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ID 118925
Title Alternative
Pressure-flow Responses to Exercise in Heart Failure Treated with Angiotensin Receptor Neprilysin Inhibitor
Author
Yamaguchi, Natsumi Tokushima University
Hirata, Yukina Tokushima University
Nishio, Susumu Tokushima University
Keywords
Cardiac function
ARNI
Echocardiography
Stress echocardiography
Content Type
Journal Article
Description
Background: The role of the angiotensin receptor neprilysin inhibitor (ARNI) in cardiac function, particularly its impact on pulmonary circulation, remains underexplored. Recent studies have described abnormal mean pulmonary artery pressure (mPAP)-cardiac output (CO) responses as having the potential to assess the disease state. The aim of this study was to assess the effects of ARNI on pulmonary circulation in heart failure. We measured echocardiographic parameters post 6-minute walk (6MW) and compared the changes with baseline and follow-up. Our hypothesis was that pulmonary pressure-flow relationship of the pulmonary circulation obtained by 6MW stress echocardiography would be improved with treatment.
Methods: We prospectively enrolled 39 heart failure patients and conducted the 6MW test indoors. Post-6MW echocardiography measured echocardiographic variables, and CO was derived from electric cardiometry. Individualized ARNI doses were optimized, with follow-up echocardiographic evaluations after 1 year.
Results: Left ventricular (LV) volume were significantly reduced (160.7±49.6ml vs 136.0±54.3ml, P<0.001), and LV ejection fraction was significantly improved (37.6±11.3% vs 44.9±11.5%, P<0.001). Among the 31 patients who underwent 6MW stress echocardiographic study at baseline and 1 year later, 6MW distance increased after treatment (380m vs 430m, P=0.003). The ΔmPAP/ΔCO by 6MW stress decreased with treatment (6.9mmHg/L/min vs 2.8mmHg/L/min, P=0.002). The left atrial volume index was associated with the response group receiving ARNI treatment for pulmonary circulation.
Conclusions: Initiation of ARNI was associated with improvement of left ventricular size and LVEF. Additionally, the 6MW distance increased and the ΔmPAP/ΔCO was improved to within normal range with treatment.
Journal Title
International Journal of Cardiology
ISSN
01675273
18741754
NCID
AA10623832
AA11530930
Publisher
Elsevier
Volume
400
Start Page
131789
Published Date
2024-01-20
Remark
論文本文は2025-01-20以降公開予定
Rights
© 2024. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
language
eng
TextVersion
その他
departments
University Hospital
Medical Sciences