EFFECTS OF SACUBITRIL/VALSARTAN ON THE ARTERIAL STIFFNESS AND LEFT VENTRICULAR-ARTERIAL COUPLING IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION
Aim. To study the effects of sacubitril/valsartan on left ventricular-arterial coupling (LVAC) and arterial stiffness in HFrEF patients.Material and methods. Arterial stiffness by applanation tonometry and LVAC – by two-dimensional echocardiography were evaluated in 18 patients with compensated HFrE...
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Stolichnaya Izdatelskaya Kompaniya
2018-05-01
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doaj-e0e24838b820443eb237edffe39aba0c2021-09-03T13:15:28ZengStolichnaya Izdatelskaya KompaniyaRacionalʹnaâ Farmakoterapiâ v Kardiologii1819-64462225-36532018-05-0114221021610.20996/1819-6446-2018-14-2-210-2161462EFFECTS OF SACUBITRIL/VALSARTAN ON THE ARTERIAL STIFFNESS AND LEFT VENTRICULAR-ARTERIAL COUPLING IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTIONZh. D. Kobalava0S. V. Villevalde1I. A. Meray2Е. E. Shkolnikova3O. I. Lukina4Peoples' Friendship University of Russia (RUDN University)Peoples' Friendship University of Russia (RUDN University)Peoples' Friendship University of Russia (RUDN University)Peoples' Friendship University of Russia (RUDN University)Peoples' Friendship University of Russia (RUDN University)Aim. To study the effects of sacubitril/valsartan on left ventricular-arterial coupling (LVAC) and arterial stiffness in HFrEF patients.Material and methods. Arterial stiffness by applanation tonometry and LVAC – by two-dimensional echocardiography were evaluated in 18 patients with compensated HFrEF (age 69Ѓ}9 years, 89% male, arterial hypertension – 83%, diabetes – 39%, myocardial infarction – 89%, left ventricular ejection fraction 32Ѓ}4%) initially and after 6 and 12 months of therapy based on sacubitril/valsartan. LVAC was calculated as the Ea (arterial elastance)/ Ees (left ventricular elastance) ratio. Differences were considered statistically significant at p<0.05.Results. 72% of patients initially had elevated pulse wave velocity (PWV>10 m/s). The decrease in PWV (from 11.5Ѓ}2.9 to 10.2Ѓ}2.9 m/s, p<0.05), of the augmentation pressure (from 15.3Ѓ}8.9 to 10.5Ѓ}5.0 mm Hg, p=0.002), the increase in the reflected wave transit time (from 132Ѓ}9 to 143Ѓ}29 ms, p=0.02) and the subendocardial viability ratio (from 164Ѓ}25 to 177Ѓ}37%; p=0.009) were found after 12 months. Sacubitryl/valsartanbased therapy was associated with a decrease in central systolic blood pressure (from 116Ѓ}19 to 106Ѓ}10 mm Hg; p=0.001) and central pulse blood pressure (from 44Ѓ}15 to 38Ѓ}7 mm Hg; p<0.05). Decrease in Ea (from 2.20Ѓ}0.84 to 1.79Ѓ}0.63 mm Hg/ml/m2; p=0.005) and Ea/Ees ratio (from 2.26Ѓ}0.77 to 1.68Ѓ}0.32, p=0.05) was found after 12 months. Ees did not change statistically significantly (1.00Ѓ}0.34 vs 1.01Ѓ}0.44 mm Hg/ml/m2). The relationship between the decrease in PWV, Ea and the dynamics of blood pressure was not found.Conclusion. Sacubitryl/valsartan-based therapy in HFrEF patients results in a BP-independent improvement in LVAC due to a decrease in Ea, an improvement in the parameters of the central pulse wave.https://www.rpcardio.com/jour/article/view/1650heart failure with reduced ejection fractionsacubitril/valsartanleft ventricular-arterial couplingarterial stiffness |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Zh. D. Kobalava S. V. Villevalde I. A. Meray Е. E. Shkolnikova O. I. Lukina |
spellingShingle |
