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Sacubitril/valsartan effect on left ventricular remodeling. the case of a super-responder
- Publication Year :
- 2019
- Publisher :
- Taylor and Francis Group, 2019.
-
Abstract
- Sacubitril/valsartan has been shown to improve clinical outcomes in patients with heart failure and reduced ejection fraction (HFrEF), but its effects on left ventricular (LV) systolic function and reverse remodeling parameters remain to be established. We hereby describe the case of a 41 year old man with HFrEF and severe reduction of left ventricular ejection fraction (LVEF). The patient was first treated with triple HF therapy (beta-blocker, angiotensin converting enzyme inhibitor and mineralocorticoid antagonist), but after three months he was still symptomatic and with an LVEF firmly low. In consideration of poor response to therapy, we switched angiotensin converting enzyme inhibitor to sacubitril/valsartan to the maximum tolerated dose (49/51 mg bid) with a marked improvement in LV systolic function and reduction in LV volumes at follow-up. In light of the almost normalized LVEF the patient was also removed from the list for the implantation of a cardiac resynchronization therapy defibrillator. In conclusion, our case showed a strong beneficial effect of sacubitril/valsartan on reverse remodeling and LVEF beyond the benefits of concomitant optimal medical therapy. This result is particular noteworthy because it was obtained although the patient wasn't able to reach the full dose of the drug. Physicians should always consider this drug effect when more demanding therapeutic strategies are needed for their HF patients.
- Subjects :
- medicine.medical_specialty
drug combinations
animal structures
implantable cardioverter defibrillator
medicine.medical_treatment
cardiac magnetic resonance imaging
heart failure
030204 cardiovascular system & hematology
ventricular remodeling
Ventricular Function, Left
Sacubitril
03 medical and health sciences
0302 clinical medicine
male
Cardiac magnetic resonance imaging
left
Internal medicine
left ventricular reverse remodeling
sacubitril/valsartan
adult
aminobutyrates
angiotensin receptor antagonists
angiotensin-converting enzyme inhibitors
humans
stroke volume
tetrazoles
treatment outcome
ventricular function, left
Medicine
030212 general & internal medicine
Ventricular remodeling
Ejection fraction
medicine.diagnostic_test
business.industry
Biphenyl Compounds
General Medicine
medicine.disease
Implantable cardioverter-defibrillator
Valsartan
Heart failure
Cardiology
ventricular function
business
Sacubitril, Valsartan
medicine.drug
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....3c136d572c0450b40f03909bbaba8c55