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Remodeling of LA function in CHF patients on Sacubitril/Valsartan treatment

Dr. Kamal Kumar Chawla

DM Cardiology, SGPGIMS Lucknow,

Interventional  Cardiologist,

Malla Reddy Narayana Specialty Hospital.


Previous research demonstrated that treatment with Sacubitril/Valsartan (S/V) led to improvements in the left ventricle (LV) and left atrium (LA) and reversed remodeling in patients suffering from heart failure with reduced ejection fraction (HFrEF). To investigate the predictors in the LA’s structure and function reverse remodeling (LARR) in these patients following S/V therapy, with a particular focus on left atrial strain parameters, notably peak atrial longitudinal strain (PALS). Patients with HFrEF were subjected to clinical and echocardiographic assessments at the beginning and after six months of S/V therapy. The patients were then categorized into two groups based on LARR: those with a relative reduction in ( LA volume index, LAVi) of over 15% (LARR+) and those without such reduction (LARR-). The findings of the study revealed a substantial increase in LAEF and a significant reduction in LAVi occurred after six months of S/V therapy. Furthermore, 47% of the patients experienced LA reverse remodeling. Additionally, LA strain parameters, specifically PALS, and LA conduit, showed significant improvement after six months of S/V therapy. LARR was not significantly associated with baseline echocardiographic variables, but it was found to be proportionate to changes in LV volumes and LA strain parameters.

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