Sacubitril/Valsartan in Patients With Heart Failure and Concomitant End‐Stage Kidney Disease
Background Heart failure with reduced ejection fraction (HFrEF) is a chronic disease with substantial mortality. Management of HFrEF has seen significant breakthrough after the launch of neprilysin inhibitor. The PARADIGM‐HF (Prospective Comparison of ARNI with ACEI to Determine Impacton Global Mort...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-09-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.026407 |
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| author | Chih‐Yuan Niu Shang‐Feng Yang Shuo‐Ming Ou Cheng‐Hsueh Wu Po‐Hsun Huang Chung‐Lieh Hung Chih‐Ching Lin Szu‐Yuan Li |
| author_facet | Chih‐Yuan Niu Shang‐Feng Yang Shuo‐Ming Ou Cheng‐Hsueh Wu Po‐Hsun Huang Chung‐Lieh Hung Chih‐Ching Lin Szu‐Yuan Li |
| author_sort | Chih‐Yuan Niu |
| collection | DOAJ |
| description | Background Heart failure with reduced ejection fraction (HFrEF) is a chronic disease with substantial mortality. Management of HFrEF has seen significant breakthrough after the launch of neprilysin inhibitor. The PARADIGM‐HF (Prospective Comparison of ARNI with ACEI to Determine Impacton Global Mortality and Morbidity in Heart Failure) trial showed that sacubitril/valsartan significantly reduces HFrEF mortality and the heart failure hospitalization rate. However, in patients with advanced kidney disease, who have the highest prevalence of heart failure, the efficacy and safety of sacubitril/valsartan remains uncertain. We aim to study the efficiency of sacubitril/valsartan in patients with end‐stage kidney disease. Methods and Results Heart function was screened by echocardiogram among all patients with end‐stage kidney disease in 2 hospitals. Patients with HFrEF received either sacubitril/valsartan or conventional treatment. Fifteen echocardiographic parameters were compared before and after treatment. After 1‐year sacubitril/valsartan treatment, parameters of systolic (left ventricular ejection fraction 31.3% to 45.1%, P<0.0001; left ventricular end‐systolic volume 95.7 to 70.1 mL, P=0.006; left ventricular internal diameter at end‐systole phase 47.2 to 40.1 mm, P=0.005), and diastolic (E/A ratio 1.3 to 0.8, P=0.009; E/Med e' ratio 25.3 to 18.8, P=0.010) function improved in patients with HFrEF and end‐stage kidney disease. These parameters were unchanged in the conventional treatment group. Serum potassium did not increase in the sacubitril/valsartan group. Conclusions Sacubitril/valsartan improves left ventricular systolic and diastolic function in patients with HFrEF and end‐stage kidney disease. |
| first_indexed | 2024-04-09T20:56:17Z |
| format | Article |
| id | doaj.art-45ff165dc37f484e8d0410d70be15c9b |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T20:56:17Z |
| publishDate | 2022-09-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-45ff165dc37f484e8d0410d70be15c9b2023-03-29T18:38:57ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-09-01111810.1161/JAHA.122.026407Sacubitril/Valsartan in Patients With Heart Failure and Concomitant End‐Stage Kidney DiseaseChih‐Yuan Niu0Shang‐Feng Yang1Shuo‐Ming Ou2Cheng‐Hsueh Wu3Po‐Hsun Huang4Chung‐Lieh Hung5Chih‐Ching Lin6Szu‐Yuan Li7Division of Nephrology, Department of Medicine Taipei Veterans General Hospital Taipei TaiwanSchool of Medicine National Yang‐Ming Chiao‐Tung University Taipei TaiwanDivision of Nephrology, Department of Medicine Taipei Veterans General Hospital Taipei TaiwanSchool of Medicine National Yang‐Ming Chiao‐Tung University Taipei TaiwanInstitute of Clinical Medicine, National Yang‐Ming Chiao‐Tung University Taipei TaiwanDivision of Cardiology, Department of Internal Medicine MacKay Memorial Hospital Taipei TaiwanDivision of Nephrology, Department of Medicine Taipei Veterans General Hospital Taipei TaiwanDivision of Nephrology, Department of Medicine Taipei Veterans General Hospital Taipei TaiwanBackground Heart failure with reduced ejection fraction (HFrEF) is a chronic disease with substantial mortality. Management of HFrEF has seen significant breakthrough after the launch of neprilysin inhibitor. The PARADIGM‐HF (Prospective Comparison of ARNI with ACEI to Determine Impacton Global Mortality and Morbidity in Heart Failure) trial showed that sacubitril/valsartan significantly reduces HFrEF mortality and the heart failure hospitalization rate. However, in patients with advanced kidney disease, who have the highest prevalence of heart failure, the efficacy and safety of sacubitril/valsartan remains uncertain. We aim to study the efficiency of sacubitril/valsartan in patients with end‐stage kidney disease. Methods and Results Heart function was screened by echocardiogram among all patients with end‐stage kidney disease in 2 hospitals. Patients with HFrEF received either sacubitril/valsartan or conventional treatment. Fifteen echocardiographic parameters were compared before and after treatment. After 1‐year sacubitril/valsartan treatment, parameters of systolic (left ventricular ejection fraction 31.3% to 45.1%, P<0.0001; left ventricular end‐systolic volume 95.7 to 70.1 mL, P=0.006; left ventricular internal diameter at end‐systole phase 47.2 to 40.1 mm, P=0.005), and diastolic (E/A ratio 1.3 to 0.8, P=0.009; E/Med e' ratio 25.3 to 18.8, P=0.010) function improved in patients with HFrEF and end‐stage kidney disease. These parameters were unchanged in the conventional treatment group. Serum potassium did not increase in the sacubitril/valsartan group. Conclusions Sacubitril/valsartan improves left ventricular systolic and diastolic function in patients with HFrEF and end‐stage kidney disease.https://www.ahajournals.org/doi/10.1161/JAHA.122.026407ARNIend‐stage kidney disease (ESKD)heart failure with reduced ejection fraction (HFrEF)sacubitril/valsartan |
| spellingShingle | Chih‐Yuan Niu Shang‐Feng Yang Shuo‐Ming Ou Cheng‐Hsueh Wu Po‐Hsun Huang Chung‐Lieh Hung Chih‐Ching Lin Szu‐Yuan Li Sacubitril/Valsartan in Patients With Heart Failure and Concomitant End‐Stage Kidney Disease Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease ARNI end‐stage kidney disease (ESKD) heart failure with reduced ejection fraction (HFrEF) sacubitril/valsartan |
| title | Sacubitril/Valsartan in Patients With Heart Failure and Concomitant End‐Stage Kidney Disease |
| title_full | Sacubitril/Valsartan in Patients With Heart Failure and Concomitant End‐Stage Kidney Disease |
| title_fullStr | Sacubitril/Valsartan in Patients With Heart Failure and Concomitant End‐Stage Kidney Disease |
| title_full_unstemmed | Sacubitril/Valsartan in Patients With Heart Failure and Concomitant End‐Stage Kidney Disease |
| title_short | Sacubitril/Valsartan in Patients With Heart Failure and Concomitant End‐Stage Kidney Disease |
| title_sort | sacubitril valsartan in patients with heart failure and concomitant end stage kidney disease |
| topic | ARNI end‐stage kidney disease (ESKD) heart failure with reduced ejection fraction (HFrEF) sacubitril/valsartan |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.026407 |
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