Influence of sacubitril/valsartan on diastolic parameters in patients with chronic heart failure with reduced ejection fraction

Type of funding sources: None.

Chronic heart failure (CHF) is one of the pressing issues of modern cardiology and is widely discussed lately. Chronic heart failure with reduced ejection fraction (HFrEF) is common and is concerned with poor outcomes. Not only systolic function, but also diastolic function is deteriorated in HFrEF. Thus, we hypothesized the efficacy of angiotensin converting enzyme-neprilysin inhibitors on the diastolic function of patients with HFrEF.

Aim of the study was to evaluate the efficacy of angiotensin converting enzyme-neprilysin inhibitor - sacubitril/valsartan on diastolic parameters in patients with CHFrEF.

114 patients with diagnosed HFrEF with NYHA II-III functional class patients had been enrolled in the study. Mean age of the patients was 61.12±14.4 years, male was 53%. Patients randomly were divided into two groups by 57. Group I was provided with sacubitril/valsartan whereas Group II was provided with valsartan. All anthropometric, laboratory and instrumental methods including echocardiography with Doppler were performed at baseline and after the six months of the treatment. All statistical analysis were performed with STATA software.

Diastolic function was significantly improved after the treatment of sacubitril/valsartan in six months compared to valsartan group (P<0.05). E/e ratio was significantly improved in patients with sacubitril/valsartan compared to valsartan group (P<0.01). Left atrial longitudinal strain was significantly lower in the first group patients than second one was (P<0.001). Even though, isovolumic relaxation time and velocity time integral of the E-A complex have been improved in both groups during the treatment in six months, there have not been observed significant changes between groups (P>0.05). During the follow-up period group I patients have been experienced less hospitalization than group II patients were (P<0.05).

Sacubitril/valsartan significantly improved diastolic function compared to valsartan in patients with HFrEF. Further studies are required with large amount of patients.