Authors:

M Galvan Ruiz¹ , M Singh¹ , M Sanmamed Giron¹ , M Groba Marco¹ , M Lopez Perez¹ , M Blanco Nuez¹ , V Quevedo Nelson¹ , P Pena Ortega¹ , J Medina Suarez¹ , D Rua-Figueroa Erausquin¹ , JR Ortega Trujillo¹ , JR Morales Gonzalez¹ , E Caballero Dorta¹ , A Garcia Quintana¹ , ¹University Hospital of Gran Canaria Doctor Negrin - Las Palmas De Gran Canaria - Spain ,

Citation:

Introduction:  Few data on echocardiographic parameters of reverse remodeling has been published after the use of sacubitril-valsartan (SV) treatment.  Objective:  To analyse the reverse remodeling response in terms of echocardiographic parameters after the use of SV and evaluate the predictors for a left ventricular reverse remodeling.
Methods: This is an observational, ambispective, multicentre study that included all patients with stable HFrEF who started SV between SEP2016 and DEC2018. Patients with an echocardiogram (TTE) after at least 6 months of treatment were included.  Reverse ventricular remodeling was defined as an increase in LVEF=5%.
Results: A follow up TTE was perform in 84 out of 276 patients (30.4%). The mean age was 65 ± 10 y, 25% women. The main aetiologies of HFrEF were IHD (46.9%) and dilated cardiomyopathy (39.3%), and most frequent comorbidities were 69.3% hypertension, 44% DM, 50% Dyslipidemia, 31.3% AF and 27.4% CKD.  TTE values are shown in Table 1.  Patients with non-ischemic cardiomyopathy (non-IHD) had a greater improvement in LVEF (29.9±7.2 to 41.3±12.7 Vs non-IHD vs 30.4±6.9 to 32.7±9.8 in IHD patients). ; p<0.001) and a greater reduction of LVED (67.6±8 to 60.9±8.9 in non-IHD vs 62.53±7 to 60.50±8.1 in IHD, p<0.001). Other predictors of LV reverse remodeling are shown in Figure 1. 
Conclusions: In our study, SV improves LVEF and reverse remodeling. Predictors of reverse remodeling were: non-IHD etiology, earlier initiation of SV since diagnosis of HF, estimated glomerular filtration rate at baseline >60 ml/min and achievement of the highest dose of SV.