Haemodynamic forces as predictors of cardiac remodelling and outcome in heart failure with reduced ejection fraction treated with sacubitril/valsartan Article Swipe
Iacopo Fabiani
,
Nicola Riccardo Pugliese
,
Vincenzo Castiglione
,
Gianni Pedrizzetti
,
Giovanni Tonti
,
Vladislav Chubuchny
,
Francesca Becherini
,
Claudia Taddei
,
Alessia Gimelli
,
Lavinia Del Punta
,
Alessio Balletti
,
Stefano Masi
,
Matteo Cameli
,
Michele Emdin
,
Alberto Giannoni
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1093/eurheartj/ehac544.930
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1093/eurheartj/ehac544.930
Background Angiotensin receptor-neprilysin inhibitor (ARNI) is a cornerstone of treatment in heart failure (HF) with reduced ejection fraction (HFrEF), but its effectiveness shows interindividual differences. Objectives To evaluate the predictive value of echo-derived hemodynamic forces (HDF), together with other echocardiographic, biohumoral and cardiopulmonary parameters on a) response to ARNI after 6 months; b) adverse cardiovascular events at follow-up. Methods Eighty-nine consecutive HFrEF patients from two HF centers performed clinical evaluation, laboratory analyses, rest echocardiography and cardiopulmonary exercise testing. Response to ARNI at 6 months was considered in patients without HF admissions, death, or urgent heart transplant and with a ≥50% reduction in NT-proBNP levels and/or ≥10% increase in left ventricle ejection fraction. After 6 months, patients were followed up for a composite endpoint of cardiovascular death, HF-related hospitalization and new-onset atrial fibrillation. Results Response to ARNI was documented in 45/89 (51%) of patients. At baseline, responders and non-responders were paired in clinical assessment, conventional echocardiography, functional status and therapy. At multivariate logistic regression analysis, HDF-derived whole cardiac cycle left ventricle strength (wLVS) was the only independent predictor of ARNI response at 6 months (odds ratio 1.36, 95% confidence interval 1.10–1.67; p=0.004). A wLVS ≥3.7% showed a good accuracy in predicting ARNI response (AUC = 0.736, 0.607–0.840; p<0.0001). During a median of 33 (IQR 23–41) months, wLVS increase from baseline to 6-month (ΔwLVS) showed a high discrimination ability at time-dependent ROC analysis (optimal cut-off: ≤0.5%; AUC=0.811, 0.69–0.90; p<0.0001), stratified prognosis at Kaplan-Meier analysis (log-rank p<0.0001), and remained an independent prognostic predictor of the composite endpoint (hazard ratio 0.76, 0.61–0.95; p<0.01) even after adjusting for clinical, functional and conventional echocardiographic parameters. Conclusions HDF analysis may help predict ARNI response and optimize follow-up and medical/device strategies in patients with HfrEF. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/eurheartj/ehac544.930
- https://academic.oup.com/eurheartj/article-pdf/43/Supplement_2/ehac544.930/46365712/ehac544.930.pdf
- OA Status
- bronze
- Cited By
- 1
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4306290955
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Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4306290955Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/eurheartj/ehac544.930Digital Object Identifier
- Title
-
Haemodynamic forces as predictors of cardiac remodelling and outcome in heart failure with reduced ejection fraction treated with sacubitril/valsartanWork title
- Type
-
articleOpenAlex work type
- Language
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enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-10-01Full publication date if available
- Authors
-
Iacopo Fabiani, Nicola Riccardo Pugliese, Vincenzo Castiglione, Gianni Pedrizzetti, Giovanni Tonti, Vladislav Chubuchny, Francesca Becherini, Claudia Taddei, Alessia Gimelli, Lavinia Del Punta, Alessio Balletti, Stefano Masi, Matteo Cameli, Michele Emdin, Alberto GiannoniList of authors in order
- Landing page
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https://doi.org/10.1093/eurheartj/ehac544.930Publisher landing page
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https://academic.oup.com/eurheartj/article-pdf/43/Supplement_2/ehac544.930/46365712/ehac544.930.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
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bronzeOpen access status per OpenAlex
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https://academic.oup.com/eurheartj/article-pdf/43/Supplement_2/ehac544.930/46365712/ehac544.930.pdfDirect OA link when available
- Concepts
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Medicine, Ejection fraction, Cardiology, Internal medicine, Heart failure, Ventricle, Atrial fibrillation, Confidence intervalTop concepts (fields/topics) attached by OpenAlex
- Cited by
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1Total citation count in OpenAlex
- Citations by year (recent)
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2024: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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