Unlocking the potential of sacubitril/valsartan therapy in improving ECG and echocardiographic parameters in heart failure patients with reduced ejection fraction (HErEF)

Abstract Background Sacubitril/valsartan therapy has been found to reduce hospitalizations, improve echocardiogram parameters, and improve mortality in HFrEF. The objective is to assess S/V therapy effect on electrocardiogram indices and how those parameters related to echocardiographic parameters....

Full description

Bibliographic Details
Main Authors: Lamyaa Elsayed Allam, Ahmed Aly Abdelmotteleb, Hayam Mohamed Eldamanhoury, Hassan Shehata Hassan
Format: Article
Language:English
Published: SpringerOpen 2024-03-01
Series:The Egyptian Heart Journal
Subjects:
Online Access:https://doi.org/10.1186/s43044-024-00468-4
_version_ 1797233450980212736
author Lamyaa Elsayed Allam
Ahmed Aly Abdelmotteleb
Hayam Mohamed Eldamanhoury
Hassan Shehata Hassan
author_facet Lamyaa Elsayed Allam
Ahmed Aly Abdelmotteleb
Hayam Mohamed Eldamanhoury
Hassan Shehata Hassan
author_sort Lamyaa Elsayed Allam
collection DOAJ
description Abstract Background Sacubitril/valsartan therapy has been found to reduce hospitalizations, improve echocardiogram parameters, and improve mortality in HFrEF. The objective is to assess S/V therapy effect on electrocardiogram indices and how those parameters related to echocardiographic parameters. Results From June 2022 until June 2023, this prospective study enrolled 100 patients (mean age 56.1, 8.2, 78% male) with non-ischemic dilated cardiomyopathy (NIDCM) used PARADIGM-HF criteria: NYHA Class II, III, or IV HF; ejection fraction EF ≤ 40%; and hospitalization for HF within previous 12 months. Before starting S/V therapy, an echo and ECG were performed, as well as 6 months following the optimal dose and if LVEF was improved by more than 5%, they were termed notable S/V treatment responders. Aside from improving echo parameters, ECG parameters improved significantly. The QRS width was reduced from 123.7 ± 20.3 to 117.1 ± 18.8 ms (p 0.00), and QTc interval was reduced from 425.4 ± 32.8 to 421.4 ± 32.3 ms (p = 0.012). QRS width was significantly reduced in patients with LBBB, RBBB, and IVCD based on QRS morphology. QRS width (r = − 0.243, p = 0.016) and QTc (r = − 0.252, p = 0.012) had a negative connection with LVEF. Conclusion S/V therapy, in addition to improving echo parameters and NYHA class, improves QRS width and corrected QTc interval on ECG in HFrEF patients. This is an indication of reverse electrical LV remodeling and can be used as an auxiliary prediction for tracking therapy outcomes.
first_indexed 2024-04-24T16:16:22Z
format Article
id doaj.art-3ffc14d7d22745b3a49e92a9117b60ae
institution Directory Open Access Journal
issn 2090-911X
language English
last_indexed 2024-04-24T16:16:22Z
publishDate 2024-03-01
publisher SpringerOpen
record_format Article
series The Egyptian Heart Journal
spelling doaj.art-3ffc14d7d22745b3a49e92a9117b60ae2024-03-31T11:24:09ZengSpringerOpenThe Egyptian Heart Journal2090-911X2024-03-017611910.1186/s43044-024-00468-4Unlocking the potential of sacubitril/valsartan therapy in improving ECG and echocardiographic parameters in heart failure patients with reduced ejection fraction (HErEF)Lamyaa Elsayed Allam0Ahmed Aly Abdelmotteleb1Hayam Mohamed Eldamanhoury2Hassan Shehata Hassan3Department of Cardiology, Faculty of Medicine, Ain Shams UniversityDepartment of Cardiology, Faculty of Medicine, Ain Shams UniversityDepartment of Cardiology, Faculty of Medicine, Ain Shams UniversityDepartment of Cardiology, Faculty of Medicine, Ain Shams UniversityAbstract Background Sacubitril/valsartan therapy has been found to reduce hospitalizations, improve echocardiogram parameters, and improve mortality in HFrEF. The objective is to assess S/V therapy