Impact of angiotensin receptor-neprilysin inhibitor on echocardiographic parameters and quality of life in heart failure patients with reduced ejection fraction

Introduction: Heart failure (HF) is a progressive clinical syndrome affecting >38 million people globally1. A new class of agents for treating chronic HF has been developed, known as angiotensin receptor neprilysin inhibitors (ARNI)2-4. ARNI enhances diuresis, natriuresis, myocardial relaxation, and anti-remodelling4-5. Aim: To assess the alterations of echocardiographic parameters and life quality while using ARNI. Methods: This was a retrospective study in which 102 patients were included. The inclusion criteria were confirmed heart failure with reduced ejection fraction (HFrEF), age >18, usage of ARNI and completed Kansas City cardiomyopathy questionnaire (Kccq12). Data was calculated by SPSS v23.0. A p value less than 0.05 was concerned as statistically significant data. Results: The sample consisted of 12 (11.8%) women and 90 (88.2%) men. The average age of subjects was 60.26±11.57 years. All the results were assessed at first appointment (V1) and at fourth appointment (V4). NTproBNP (pg/ml) V1 3073.02±488.99; V4 2207.43±379.75,(p=0.018); LVEF(%) V1 25.95±1.28; V4 31.12±1.23,(p<0.001); LVDD(mm) V1 62.28±1.08; V4 59.40±1.19,(p<0.001); mean of the sum of KCCQ12 V1 30.34±1.06; V4 21.28±0.87,(p<0.001); 6-minute walk test(m) V1 400.19±10.27; V4 407.95±8.77,(p=0.350). The amount of patients with the presence of heart failure symptoms assessed at V1 and at V4: shortness of breath V1 73,3%(66) V4 64,4%(56); orthopnoea V1 5,5%(5) V4 3,4%(3); nocturnal dyspnea V1 22%(20) V4 14%(12); fatigue V1 58,2%(53) V4 48,3%(42); palpitations V1 43,4%(39) V4 20,7%(18); sweating V1 20,9%(19) V4 16,1%(14). Conclusions: In HFrEF patients, ARNI significantly reduced NTproBNP values and LVDD, significantly improved EF and patient’s life quality. At fourth appointment there were less patients with clinical HF symptoms