Zh. D. Kobalava S. V. Villevalde I. A. Meray Е. E. Shkolnikova O. I. Lukina EFFECTS OF SACUBITRIL/VALSARTAN ON THE ARTERIAL STIFFNESS AND LEFT VENTRICULAR-ARTERIAL COUPLING IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION Racionalʹnaâ Farmakoterapiâ v Kardiologii heart failure with reduced ejection fraction sacubitril/valsartan left ventricular-arterial coupling arterial stiffness |
author_facet |
Zh. D. Kobalava S. V. Villevalde I. A. Meray Е. E. Shkolnikova O. I. Lukina |
author_sort |
Zh. D. Kobalava |
title |
EFFECTS OF SACUBITRIL/VALSARTAN ON THE ARTERIAL STIFFNESS AND LEFT VENTRICULAR-ARTERIAL COUPLING IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION |
title_short |
EFFECTS OF SACUBITRIL/VALSARTAN ON THE ARTERIAL STIFFNESS AND LEFT VENTRICULAR-ARTERIAL COUPLING IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION |
title_full |
EFFECTS OF SACUBITRIL/VALSARTAN ON THE ARTERIAL STIFFNESS AND LEFT VENTRICULAR-ARTERIAL COUPLING IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION |
title_fullStr |
EFFECTS OF SACUBITRIL/VALSARTAN ON THE ARTERIAL STIFFNESS AND LEFT VENTRICULAR-ARTERIAL COUPLING IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION |
title_full_unstemmed |
EFFECTS OF SACUBITRIL/VALSARTAN ON THE ARTERIAL STIFFNESS AND LEFT VENTRICULAR-ARTERIAL COUPLING IN PATIENTS WITH HEART FAILURE WITH REDUCED EJECTION FRACTION |
title_sort |
effects of sacubitril/valsartan on the arterial stiffness and left ventricular-arterial coupling in patients with heart failure with reduced ejection fraction |
publisher |
Stolichnaya Izdatelskaya Kompaniya |
series |
Racionalʹnaâ Farmakoterapiâ v Kardiologii |
issn |
1819-6446 2225-3653 |
publishDate |
2018-05-01 |
description |
Aim. To study the effects of sacubitril/valsartan on left ventricular-arterial coupling (LVAC) and arterial stiffness in HFrEF patients.Material and methods. Arterial stiffness by applanation tonometry and LVAC – by two-dimensional echocardiography were evaluated in 18 patients with compensated HFrEF (age 69Ѓ}9 years, 89% male, arterial hypertension – 83%, diabetes – 39%, myocardial infarction – 89%, left ventricular ejection fraction 32Ѓ}4%) initially and after 6 and 12 months of therapy based on sacubitril/valsartan. LVAC was calculated as the Ea (arterial elastance)/ Ees (left ventricular elastance) ratio. Differences were considered statistically significant at p<0.05.Results. 72% of patients initially had elevated pulse wave velocity (PWV>10 m/s). The decrease in PWV (from 11.5Ѓ}2.9 to 10.2Ѓ}2.9 m/s, p<0.05), of the augmentation pressure (from 15.3Ѓ}8.9 to 10.5Ѓ}5.0 mm Hg, p=0.002), the increase in the reflected wave transit time (from 132Ѓ}9 to 143Ѓ}29 ms, p=0.02) and the subendocardial viability ratio (from 164Ѓ}25 to 177Ѓ}37%; p=0.009) were found after 12 months. Sacubitryl/valsartanbased therapy was associated with a decrease in central systolic blood pressure (from 116Ѓ}19 to 106Ѓ}10 mm Hg; p=0.001) and central pulse blood pressure (from 44Ѓ}15 to 38Ѓ}7 mm Hg; p<0.05). Decrease in Ea (from 2.20Ѓ}0.84 to 1.79Ѓ}0.63 mm Hg/ml/m2; p=0.005) and Ea/Ees ratio (from 2.26Ѓ}0.77 to 1.68Ѓ}0.32, p=0.05) was found after 12 months. Ees did not change statistically significantly (1.00Ѓ}0.34 vs 1.01Ѓ}0.44 mm Hg/ml/m2). The relationship between the decrease in PWV, Ea and the dynamics of blood pressure was not found.Conclusion. Sacubitryl/valsartan-based therapy in HFrEF patients results in a BP-independent improvement in LVAC due to a decrease in Ea, an improvement in the parameters of the central pulse wave. |
topic |
heart failure with reduced ejection fraction sacubitril/valsartan left ventricular-arterial coupling arterial stiffness |
url |
https://www.rpcardio.com/jour/article/view/1650 |
work_keys_str_mv |
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