Author + information
- Tor Biering-Sorensen,
- Amil Shah,
- Brian Claggett,
- Michael Zile,
- Burkert Pieske,
- Elisabeth Pieske-Kraigher,
- Adriaan Voors,
- Victor Shi,
- Martin Lefkowitz,
- Milton Packer,
- John J.V. McMurray and
- Scott Solomon
The angiotensin receptor neprilysin inhibitor (ARNI) sacubitril/valsartan (S/V) improves cardiovascular outcomes in heart failure with reduced ejection fraction (HFrEF), and reduced NT-proBNP and left atrial size in a phase II heart failure with preserved ejection fraction (HFpEF) trial. Global longitudinal (GLS) and global circumferential strain (GCS) have been shown to be impaired in HFpEF. We hypothesized that treating HFpEF patients with sacubitril/valsartan would significantly improve GLS and GCS compared to valsartan alone.
PARAMOUNT was a phase 2, randomized, parallel-group, double-blind multicenter trial in 301 patients with New York Heart Association (NYHA) class II-III HF, LVEF ≥45%, and NT-proBNP ≥400 pg/mL. Participants were randomly assigned (1:1) to sacubitril/valsartan titrated to 200 mg twice daily or valsartan titrated to 160 mg twice daily for 36 weeks. We assessed change in GLS and GCS from baseline to 36 weeks, adjusting for baseline value, in patients with sufficient imaging quality for 2D speckle tracking analysis at both timepoints (n=60 S/V, 75 valsartan only).
GCS was significantly improved at 36 weeks in the ARNI group when compared with the valsartan group (· 4.42, 95% CI 0.67-8.17, p=0.021), with no significant difference observed in GLS (·0.25, 95% CI −1.19-1.70, p=0.73)(Figure).
In patients with HFpEF, S/V improved global circumferential but not longitudinal strain when compared to valsartan during a 36 weeks period.
Interventional Cardiology Moderated Poster Theater, Poster Hall, Hall A/B
Saturday, March 10, 2018, 5:15 p.m.-5:30 p.m.
Session Title: Young Investigator Awards: Clinical Investigations
Abstract Category: Clinical Investigations
Presentation Number: 914-05
- 2018 American College of Cardiology Foundation