Heart failure & cardiomyopathies
Haemodynamic Forces Predicting Remodelling and Outcome in Patients with Heart Failure Treated with Sacubitril/Valsartan
Main findingResult — go to the resultOdds ratio 1.36 95% CI 1.10–1.67Authors' conclusion
HDF analysis predicts sacubitril/valsartan response and might optimise decision-making in HFrEF patients.
Study context
- Population
- Heart failure with reduced ejection fraction (HFrEF) patients initiating sacubitril/valsartan (70% males, 65 ± 9 years, LV ejection fraction (LVEF) 27 ± 7%)
- Participants
- 89 patients
- Exposure
- Responders vs non-responders to sacubitril/valsartan
- Respondersn = 45
- Outcome
- 6-month treatment response to sacubitril/valsartan, predicted by echo-derived haemodynamic forces (HDFs)
- Follow-up
- 6 months
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Odds ratio
1.36
95% CI 1.10–1.67
By group
Responders
4.4
SD 1.3
Non-responders
3.6
SD 1.2
wLVS
OR 1.36 (95% CI 1.10–1.67)
- Responders
- 45 (51%)
- wLVS ROC optimal cutpoint ≥3.7%, AUC
- 0.736
Observational data: associations, not effects.
Further findings
Composite of HF hospitalisation, AF and CV death, by ΔwLVS after 6 months · median follow-up 33 months (23-41)
| HR (95% CI) | P value | ||
|---|---|---|---|
| ΔwLVSAdjusted for clinical and instrumental variables | 0.76 (0.61–0.95) | P < 0.01 | |
| 0.512Hazard ratio (log scale) |
- Composite of HF hospitalisation, AF and CV death, by ΔwLVS after 6 months — Time-dependent ROC, optimal cut-off ≥0.5%, AUC
- 0.811
- Composite of HF hospitalisation, AF and CV death, by ΔwLVS after 6 months — Stratified prognosis, log-rank
- p < 0.0001
Original publication
Haemodynamic Forces Predicting Remodelling and Outcome in Patients with Heart Failure Treated with Sacubitril/Valsartan. ESC Heart Fail. Published 17 July 2023. doi:10.
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