Short-term effects of angiotensin receptor-neprilysin inhibitors on diastolic strain and tissue doppler parameters in heart failure patients with reduced ejection fraction: A pilot trial

Abstract Funding Acknowledgements Type of funding sources: None. Background ARNI has been shown to be superior to enalapril in long term reducing the mortality and hospitalization of heart failure (HF). However short-term effect on diastolic function remain unclear. We sought to evaluate 6 months" effects of ARNI on left ventricular (LV) diastolic parameters determined by speckle tracking and tissue Doppler imaging. Objectives This study aims to evaluate the torsional dynamics and 2D speckle tracking in heart failure with reduced ejection fraction on patients taking angiotensin receptor neprilysin inhibitors (ARNI) and non. Methods This study was carried out in Menoufia university hospitals included 60 patients of HFrEF during the period from august 2019 to January 2020. (50%) of patients was treated with traditional treatment of heart failure and the remaining was treated with ARNI. Data were collected including history and clinical examination. ECG and speckle tracking and tissue Doppler imaging was done to evaluate the diastolic function. Results Our results showed no significant difference between the two groups at baseline. There was significant improvement of the LV diastolic function. Untwist time and untwist onset showed the highly significant parameters of improvement. Conclusion This study concluded that ARNI showed short term improvement of diastolic function of the left ventricle that can be detected by STE. Comparison between the studied groups re Echocardiographic diastolic parameters after 6 months ARNI Traditional P-value (Sig.) Count 30 30 Diastolic dysfunction grade Grade 1 9 (30%) 1 (3.3%) 0.008 (S) Grade 2 18 (60%) 22 (73.4%) Grade 3 3 (10%) 7 (23.3%) Other doppler diastolic parameters E/A 0.93 ± 0.30 1.16 ± 0.26 0.002 (S) E/e" 9.1 ± 1.9 10.8 ± 1.6 <0.001 (HS) TR velocity (m/s) 2.6 ± 0.3 2.8 ± 0.3 0.003 (S) Speckle diastolic parameters Untwist rate (°/s) -65.4 ± 5.2 -60.4 ± 4.5 <0.001 (HS) Untwist onset (ms) 96.8 ± 16.2 106.1 ± 15.7 0.028 (S) Shows comparison between ARNI vs Traditionally treated patients and how the parameters of conventional and STE was improved in favor of diastolic parameters. Abstract Figure. Baseline vs 6 months inbetween studied g

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Evaluation of the Efficacy of ST2 and NT-proBNP in the Diagnosis and Prediction of Short- Term Prognosis in Heart Failure with Reduced Ejection Fraction

International Journal of Pharmaceutical and Clinical Research ◽

10.25258/ijpcr.v9i04.8539 ◽

2017 ◽

Vol 9 (04) ◽

Author(s):

Shivananda B Nayak ◽

Dharindra Sawh ◽

Brandon Scott ◽

Vestra Sears ◽

Kareshma Seebalack ◽

...

Keyword(s):

Heart Failure ◽

Ejection Fraction ◽

Cardiac Biomarkers ◽

Double Blind Study ◽

Short Term ◽

Double Blind ◽

Reduced Ejection Fraction ◽

The Mean ◽

Design And Methods ◽

The Relationship

Purpose: i) To determine the relationship between the cardiac biomarkers ST2 and NT-proBNP with ejection fraction (EF) in heart failure (HF) patients. ii) Assess whether a superiority existed between the aforementioned cardiac markers in diagnosing the HF with reduced EF. iii) Determine the efficacy of both biomarkers in predicting a 30-day cardiovascular event and rehospitalization in patients with HF with reduced EF iv) To assess the influence of age, gender, BMI, anaemia and renal failure on the ST2 and NT-proBNP levels. Design and Methods: A prospective double-blind study was conducted to obtain data from a sample of 64 cardiology patients. A blood sample was collected to test for ST2 and NT-proBNP. An echocardiogram (to obtain EF value), electrocardiogram and questionnaire were also obtained. Results: Of the 64 patients enrolled, 59.4% of the population had an EF less than 40%. At the end of the 30- day period, 7 patients were warded, 37 were not warded, one died and 17 were non respondent. Both biomarkers were efficacious at diagnosing HF with a reduced EF. However, neither of them were efficacious in predicting 30-day rehospitalization. The mean NT-proBNP values being: not rehospitalized (2114.7486) and 30 day rehospitalization (1008.42860) and the mean ST2 values being: not rehospitalized (336.1975), and 30-day rehospitalization. (281.9657). Conclusion: Neither ST2 or NT-proBNP was efficacious in predicting the short- term prognosis in HF with reduced EF. Both however were successful at confirming the diagnosis of HF in HF patients with reduced EF.

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