Haemodynamic forces predicting remodelling and outcome in patients with heart failure treated with sacubitril/valsartan Article Swipe
Iacopo Fabiani
,
Nicola Riccardo Pugliese
,
Gianni Pedrizzetti
,
Giovanni Tonti
,
Vincenzo Castiglione
,
Vladislav Chubuchny
,
Claudia Taddei
,
Alessia Gimelli
,
Lavinia Del Punta
,
Alessio Balletti
,
Annamaria Del Franco
,
Stefano Masi
,
Carlo Lombardi
,
Matteo Cameli
,
Michele Emdin
,
Alberto Giannoni
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1002/ehf2.14346
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1002/ehf2.14346
Aims A novel tool for the evaluation of left ventricular (LV) systo‐diastolic function through echo‐derived haemodynamic forces (HDFs) has been recently proposed. The present study aimed to assess the predictive value of HDFs on (i) 6 month treatment response to sacubitril/valsartan in heart failure with reduced ejection fraction (HFrEF) patients and (ii) cardiovascular events. Methods and results Eighty‐nine consecutive HFrEF patients [70% males, 65 ± 9 years, LV ejection fraction (LVEF) 27 ± 7%] initiating sacubitril/valsartan underwent clinical, laboratory, ultrasound and cardiopulmonary exercise testing evaluations. Patients experiencing no adverse events and showing ≥50% reduction in plasma N‐terminal pro‐B‐type natriuretic peptide and/or ≥10% LVEF increase over 6 months were considered responders. Patients were followed up for the composite endpoint of HF‐related hospitalisation, atrial fibrillation and cardiovascular death. Forty‐five (51%) patients were responders. Among baseline variables, only HDF‐derived whole cardiac cycle LV strength (wLVS) was higher in responders (4.4 ± 1.3 vs. 3.6 ± 1.2; p = 0.01). wLVS was also the only independent predictor of sacubitril/valsartan response at multivariable logistic regression analysis [odds ratio 1.36; 95% confidence interval (CI) 1.10–1.67], with good accuracy at receiver operating characteristic (ROC) analysis [optimal cutpoint: ≥3.7%; area under the curve (AUC) = 0.736]. During a 33 month (23–41) median follow‐up, a wLVS increase after 6 months (ΔwLVS) showed a high discrimination ability at time‐dependent ROC analysis (optimal cut‐off: ≥0.5%; AUC = 0.811), stratified prognosis (log‐rank p < 0.0001) and remained an independent predictor for the composite endpoint (hazard ratio 0.76; 95% CI 0.61–0.95; p < 0.01), after adjusting for clinical and instrumental variables. Conclusions HDF analysis predicts sacubitril/valsartan response and might optimise decision‐making in HFrEF patients.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1002/ehf2.14346
- https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ehf2.14346
- OA Status
- gold
- Cited By
- 7
- References
- 42
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4384626105
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4384626105Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1002/ehf2.14346Digital Object Identifier
- Title
-
Haemodynamic forces predicting remodelling and outcome in patients with heart failure treated with sacubitril/valsartanWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-07-17Full publication date if available
- Authors
-
Iacopo Fabiani, Nicola Riccardo Pugliese, Gianni Pedrizzetti, Giovanni Tonti, Vincenzo Castiglione, Vladislav Chubuchny, Claudia Taddei, Alessia Gimelli, Lavinia Del Punta, Alessio Balletti, Annamaria Del Franco, Stefano Masi, Carlo Lombardi, Matteo Cameli, Michele Emdin, Alberto GiannoniList of authors in order
- Landing page
-
https://doi.org/10.1002/ehf2.14346Publisher landing page
- PDF URL
-
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ehf2.14346Direct link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ehf2.14346Direct OA link when available
- Concepts
-
Medicine, Ejection fraction, Sacubitril, Internal medicine, Cardiology, Sacubitril, Valsartan, Heart failure, Valsartan, Receiver operating characteristic, Natriuretic peptide, Confidence interval, Atrial fibrillation, Clinical endpoint, Area under the curve, Blood pressure, Clinical trialTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
7Total citation count in OpenAlex
- Citations by year (recent)
-
2025: 4, 2024: 2, 2023: 1Per-year citation counts (last 5 years)
- References (count)
-
42Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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