effect on electrocardiogram indices and how those parameters related to echocardiographic parameters. Results From June 2022 until June 2023, this prospective study enrolled 100 patients (mean age 56.1, 8.2, 78% male) with non-ischemic dilated cardiomyopathy (NIDCM) used PARADIGM-HF criteria: NYHA Class II, III, or IV HF; ejection fraction EF ≤ 40%; and hospitalization for HF within previous 12 months. Before starting S/V therapy, an echo and ECG were performed, as well as 6 months following the optimal dose and if LVEF was improved by more than 5%, they were termed notable S/V treatment responders. Aside from improving echo parameters, ECG parameters improved significantly. The QRS width was reduced from 123.7 ± 20.3 to 117.1 ± 18.8 ms (p 0.00), and QTc interval was reduced from 425.4 ± 32.8 to 421.4 ± 32.3 ms (p = 0.012). QRS width was significantly reduced in patients with LBBB, RBBB, and IVCD based on QRS morphology. QRS width (r = − 0.243, p = 0.016) and QTc (r = − 0.252, p = 0.012) had a negative connection with LVEF. Conclusion S/V therapy, in addition to improving echo parameters and NYHA class, improves QRS width and corrected QTc interval on ECG in HFrEF patients. This is an indication of reverse electrical LV remodeling and can be used as an auxiliary prediction for tracking therapy outcomes.https://doi.org/10.1186/s43044-024-00468-4Sacubitril/valsartan combinationECGEchocardiographyHeart failureReduced ejection fraction
spellingShingle Lamyaa Elsayed Allam
Ahmed Aly Abdelmotteleb
Hayam Mohamed Eldamanhoury
Hassan Shehata Hassan
Unlocking the potential of sacubitril/valsartan therapy in improving ECG and echocardiographic parameters in heart failure patients with reduced ejection fraction (HErEF)
The Egyptian Heart Journal
Sacubitril/valsartan combination
ECG
Echocardiography
Heart failure
Reduced ejection fraction
title Unlocking the potential of sacubitril/valsartan therapy in improving ECG and echocardiographic parameters in heart failure patients with reduced ejection fraction (HErEF)
title_full Unlocking the potential of sacubitril/valsartan therapy in improving ECG and echocardiographic parameters in heart failure patients with reduced ejection fraction (HErEF)
title_fullStr Unlocking the potential of sacubitril/valsartan therapy in improving ECG and echocardiographic parameters in heart failure patients with reduced ejection fraction (HErEF)
title_full_unstemmed Unlocking the potential of sacubitril/valsartan therapy in improving ECG and echocardiographic parameters in heart failure patients with reduced ejection fraction (HErEF)
title_short Unlocking the potential of sacubitril/valsartan therapy in improving ECG and echocardiographic parameters in heart failure patients with reduced ejection fraction (HErEF)
title_sort unlocking the potential of sacubitril valsartan therapy in improving ecg and echocardiographic parameters in heart failure patients with reduced ejection fraction heref
topic Sacubitril/valsartan combination
ECG
Echocardiography
Heart failure
Reduced ejection fraction
url https://doi.org/10.1186/s43044-024-00468-4
work_keys_str_mv AT lamyaaelsayedallam unlockingthepotentialofsacubitrilvalsartantherapyinimprovingecgandechocardiographicparametersinheartfailurepatientswithreducedejectionfractionheref
AT ahmedalyabdelmotteleb unlockingthepotentialofsacubitrilvalsartantherapyinimprovingecgandechocardiographicparametersinheartfailurepatientswithreducedejectionfractionheref
AT hayammohamedeldamanhoury unlockingthepotentialofsacubitrilvalsartantherapyinimprovingecgandechocardiographicparametersinheartfailurepatientswithreducedejectionfractionheref
AT hassanshehatahassan unlockingthepotentialofsacubitrilvalsartantherapyinimprovingecgandechocardiographicparametersinheartfailurepatientswithreducedejectionfractionheref