Effectiveness of Angiotensin Receptor Blocker/Neprilysin Inhibitor in Heart Failure with Reduced Ejection Fraction Patients at Somdejphrajaotaksin Maharaj Hospital

Authors

  • Phongsathon Pacharasupa Cardiac Center, Department of Internal Medicine, Somdejphrajaotaksin Maharaj Hospital

Keywords:

heart failure with reduced ejection fraction, heart failure drugs

Abstract

Background and objectives: Due to patients with HFrEF had increased tendency in Somdejphrajaotaksin Maharaj Hospital annually, and they were started ARNI treatment in HF clinic. Many abroad studies shown benefits of ARNI for improve symptoms in patients with HFrEF by many mechanisms (increase urine sodium excretion, vasodilatation, anti-proliferative effect and reverse cardiac remodeling). So, this study aimed to study the effectiveness and adverse events of ARNI in HFrEF patients at HF clinic in Thai practice, primary outcome is improvement of left ventricular ejection fraction (LVEF). Secondary outcomes are improvements of cardiac size (LA size, LVIDd)  and New York Heart Association Functional Classification (NYHA).

Methods: The quasiexperiment one group pre-posttest study was conducted to collect data (anthropometric data, NYHA, underlying diseases, guideline-directed therapy drugs, duration to change ARNI, vital signs, serum potassium, serum creatinine, eGFR, echocardiographic parameters) from patients with HFrEF who attended in HF clinic at Somdejphrajaotaksin Maharaj Hospital from September 1, 2020 to August 31, 2021 for a period of 12 months.

Result: A total of 35 patients (26 male, 74.3 %), mean age 66.20 ±0.44 years, were included. Mean LVEF (baseline, 3rd ARNI mo, 12th ARNI mo) were 29.81 ±9.48 %, 48.05 ±9.80 %, 49.58 ±9.32 %, respectively. From baseline to 3rd ARNI mo, baseline to 12th ARNI mo, and from 3rd to 12th ARNI mo, mean LVEF change increased 18.25 % (p<0.001), 19.77 % (p<0.001) and 1.52 % (p=0.011) respectively. The cardiac size (LA size, LVIDd). Mean LA size (baseline, 3rd ARNI mo,12th ARNI mo) were 4.28 ±0.71 cm, 4.05 ±0.62 cm, 3.98 ±0.60 cm, respectively. From baseline to 3rd ARNI mo, baseline to 12th ARNI mo, and from 3rd to 12th ARNI mo, mean LA size change decreased 0.22 cm (p<0.001), 0.30 cm (p<0.001) and 0.08 cm (p=0.016), respectively. Mean LVIDd (baseline, 3rd ARNI mo, 12th ARNI mo) were 5.72 ±0.66 cm, 5.52 ±0.61 cm, 5.35 ±0.58 cm, respectively. From baseline to 3rd ARNI mo, baseline to 12th ARNI mo, and from 3rd to 12th ARNI mo, mean LVIDd change decreased 0.21 cm (p<0.001), 0.37 cm (p<0.001) and 0.16 cm (p<0.001), respectively. Median NYHA (baseline, 3rd ARNI mo, and 12th ARNI mo) were 3.00 ±1.00, 2.00 ±1.00, 2.00 ±1.00, respectively. From baseline to 3rd ARNI mo, baseline to 12th ARNI mo, and from 3rd to 12th ARNI mo, NYHA change were 2.00 ±1.00 (p<0.001), 2.00 ±1.00 (p<0.001), 2.00 ±1.00 (p=0.317) respectively. There were no statistically significant difference in serum potassium level, serum creatinine and eGFR during treatment period and no hypotension was reported in volunteers.

Conclusion: In patients with HFrEF treated with sacubitril-valsartan (ARNI), The cardiac function (LVEF), cardiac size (LA size, LVIDd) and NYHA were improved significantly from the 3rd month until 12th month of ARNI treatment. No adverse event was reported.

References

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Published

2023-02-24

How to Cite

1.
Pacharasupa P. Effectiveness of Angiotensin Receptor Blocker/Neprilysin Inhibitor in Heart Failure with Reduced Ejection Fraction Patients at Somdejphrajaotaksin Maharaj Hospital. SRIMEDJ [Internet]. 2023 Feb. 24 [cited 2024 Jul. 15];38(1):37-44. Available from: https://li01.tci-thaijo.org/index.php/SRIMEDJ/article/view/256202

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Section

Original Articles