We have located links that may give you full text access.
Sacubitril/valsartan reversal of left ventricular remodeling is associated with improved hemodynamics in resistant hypertension.
Hellenic Journal of Cardiology : HJC 2024 April 5
BACKGROUND: Sacubitril/valsartan (S/V) has been shown to be an effective antihypertensive drug combination. However, its therapeutic effects on blood pressure (BP) and hemodynamics as well as left ventricular (LV) remodeling in resistant hypertension (RHTN) remain unclear.
METHODS: Eighty-six patients completed this self-control study, during which olmesartan was administered within the first 8 weeks (phase 1) followed by S/V within the second 8 weeks (phase 2), with nifedipine and hydrochlorothiazide taken as background medications. Office BP, echocardiography and hemodynamics assessment using impedance cardiography were performed at baseline, the eighth and sixteenth weeks.
RESULTS: The reduction in office BP was larger in phase 2 than in phase 1 (19.59/11.66 mmHg vs. 2.88/1.15 mmHg). Besides, the treatment in phase 2 provided greater reductions in systemic vascular resistance index (SVRI) and thoracic blood saturation ratio (TBR), with differences between two phases of -226.59 (-1212.80 to 509.55) dyn·s/cm5 /m2 and -0.02 (-0.04 to 0.02). Switching from olmesartan to S/V also significantly reduced E/E`, LV mass index, LV end-diastolic volume index and LV end-systolic volume index (all P < 0.05). Decreases in AS, SVRI and TBR were correlated with changes in indicators of LV remodeling (all P < 0.05). And the correlation still remained even after adjusting for confounders including changes in BP.
CONCLUSIONS: Switching from olmesartan to S/V effectively lowered BP and reversed ventricular remodeling in RHTN. In addition, hemodynamics improvement was also observed. Changes in hemodynamics played an important role in reversing LV remodeling of S/V, which were independent of its antihypertensive effect.
METHODS: Eighty-six patients completed this self-control study, during which olmesartan was administered within the first 8 weeks (phase 1) followed by S/V within the second 8 weeks (phase 2), with nifedipine and hydrochlorothiazide taken as background medications. Office BP, echocardiography and hemodynamics assessment using impedance cardiography were performed at baseline, the eighth and sixteenth weeks.
RESULTS: The reduction in office BP was larger in phase 2 than in phase 1 (19.59/11.66 mmHg vs. 2.88/1.15 mmHg). Besides, the treatment in phase 2 provided greater reductions in systemic vascular resistance index (SVRI) and thoracic blood saturation ratio (TBR), with differences between two phases of -226.59 (-1212.80 to 509.55) dyn·s/cm5 /m2 and -0.02 (-0.04 to 0.02). Switching from olmesartan to S/V also significantly reduced E/E`, LV mass index, LV end-diastolic volume index and LV end-systolic volume index (all P < 0.05). Decreases in AS, SVRI and TBR were correlated with changes in indicators of LV remodeling (all P < 0.05). And the correlation still remained even after adjusting for confounders including changes in BP.
CONCLUSIONS: Switching from olmesartan to S/V effectively lowered BP and reversed ventricular remodeling in RHTN. In addition, hemodynamics improvement was also observed. Changes in hemodynamics played an important role in reversing LV remodeling of S/V, which were independent of its antihypertensive effect.
Full text links
Related Resources
Trending Papers
Renin-Angiotensin-Aldosterone System: From History to Practice of a Secular Topic.International Journal of Molecular Sciences 2024 April 5
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app