Sacubitril/Valsartan Induces Global Cardiac Reverse Remodeling in Long-Lasting Heart Failure with Reduced Ejection Fraction: Standard and Advanced Echocardiographic Evidences

10Sacubitril/valsartan reduces mortality in heart failure with reduced ejection fraction (HFrEF) patients, partially due to cardiac reverse remodeling (RR). Little is known about the RR rate in long-lasting HFrEF and the evolution of advanced echocardiographic parameters, despite their known prognostic impact in this setting. We sought to evaluate the rates of left ventricle (LV) and left atrial (LA) RR through standard and advanced echocardiographic imaging in a cohort of HFrEF patients, after the introduction of sacubitril/valsartan. A multi-parametric standard and advanced echocardiographic evaluation was performed at the moment of introduction of sacubitril/valsartan and at 3 to 18 months subsequent follow-up. LVRR was defined as an increase in the LV ejection fraction ≥10 points associated with a decrease ≥10% in indexed LV end-diastolic diameter; LARR was defined as a decrease >15% in the left atrium end-systolic volume. We analyzed 77 patients (65 ± 11 years old, 78% males, 40% ischemic etiology) with 76 (28-165) months since HFrEF diagnosis. After a median follow-up of 9 (interquartile range 6-14) months from the beginning of sacubitril/valsartan, LVRR occurred in 20 patients (26%) and LARR in 33 patients (43%). Moreover, left ventricular global longitudinal strain (LVGLS) improved from -8.3 ± 4% to -12 ± 4.7% (p 25% of cases, both at standard and advanced echocardiographic evaluations.openopenMatteo Castrichini, Paolo Manca, Vincenzo Nuzzi, Giulia Barbati, Antonio De Luca, Renata Korcova, Davide Stolfo, Andrea Di Lenarda, Marco Merlo, Gianfranco SinagraCastrichini, Matteo; Manca, Paolo; Nuzzi, Vincenzo; Barbati, Giulia; DE LUCA, Antonio; Korcova, Renata; Stolfo, Davide; Di Lenarda, Andrea; Merlo, Marco; Sinagra, Gianfranc