Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril‐Valsartan: A Multicenter Echocardiographic Registry
Abstract Aims Sacubitril/valsartan has changed the treatment of heart failure with reduced ejection fraction (HFrEF), due to the positive effects on morbidity and mortality, partly mediated by left ventricular (LV) reverse remodelling (LVRR). The aim of this multicenter study was to identify echocar...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-04-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.14155 |
| _version_ | 1827977121855700992 |
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| author | Giulia Elena Mandoli Maria Concetta Pastore Alberto Giannoni Giovanni Benfari Frank Lloyd Dini Gianmarco Rosa Nicola Riccardo Pugliese Claudia Taddei Michele Correale Natale Daniele Brunetti Pietro Mazzeo Erberto Carluccio Anna Mengoni Andrea Igoren Guaricci Laura Piscitelli Rodolfo Citro Michele Ciccarelli Giuseppina Novo Egle Corrado Annalisa Pasquini Valentina Loria Giuseppe De Carli Anna Degiovanni Giuseppe Patti Ciro Santoro Luca Moderato Mariantonietta Cicoira Marco Canepa Alessandro Malagoli Michele Emdin Matteo Cameli |
| author_facet | Giulia Elena Mandoli Maria Concetta Pastore Alberto Giannoni Giovanni Benfari Frank Lloyd Dini Gianmarco Rosa Nicola Riccardo Pugliese Claudia Taddei Michele Correale Natale Daniele Brunetti Pietro Mazzeo Erberto Carluccio Anna Mengoni Andrea Igoren Guaricci Laura Piscitelli Rodolfo Citro Michele Ciccarelli Giuseppina Novo Egle Corrado Annalisa Pasquini Valentina Loria Giuseppe De Carli Anna Degiovanni Giuseppe Patti Ciro Santoro Luca Moderato Mariantonietta Cicoira Marco Canepa Alessandro Malagoli Michele Emdin Matteo Cameli |
| author_sort | Giulia Elena Mandoli |
| collection | DOAJ |
| description | Abstract Aims Sacubitril/valsartan has changed the treatment of heart failure with reduced ejection fraction (HFrEF), due to the positive effects on morbidity and mortality, partly mediated by left ventricular (LV) reverse remodelling (LVRR). The aim of this multicenter study was to identify echocardiographic predictors of LVRR after sacubitril/valsartan administration. Methods and results Patients with HFrEF requiring therapy with sacubitril/valsartan from 13 Italian centres were included. Echocardiographic parameters including LV global longitudinal strain (GLS) and global peak atrial longitudinal strain by speckle tracking echocardiography were measured to find the predictors of LVRR [= LV end‐systolic volume reduction ≥10% and ejection fraction (LVEF) improvement ≥10% at follow‐up] at 6 month follow‐up as the primary endpoint. Changes in symptoms [New York Heart Association (NYHA) class] and neurohormonal activations [N‐terminal pro‐brain natriuretic peptide (NT‐proBNP)] were also evaluated as secondary endpoints; 341 patients (excluding patients with poor acoustic windows and missing data) were analysed (mean age: 65 ± 10 years; 18% female, median LVEF 30% [inter‐quartile range: 25−34]). At 6 month follow‐up, 82 (24%) patients showed early complete response (LVRR and LVEF ≥ 35%), 55 (16%) early incomplete response (LVRR and LVEF < 35%), and 204 (60%) no response (no LVRR and LVEF < 35%). Non‐ischaemic aetiology, a lower left atrial volume index, and a higher GLS were all independent predictors of LVRR at multivariable logistic analysis (all P < 0.01). A baseline GLS < −9.3% was significantly associated with early response (area under the curve 0.75, P < 0.0001). Left atrial strain was the best predictor of positive changes in NYHA class and NT‐proBNP (all P < 0.05). Conclusions Speckle tracking echocardiography parameters at baseline could be useful to predict LVRR and clinical response to sacubitril–valsartan and could be used as a guide for treatment in patients with HFrEF. |
| first_indexed | 2024-04-09T21:00:05Z |
| format | Article |
