria AU - Sarullo FM AD - Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, via Messina Marine, 197, 90123 Palermo, Italy. FAU - Clemenza, Francesco AU - Clemenza F AD - Cardiology Unit and Research Office, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Via Tricomi 5, 90127 Palermo, Italy. LA - eng PT - Journal Article DEP - 20191206 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC6947355 OTO - NOTNLM OT - Nt-ProBNP OT - echocardiography OT - heart failure OT - hemodynamic OT - neprilysin inhibition OT - reduced ejection fraction OT - remodeling OT - sacubitril/valsartan COIS- The authors declare no conflict of interest. EDAT- 2019/12/11 06:00 MHDA- 2019/12/11 06:01 PMCR- 2019/12/06 CRDT- 2019/12/11 06:00 PHST- 2019/10/31 00:00 [received] PHST- 2019/11/26 00:00 [revised] PHST- 2019/12/03 00:00 [accepted] PHST- 2019/12/11 06:00 [entrez] PHST- 2019/12/11 06:00 [pubmed] PHST- 2019/12/11 06:01 [medline] PHST- 2019/12/06 00:00 [pmc-release] AID - jcm8122165 [pii] AID - jcm-08-02165 [pii] AID - 10.3390/jcm8122165 [doi] PST - epublish SO - J Clin Med. 2019 Dec 6;8(12):2165. doi: 10.3390/jcm8122165.