| Title: |
Sacubitril/valsartan reduces indications for arrhythmic primary prevention in heart failure with reduced ejection fraction: insights from DISCOVER-ARNI, a multicenter Italian register |
| Authors: |
Pastore, Maria Concetta; Mandoli, Giulia Elena; Giannoni, Alberto; Benfari, Giovanni; Dini, Frank Lloyd; Pugliese, Nicola Riccardo; Taddei, Claudia; Correale, Michele; Brunetti, Natale Daniele; Carluccio, Erberto; Mengoni, Anna; Guaricci, Andrea Igoren; Piscitelli, Laura; Citro, Rodolfo; Ciccarelli, Michele; Novo, Giuseppina; Corrado, Egle; Pasquini, Annalisa; Loria, Valentina; Degiovanni, Anna; Patti, Giuseppe; Santoro, Ciro; Moderato, Luca; Malagoli, Alessandro; Emdin, Michele; Cameli, Matteo; Rosa, Gianmarco; Magnesa, Michele; Mazzeo, Pietro; De Carli, Giuseppe; Bellino, Michele; Iuliano, Giuseppe; Casciano, Ofelia; Binno, Simone; Canepa, Marco; Tondi, Stefano; Cicoira, Mariantonietta; Mega, Simona |
| Contributors: |
Pastore, Maria Concetta; Mandoli, Giulia Elena; Giannoni, Alberto; Benfari, Giovanni; Dini, Frank Lloyd; Pugliese, Nicola Riccardo; Taddei, Claudia; Correale, Michele; Brunetti, Natale Daniele; Carluccio, Erberto; Mengoni, Anna; Guaricci, Andrea Igoren; Piscitelli, Laura; Citro, Rodolfo; Ciccarelli, Michele; Novo, Giuseppina; Corrado, Egle; Pasquini, Annalisa; Loria, Valentina; Degiovanni, Anna; Patti, Giuseppe; Santoro, Ciro; Moderato, Luca; Malagoli, Alessandro; Emdin, Michele; Cameli, Matteo; Rosa, Gianmarco; Magnesa, Michele; Mazzeo, Pietro; De Carli, Giuseppe; Bellino, Michele; Iuliano, Giuseppe; Casciano, Ofelia; Binno, Simone; Canepa, Marco; Tondi, Stefano; Cicoira, Mariantonietta; Mega, Simona |
| Publication Year: |
2022 |
| Collection: |
Scuola Universitaria Superiore Pisa Sant'Anna: CINECA IRIS |
| Subject Terms: |
Heart failure; Implantable cardioverter-defibrillator; Left ventricular strain; Remodelling; Sacubitril/valsartan |
| Description: |
Aims: This sub-study deriving from a multicentre Italian register [Deformation Imaging by Strain in Chronic Heart Failure Over Sacubitril-Valsartan: A Multicenter Echocardiographic Registry (DISCOVER)-ARNI] investigated whether sacubitril/valsartan in addition to optimal medical therapy (OMT) could reduce the rate of implantable cardioverter-defibrillator (ICD) indications for primary prevention in heart failure with reduced ejection fraction (HFrEF) according to European guidelines indications, and its potential predictors. Methods and results: In this observational study, consecutive patients with HFrEF eligible for sacubitril/valsartan from 13 Italian centres were included. Lack of follow-up or speckle tracking data represented exclusion criteria. Demographic, clinical, biochemical, and echocardiographic data were collected at baseline and after 6 months from sacubitril/valsartan initiation. Of 351 patients, 225 (64%) were ICD carriers and 126 (36%) were not ICD carriers (of whom 13 had no indication) at baseline. After 6 months of sacubitril/valsartan, among 113 non-ICD carriers despite having baseline left ventricular (LV) ejection fraction (EF) ≤ 35% and New York Heart Association (NYHA) class = II-III, 69 (60%) did not show ICD indications; 44 (40%) still fulfilled ICD criteria. Age, atrial fibrillation, mitral regurgitation > moderate, left atrial volume index (LAVi), and LV global longitudinal strain (GLS) significantly varied between the groups. With receiver operating characteristic curves, age ≥ 75 years, LAVi ≥ 42 mL/m2 and LV GLS ≥-8.3% were associated with ICD indications persistence (area under the curve = 0.65, 0.68, 0.68, respectively). With univariate and multivariate analysis, only LV GLS emerged as significant predictor of ICD indications at follow-up in different predictive models. Conclusions: Sacubitril/valsartan may provide early improvement of NYHA class and LVEF, reducing the possible number of implanted ICD for primary prevention in HFrEF. Baseline reduced LV GLS was a strong ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
volume:2; issue:1; firstpage:oeab046; numberofpages:10; journal:EUROPEAN HEART JOURNAL OPEN; https://hdl.handle.net/11382/558818 |
| DOI: |
10.1093/ehjopen/oeab046 |
| Availability: |
https://hdl.handle.net/11382/558818; https://doi.org/10.1093/ehjopen/oeab046 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.8835FC55 |
| Database: |
BASE |