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Association Between Angiotensin Receptor–Neprilysin Inhibition, Cardiovascular Biomarkers, and Cardiac Remodeling in Heart Failure With Reduced Ejection Fraction
- Source :
- Circulation: Heart Failure. 14
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Background: Sacubitril/valsartan (S/V) treatment is associated with reverse cardiac remodeling and reductions in biomarkers reflecting ventricular wall stress and myocardial injury, such as NT-proBNP (N-terminal pro-B-type natriuretic peptide), hs-cTnT (high-sensitivity cardiac troponin T), and soluble suppressor of tumorigenicity 2 (sST2). How longitudinal changes in these biomarkers analyzed collectively are associated with cardiac remodeling in patients with heart failure with reduced ejection fraction treated with S/V is uncertain. Methods: In a prospective study of S/V in patients with heart failure with reduced ejection fraction, this prespecified exploratory analysis included patients with serially collected biomarkers and echocardiographic measures of cardiac remodeling through 12 months of treatment. A multivariate latent growth curve model assessed associations between simultaneous changes in biomarkers and left ventricular ejection fraction and left atrial volume index. Results: Seven hundred fifteen out of 794 total study participants were included (mean age 65 years, 73% male). Mean baseline left ventricular ejection fraction and left atrial volume index were 29% and 40 mL/m 2 , respectively. Adjusted geometric mean baseline concentrations for biomarkers included NT-proBNP of 649 pg/mL, hs-cTnT of 15.9 ng/L, and sST2 of 24.7 ng/mL. Following initiation of S/V, circulating concentrations of NT-proBNP, hs-cTnT, and sST2 significantly decreased within 30 days and remained significantly different than baseline at all subsequent timepoints. From baseline to month 12, decreases in adjusted biomarker concentrations averaged −27.9% (95% CI, −35.1% to −20.7%; P P P Conclusions: Following initiation of S/V, NT-proBNP, hs-cTnT, and sST2 concentrations decreased significantly. Longitudinal changes in NT-proBNP and hs-cTnT together associated with left atrial and left ventricular reverse remodeling. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT02887183.
- Subjects :
- Male
Angiotensin receptor
medicine.medical_specialty
Angiotensins
Cardiovascular biomarkers
Ventricular Function, Left
Sacubitril
Internal medicine
medicine
Humans
Neprilysin
Aged
Aged, 80 and over
Heart Failure
Receptors, Angiotensin
Ejection fraction
Ventricular Remodeling
business.industry
Aminobutyrates
Biphenyl Compounds
Ventricular wall
Heart
Stroke Volume
Middle Aged
medicine.disease
Drug Combinations
Valsartan
Heart failure
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Biomarkers
medicine.drug
Subjects
Details
- ISSN :
- 19413297 and 19413289
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Circulation: Heart Failure
- Accession number :
- edsair.doi.dedup.....4cb731a1772e1a5b1c1fbfb3b0c95b50