Bibliographic Details
| Title: |
Effect of optimisation to contemporary HFrEF medical therapy with sacubitril/valsartan (Entresto) and dapaglifloziN on left Ventricular reverse remodelling as demonstrated by cardiac magnetic resonance (CMR) Imaging: the ENVI study |
| Authors: |
James Shambrook, Alice Zheng, Simon Smith, Ausami Abbas, Christopher Young, Paul Haydock, Andrew Flett, Peter Cowburn, Stephen Harden, Charles Peebles, Robert Adam, Elizabeth Greenwood, Katharine Vedwan, Georgina Adam, Jane Long, Michelle Walkden, Paula Olden |
| Source: |
Open Heart, Vol 11, Iss 2 (2024) |
| Publisher Information: |
BMJ Publishing Group, 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Diseases of the circulatory (Cardiovascular) system |
| Subject Terms: |
Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| More Details: |
Introduction Heart failure with reduced ejection fraction (HFrEF) guidelines recommend ‘four pillars’ of medical therapy and device therapy if left ventricular ejection fraction (LVEF) remains ≤35% after 3 months optimum medical therapy.We conducted the first study to examine the effects of optimisation to contemporary medical therapy on cardiac reverse remodelling, as demonstrated by cardiac magnetic resonance imaging (CMR).We hypothesised a proportion of patients would undergo beneficial remodelling and LVEF improvement above the threshold for complex device prescription after 6 months.Methods HFrEF patients with symptomatic LVEF≤35% despite ACE inhibitor/beta blocker/mineralocorticoid receptor antagonist therapy, and qualified for sacubitril/valsartan switchover were recruited to this single centre prospective study.CMR was performed at baseline and at follow-up. Clinical, volumetric and outcome data were collected and compared.Results Between June 2021 and August 2022, 49 patients were recruited. The majority (80%) were male, mean age 63±14 years. 35 (71%) had non-ischaemic cardiomyopathy. 2 (4%) patients died and 47 were followed up for a median of 7.4 months. There were no heart failure hospitalisations.Significant reductions were seen in median indexed left atrial volume: 54 mL/m2 (41–72) to 39 mL/m2 (30–60) (p35%. 13 (27%) patients improved to LVEF≥50%.Median N-terminal pro B type natriuretic peptide (NTproBNP) reduced from 883 ng/L (293–2043) to 429 ng/L (171–1421) (p |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2053-3624 |
| Relation: |
https://openheart.bmj.com/content/11/2/e002933.full; https://doaj.org/toc/2053-3624 |
| DOI: |
10.1136/openhrt-2024-002933 |
| Access URL: |
https://doaj.org/article/4c07939c3a374f8a9afb4959adde16d3 |
| Accession Number: |
edsdoj.4c07939c3a374f8a9afb4959adde16d3 |
| Database: |
Directory of Open Access Journals |