| id | doaj.art-c8131d0985ed4f18b6787e51d622d7b1 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-04-09T21:00:05Z |
| publishDate | 2023-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-c8131d0985ed4f18b6787e51d622d7b12023-03-29T11:45:20ZengWileyESC Heart Failure2055-58222023-04-0110284685710.1002/ehf2.14155Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril‐Valsartan: A Multicenter Echocardiographic RegistryGiulia Elena Mandoli0Maria Concetta Pastore1Alberto Giannoni2Giovanni Benfari3Frank Lloyd Dini4Gianmarco Rosa5Nicola Riccardo Pugliese6Claudia Taddei7Michele Correale8Natale Daniele Brunetti9Pietro Mazzeo10Erberto Carluccio11Anna Mengoni12Andrea Igoren Guaricci13Laura Piscitelli14Rodolfo Citro15Michele Ciccarelli16Giuseppina Novo17Egle Corrado18Annalisa Pasquini19Valentina Loria20Giuseppe De Carli21Anna Degiovanni22Giuseppe Patti23Ciro Santoro24Luca Moderato25Mariantonietta Cicoira26Marco Canepa27Alessandro Malagoli28Michele Emdin29Matteo Cameli30Division of Cardiology, Department of Medical Biotechnologies University of Siena Viale Bracci 1 Siena ItalyDivision of Cardiology, Department of Medical Biotechnologies University of Siena Viale Bracci 1 Siena ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalySection of Cardiology, Department of Medicine University of Verona Verona ItalyCentro Medico Santagostino Milan ItalyDepartment of Internal Medicine and Medical Specialities University of Genoa Genoa ItalyDepartment of Clinical and Experimental Medicine University of Pisa Pisa ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyCardiology Department Policlinico Riuniti University Hospital Foggia ItalyDepartment of Medical and Surgical Sciences University of Foggia Foggia ItalyDepartment of Medical and Surgical Sciences University of Foggia Foggia ItalyCardiology and Cardiovascular Pathophysiology—Heart Failure Unit, ‘Santa Maria della Misericordia’ Hospital University of Perugia Perugia ItalyCardiology and Cardiovascular Pathophysiology—Heart Failure Unit, ‘Santa Maria della Misericordia’ Hospital University of Perugia Perugia ItalyUniversity Cardiology Unit, Cardiothoracic Department Polyclinic University Hospital Bari ItalyUniversity Cardiology Unit, Cardiothoracic Department Polyclinic University Hospital Bari ItalyCardio‐Thoracic‐Vascular Department University Hospital San Giovanni di Dio e Ruggi d'Aragona Salerno ItalyDepartment of Medicine, Surgery and Dentistry University of Salerno Baronissi ItalyDivision of Cardiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University Hospital Paolo Giaccone University of Palermo Palermo ItalyDivision of Cardiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University Hospital Paolo Giaccone University of Palermo Palermo ItalyDepartment of Cardiovascular and Thoracic Sciences Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore Rome ItalyDepartment of Cardiovascular and Thoracic Sciences Fondazione Policlinico Universitario A. Gemelli, IRCCS, Università Cattolica del Sacro Cuore Rome ItalyDivision of Cardiology, Department of Medical Biotechnologies University of Siena Viale Bracci 1 Siena ItalyDepartment of Thoracic, Heart and Vascular Diseases Maggiore della Carità Hospital Novara ItalyDepartment of Thoracic, Heart and Vascular Diseases Maggiore della Carità Hospital Novara ItalyDepartment of Advanced Biomedical Science Federico II University Hospital Naples ItalyCardiology Department Ospedale Guglielmo da Saliceto Piacenza ItalySection of Cardiology, Department of Medicine University of Verona Verona ItalyCardiovascular Disease Unit IRCCS Ospedale Policlinico San Martino, IRCCS Italian Cardiovascular Network Genoa ItalyDivision of Cardiology, Nephro‐Cardiovascular Department, Baggiovara Hospital University of Modena and Reggio Emilia Modena ItalyCardiology and Cardiovascular Medicine Department Fondazione Toscana G. Monasterio Pisa ItalyDivision of Cardiology, Department of Medical Biotechnologies University