Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Ischemic and nonischemic heart failure with reduced ejection fraction: assessing left atrial strain imaging after sacubitril/valsartan therapy
Session:
Comunicações Orais - Sessão 18 - Insuficiência cardíaca: tratamento
Speaker:
Pedro Brás
Congress:
CPC 2023
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.4 Chronic Heart Failure – Treatment
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Pedro Garcia Brás; António Valentim Gonçalves; Rita Ilhão Moreira; Tiago Pereira da Silva; Isabel Cardoso; José Viegas; André Grazina; Sofia Jacinto; Rita Teixeira; Bárbara Teixeira; Ana Teresa Timóteo; Pedro Rio; Ana Galrinho; Rui Soares; Rui Cruz Ferreira; Luísa Moura Branco
Abstract
<p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt">Introduction: Sacubitril/valsartan (SV) is currently a mainstay of heart failure with reduced ejection (HFrEF) therapy, with proven results in reverse left ventricular (LV) remodeling. However there is limited data regarding left atrial (LA) strain parameters assessment after SV therapy in different HFrEF etiologies. The aim of this study was to evaluate improvement in LA volume, strain and strain rate parameters before and after SV therapy in ischemic HFrEF patients (P) and nonischemic HFrEF P.</span></span></p> <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt">Methods: Prospective evaluation of echocardiographic data of HFrEF patients under optimized guideline-directed medical therapy. LA mechanics were assessed by 2D speckle-tracking at baseline and after 6 months of SV therapy. LA volume, reservoir phase strain (LASr), conduit phase strain (LAScd) and contraction phase strain (LASct) and respective phases’ strain rate (SR) were compared (Figure 1). </span></span></p> <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt">Results: 35 P were evaluated, mean age 59±11 years, 83% male gender, 40% atrial fibrillation and 43% with ischemic etiology. While there was a significant reduction in LA volume index (LAVi) in nonischemic HFrEF P (56.2±26.9 mL/m2 vs 44.5±15.8 mL/m2, p=0.005), there was only a mild nonsignificant reduction in ischemic HFrEF P (44.9±12.6 mL/m2 vs 42.6±16.2 mL/m2, p=0.442). There was a significant improvement in LASr both in nonischemic HFrEF P (10.08±4.82% vs 14.96±7.76%, p=0.001) and ischemic HFrEF P (13.53±7.42% vs 17.73±7.89%, p=0.011). While ischemic HFrEF P had a significantly improved LAScd (-6.39 [-8.48–-4.38]% vs -7.81 [-10.89–-6.9]%, p=0.033), nonischemic HFrEF P showed a trend to improvement (-5.47 [-9.53–-4.22]% vs -6.02 [12.5–-4.22]%, p=0.059). On the contrary, nonischemic HFrEF P showed a significantly improved LASct (-6.17±4.44% vs -10.62±4.82%, p<0.001) while ischemic HFrEF P showed a trend to improvement (-8.23±3.58% vs -11.14±2.65%, p=0.052). Regarding SR, the authors found an improved reservoir phase SR (0.47±0.21 s-1 vs 0.65±0.24 s-1, p=0.001) and contraction phase SR (-0.58 [-1.1–0.33] s-1 vs -1.22 [-1.51–-0.71] s-1, p=0.016) in nonischemic HFrEF P, versus a statistically non-significant improvement in ischemic HFrEF P (reservoir SR 0.51 ± 0.24 s-1 vs 0.64 ± 0.2 s-1, p=0.065) and contraction phase SR (0.89 [-1.25–-0.66] s-1 vs -1.07 [-1.28–1.03] s-1, p=0.285). However, there was a significant increase in conduit phase SR in ischemic HFrEF P (-0.46 [-0.63–-0.29] s-1 vs -0.55 [-0.7–-0.41] s-1, p=0.023), in contrast to nonischemic HFrEF P (-0.52 [-0.79–-0.28] s-1 vs -0.63 [-0.9–-0.35] s-1, p=0.184).</span></span></p> <p style="text-align:justify"><span style="font-family:Arial,Helvetica,sans-serif"><span style="font-size:11pt">Conclusion: After 6 months of SV therapy, there was significant improvement in LA strain and strain rate parameters. Ischemic HFrEF P showed a significantly improved conduit function (LAScd and SR) while nonischemic HFrEF P revealed improved reservoir and contractile function (LASr, LASct, reservoir and contraction phase SR) as well as significant reduction in LAVi.</span></span></p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site