Effect of Sacubitril/Valsartan on Echocardiographic Parameters and Functional Class in Patients of Heart Failure with Reduced Ejection Fraction

Abstract

  Background: This study sought to determine, in retrospect, the effect of Sacubitril/Valsartan on the echocardiographic and functional class of ambulatory HFrEF patients taking conventional heart failure therapy. Methods: We conducted a retrospective observational single-center cohort of ninety HFrEF patients with NYHA Class II-III attending as an outpatient at a tertiary cardiac care facility between November 2018 and January 2020. Standardized two-dimensional transthoracic echocardiography and functional class evaluation were conducted at baseline and after 03-month of SV treatment. Results: At 03-month follow-up evaluation, SV treatment was found to contribute substantially in reversing the cardiac remodeling of HFrEF patients as evidenced by improvement in LVEF (28.51±5.06 to 36.01±10.63; p < 0.001), LVEDD (57.29±7.99 to 53.14±8.22; p <0.001), and LVESD (46.07±9.49 to 43.20±9.22; p <0.001). Additionally, an improvement in sPAP (34.13±9.49 to 32.46±8.14; p <0.001) was observed along with a significant NYHA functional class recovery (2.76 to 1.89, p < 0.001). Upon gender-based stratification, the data suggested no gender-based differences in reverse remodeling effects of SV; though statistically insignificant, LA (38.51±8.23 to 37.3±5.92 mm) and RV (27.10±5.74 to 26.42±2.81 mm) diameters were observed to reduce only in men. Conclusion: Our study maintained that earlier commencement of SV in parallel with conventional heart failure therapy results in a significant amount of improvement in LVEF, LVEDD, LVESD, and sPAP in HFrEF patients irrespective of their gender. Simultaneously, SV alleviates the heart failure-related morbidity through rapid functional status (NYHA Class) recovery.