of Siena Viale Bracci 1 Siena ItalyAbstract Aims Sacubitril/valsartan has changed the treatment of heart failure with reduced ejection fraction (HFrEF), due to the positive effects on morbidity and mortality, partly mediated by left ventricular (LV) reverse remodelling (LVRR). The aim of this multicenter study was to identify echocardiographic predictors of LVRR after sacubitril/valsartan administration. Methods and results Patients with HFrEF requiring therapy with sacubitril/valsartan from 13 Italian centres were included. Echocardiographic parameters including LV global longitudinal strain (GLS) and global peak atrial longitudinal strain by speckle tracking echocardiography were measured to find the predictors of LVRR [= LV end‐systolic volume reduction ≥10% and ejection fraction (LVEF) improvement ≥10% at follow‐up] at 6 month follow‐up as the primary endpoint. Changes in symptoms [New York Heart Association (NYHA) class] and neurohormonal activations [N‐terminal pro‐brain natriuretic peptide (NT‐proBNP)] were also evaluated as secondary endpoints; 341 patients (excluding patients with poor acoustic windows and missing data) were analysed (mean age: 65 ± 10 years; 18% female, median LVEF 30% [inter‐quartile range: 25−34]). At 6 month follow‐up, 82 (24%) patients showed early complete response (LVRR and LVEF ≥ 35%), 55 (16%) early incomplete response (LVRR and LVEF < 35%), and 204 (60%) no response (no LVRR and LVEF < 35%). Non‐ischaemic aetiology, a lower left atrial volume index, and a higher GLS were all independent predictors of LVRR at multivariable logistic analysis (all P < 0.01). A baseline GLS < −9.3% was significantly associated with early response (area under the curve 0.75, P < 0.0001). Left atrial strain was the best predictor of positive changes in NYHA class and NT‐proBNP (all P < 0.05). Conclusions Speckle tracking echocardiography parameters at baseline could be useful to predict LVRR and clinical response to sacubitril–valsartan and could be used as a guide for treatment in patients with HFrEF.https://doi.org/10.1002/ehf2.14155Heart failureSacubitril/valsartanSpeckle trackingEchocardiographyRemodellingImaging |
| spellingShingle | Giulia Elena Mandoli Maria Concetta Pastore Alberto Giannoni Giovanni Benfari Frank Lloyd Dini Gianmarco Rosa Nicola Riccardo Pugliese Claudia Taddei Michele Correale Natale Daniele Brunetti Pietro Mazzeo Erberto Carluccio Anna Mengoni Andrea Igoren Guaricci Laura Piscitelli Rodolfo Citro Michele Ciccarelli Giuseppina Novo Egle Corrado Annalisa Pasquini Valentina Loria Giuseppe De Carli Anna Degiovanni Giuseppe Patti Ciro Santoro Luca Moderato Mariantonietta Cicoira Marco Canepa Alessandro Malagoli Michele Emdin Matteo Cameli Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril‐Valsartan: A Multicenter Echocardiographic Registry ESC Heart Failure Heart failure Sacubitril/valsartan Speckle tracking Echocardiography Remodelling Imaging |
| title | Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril‐Valsartan: A Multicenter Echocardiographic Registry |
| title_full | Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril‐Valsartan: A Multicenter Echocardiographic Registry |
| title_fullStr | Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril‐Valsartan: A Multicenter Echocardiographic Registry |
| title_full_unstemmed | Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril‐Valsartan: A Multicenter Echocardiographic Registry |
| title_short | Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril‐Valsartan: A Multicenter Echocardiographic Registry |
| title_sort | deformation imaging by strain in chronic heart failure over sacubitril valsartan a multicenter echocardiographic registry |
| topic | Heart failure Sacubitril/valsartan Speckle tracking Echocardiography Remodelling Imaging |
| url | https://doi.org/10.1002/ehf2.14155 |
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