Effects of sacubitril/valsartan in patients with cancer therapy-related heart failure
- Authors: Vitsenya M.V.1, Potekhina A.V.1, Gavryushina S.V.1, Ibragimova N.M.1, Stukalova O.V.1, Masenko V.P.1, Sharf T.V.1, Ageev F.T.1
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Affiliations:
- Chazov National Medical Research Center of Cardiology
- Issue: Vol 95, No 7 (2023)
- Pages: 560-567
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/148297
- DOI: https://doi.org/10.26442/00403660.2023.07.202281
- ID: 148297
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Abstract
Aim. To evaluate the effect of Sacubitril/Valsartan (S/V) on the functional status, systolic and diastolic function of the left ventricle (LV), tolerability of therapy and to determine predictors of its effectiveness in patients with cancer therapy-related heart failure (СTRHF).
Materials and methods. Forty patients 58 [46; 65.5] years of age with HF associated with anthracycline-containing cancer therapy were enrolled. Clinical examination, echocardiography, and assessment of potassium and creatinine levels were performed at baseline and after 6 months of S/V therapy.
Results. NYHA functional class (FC) improvement was observed in 22 (64.7%) patients. Radiation therapy (RT) decreased (OR 0.091; 95% CI 0.01–0.83; p=0.03) while baseline low LV EF increased (OR 9.0; 95% CI 1.78–45.33; p=0.008) the odds of FC improvement. LV EF increased from 37.3 [30; 42.5] % to 45 [38; 48] % (p<0.0001) and exceeded 50% in 7 (20.6%) patients. The odds of LV EF recovery increased when S/V therapy was initiated ≤1 year after anthracycline therapy (OR 10.67; 95% CI 1.57–72.67; p=0.0016) and decreased in patients with the history of RT (OR 0.14; 95% CI 0.02–0.89; p=0.0037) and in patients over 58 years (OR 0.07; 95% CI 0.01–0.68; p=0.022). LV diastolic function improvement included E/e’ descent from 13.6 [10; 18.3] to 8.9 [6.9; 13.7] (p=0.0005), and decrease in diastolic dysfunction grade in 18 (45%) patients (p=0.0001). No significant change in serum potassium (4.45 [4.2; 4.8] versus 4.5 [4.3; 4.8]; p=0.5) and creatinine (75.4 [67.6; 85.1] versus 75.5 [68.2; 98.3]; p=0.08) levels were observed.
Conclusion. S/V therapy is associated with improvement of EF, systolic and diastolic LV function, demonstrates a favorable tolerability profile in patients with СTRHF. Lack of RT and low baseline LV EF increased the odds of LV EF improvement; lack of RT, early (≤1 year) start of treatment after discontinuation of anthracycline therapy, and age <58 years increased the odds of LV EF recovery.
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##article.viewOnOriginalSite##About the authors
Marina V. Vitsenya
Chazov National Medical Research Center of Cardiology
Author for correspondence.
Email: marinavitsenya@gmail.com
ORCID iD: 0000-0003-1996-3416
канд. мед. наук, ст. науч. сотр. отд. амбулаторных лечебно-диагностических технологий
Russian Federation, MoscowAlexandra V. Potekhina
Chazov National Medical Research Center of Cardiology
Email: marinavitsenya@gmail.com
ORCID iD: 0000-0001-9290-9884
канд. мед. наук, науч. сотр. отд. легочной гипертензии и заболеваний сердца
Russian Federation, MoscowSvetlana V. Gavryushina
Chazov National Medical Research Center of Cardiology
Email: marinavitsenya@gmail.com
ORCID iD: 0009-0009-8159-7948
канд. мед. наук, врач-кардиолог консультативно-диагностического центра
Russian Federation, MoscowNursiiat M. Ibragimova
Chazov National Medical Research Center of Cardiology
Email: marinavitsenya@gmail.com
врач функциональной диагностики консультативно-диагностического центра
Russian Federation, MoscowOlga V. Stukalova
Chazov National Medical Research Center of Cardiology
Email: marinavitsenya@gmail.com
ORCID iD: 0000-0001-8377-2388
канд. мед. наук, ст. науч. сотр. лаб. магнитно-резонансной томографии
Russian Federation, MoscowValery P. Masenko
Chazov National Medical Research Center of Cardiology
Email: marinavitsenya@gmail.com
ORCID iD: 0000-0003-3280-3521
д-р мед. наук, проф., гл. науч. сотр. отд. нейрогуморальных и иммунологических исследований сердечно-сосудистых заболеваний
Russian Federation, MoscowTatiana V. Sharf
Chazov National Medical Research Center of Cardiology
Email: marinavitsenya@gmail.com
ORCID iD: 0000-0003-1993-9264
науч. сотр. лаб. иммунохимии НИИЭК
Russian Federation, MoscowFail T. Ageev
Chazov National Medical Research Center of Cardiology
Email: marinavitsenya@gmail.com
ORCID iD: 0000-0003-4369-1393
д-р мед. наук, проф., гл. науч. сотр. отд. амбулаторных лечебно-диагностических технологий
Russian Federation, MoscowReferences
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