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- Title
Left ventricular reverse remodeling following initiation of sacubitril/valsartan for heart failure with reduced ejection fraction and low blood pressure.
- Authors
Nishihara, Yu; Nishimori, Makoto; Sawa, Takuma; Uemura, Koya; Nagai, Shun; Todo, Saki; Oota, Eri; Odajima, Susumu; Takeuchi, Kimikazu; Ichikawa, Yasushi; Kintsu, Masayuki; Yamauchi, Yuki; Shiraki, Hiroaki; Yamashita, Kentaro; Fukuda, Terunobu; Hisamatsu, Eriko; Shimizu, Masatoshi; Hirata, Ken-ichi; Tanaka, Hidekazu
- Abstract
Sacubitril/valsartan has become an important first-line drug for symptomatic heart failure (HF) patients, especially with left ventricular (LV) ejection fraction (LVEF) < 50%. However, the impact of sacubitril/valsartan on cardiovascular outcomes, especially LV reverse remodeling for such patients with low blood pressure, remains uncertain. We retrospectively studied 164 HF patients with LVEF < 50% who were treated with sacubitril/valsartan from two institutions. Echocardiography was performed before and 9.5 ± 5.1 months after initiation of maximum tolerated dose of sacubitril/valsartan. The maximum tolerated dose of sacubitril/valsartan was lower for the low blood pressure group (≤ 100 mmHg in systole) than for the non-low blood pressure group (> 100 mmHg in systole) (165 ± 106 mg vs. 238 ± 124 mg, P = 0.017). As expected, significant LV reverse remodeling was observed in the non-low blood pressure group after initiation of sacubitril/valsartan. It was noteworthy that significant LV reverse remodeling was also observed in the low blood pressure group after initiation of sacubitril/valsartan (LV end‐diastolic volume: 177.3 ± 66.0 mL vs. 137.7 ± 56.1 mL, P < 0.001, LV end-systolic volume: 131.6 ± 60.3 mL vs. 94.6 ± 55.7 mL, P < 0.001, LVEF: 26.8 ± 10.3% vs. 33.8 ± 13.6%, P = 0.015). Relative changes in LV volumes and LVEF after initiation of sacubitril/valsartan were similar for the two groups. In conclusion, significant LV reverse remodeling occurred after initiation of sacubitril/valsartan, even in HF patients with LVEF < 50% and systolic blood pressure ≤ 100 mmHg.
- Subjects
HYPOTENSION; VENTRICULAR remodeling; ENTRESTO; VALSARTAN; VENTRICULAR ejection fraction
- Publication
Heart & Vessels, 2024, Vol 39, Issue 2, p95
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-023-02311-3