Vol. 6, Issue 1, Part A (2024)

Background: Chronic heart failure (CHF) is a clinical syndrome that occurs because of mechanical dysfunction, molecular and inflammatory changes of the left ventricle. 
Aims: This study aimed to investigate the effect of Sacubitril/Valsartan on remodelling and serum brain natriuretic peptide (BNP).
Methods: 50 patients with heart failure with reduced ejection fraction (HfrEF) were planned for starting Sacubitril/Valsartan. Echocardiographic parameters for remodelling and Pro BNP level were assessed at baseline and after 6 months. 
Results: End diastolic volume (EDV), end systolic volume (ESV) and left ventricular ejection fraction (LVEF) of the patients at baseline were found to be 193.996±69.5142, 142.538±63.7695 and 27.098±7.1668 respectively. After six months, they were found to be 170.546±79.4744, 107.010 ±70.1144 and 40.546±12.8909. Pro BNP at baseline was found to be 1524.78±1922.704. While after six months, it was found to be 594.898±1201.7862 with P value 0.001. Linear regression analysis was done between six months Pro BNP and the factors that showed significant correlations with it. They were 6m New York heart association (NYHA) class, 6m ejection fraction (EF), 6m EDV, 6m ESV, 6m end diastolic dimension (EDD), and 6m end systolic dimension (ESD). Only 6 months EDV, EF and NYHA class are still significantly correlated with the 6 months Pro BNP, so that they can be used as indirect markers for Left Ventricular (LV) remodelling. 
Conclusion: The use of Sacubitril/Valsartan in patients with HFrEF resulted in a significant decrease in Pro BNP levels and the reversal of LV remodelling.