Right ventricular strain predicts outcome in patients receiving sacubitril/valsartan: A sub‐analysis of DISCOVER‐ARNI DOI Creative Commons
Maria Concetta Pastore, Giulia Elena Mandoli, Alberto Giannoni

et al.

ESC Heart Failure, Journal Year: 2025, Volume and Issue: unknown

Published: April 16, 2025

Abstract Aims Angiotensin receptor/neprilysin inhibitors (ARNI) have emerged as a pivotal medical treatment considerably improving the clinical outcome of patients with heart failure and reduced ejection fraction (HFrEF). Identifying individuals who stand to benefit most from ARNI could markedly enhance patient management strategies. The aim this sub‐analysis DISCOVER‐ARNI register was evaluate prospective prognostic significance speckle tracking echocardiography (STE) parameters in undergoing therapy. Methods results multicentre Italian retrospectively enrolled 341 HFrEF referred for ARNI. These underwent clinical, biohumuoral, echocardiographic assessment at baseline. Subsequently, among those available right ventricular STE data, long‐term follow‐up conducted by telephone interview or on‐site visits. primary endpoint encompassed composite outcomes, including all‐cause cardiovascular mortality, hospitalization, transplantation, left assist device (LVAD) implantation. Overall, 136 were included (mean age 65 ± 10 years, 82% male). mean 40 18 months, during which 32 reached (14 deaths due reasons, 22 3 1 LVAD implantation). Baseline revealed that events had higher LV volumes EF (LV end‐diastolic volume 212 vs.174 57 mL, P = 0.002 ; end‐systolic 156 52 vs. 122 49 0.001 26 5 29 0.006 , respectively), lower but preserved tricuspid annular plane systolic excursion (TAPSE, 17 vs.19 3, 0.008 ), pulmonary artery pressures (38 11 31 8 mmHg, ) compared did not experience events. LV, atrial (LA), free wall longitudinal strain (fwRVLS) (−7 2 −8 2%, 15 7%, −15 −22 5%, 0.007 respectively). Employing Cox proportional hazard model LVEF, TAPSE, RVFAC, strain, LA fwRVLS, latest sole independent predictor combined (hazard ratio 1.15 [1.05;1.26], 0.002). Receiver operating characteristic (ROC) curves determined fwRVLS −20% optimal cut‐off predicting (area under curve [AUC] 0.70). This threshold used constructing Kaplan–Meier survival curves, demonstrating effective risk stratification over endpoint. Conclusions holds promise valuable parameter assess response therapy terms overall survival, hospitalizations,

Language: Английский

Right ventricular strain predicts outcome in patients receiving sacubitril/valsartan: A sub‐analysis of DISCOVER‐ARNI DOI Creative Commons
Maria Concetta Pastore, Giulia Elena Mandoli, Alberto Giannoni

et al.

ESC Heart Failure, Journal Year: 2025, Volume and Issue: unknown

Published: April 16, 2025

Abstract Aims Angiotensin receptor/neprilysin inhibitors (ARNI) have emerged as a pivotal medical treatment considerably improving the clinical outcome of patients with heart failure and reduced ejection fraction (HFrEF). Identifying individuals who stand to benefit most from ARNI could markedly enhance patient management strategies. The aim this sub‐analysis DISCOVER‐ARNI register was evaluate prospective prognostic significance speckle tracking echocardiography (STE) parameters in undergoing therapy. Methods results multicentre Italian retrospectively enrolled 341 HFrEF referred for ARNI. These underwent clinical, biohumuoral, echocardiographic assessment at baseline. Subsequently, among those available right ventricular STE data, long‐term follow‐up conducted by telephone interview or on‐site visits. primary endpoint encompassed composite outcomes, including all‐cause cardiovascular mortality, hospitalization, transplantation, left assist device (LVAD) implantation. Overall, 136 were included (mean age 65 ± 10 years, 82% male). mean 40 18 months, during which 32 reached (14 deaths due reasons, 22 3 1 LVAD implantation). Baseline revealed that events had higher LV volumes EF (LV end‐diastolic volume 212 vs.174 57 mL, P = 0.002 ; end‐systolic 156 52 vs. 122 49 0.001 26 5 29 0.006 , respectively), lower but preserved tricuspid annular plane systolic excursion (TAPSE, 17 vs.19 3, 0.008 ), pulmonary artery pressures (38 11 31 8 mmHg, ) compared did not experience events. LV, atrial (LA), free wall longitudinal strain (fwRVLS) (−7 2 −8 2%, 15 7%, −15 −22 5%, 0.007 respectively). Employing Cox proportional hazard model LVEF, TAPSE, RVFAC, strain, LA fwRVLS, latest sole independent predictor combined (hazard ratio 1.15 [1.05;1.26], 0.002). Receiver operating characteristic (ROC) curves determined fwRVLS −20% optimal cut‐off predicting (area under curve [AUC] 0.70). This threshold used constructing Kaplan–Meier survival curves, demonstrating effective risk stratification over endpoint. Conclusions holds promise valuable parameter assess response therapy terms overall survival, hospitalizations,

Language: Английский

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