Angiotensin Receptor‐Neprilysin Inhibitor Is Associated With Improved Cardiac Autonomic Function in Heart Failure

Autor: Andreas A. Boehmer, Tim Schubert, Moritz Rothe, Christoph Keim, Lilli Wiedenmann, Christian Ruckes, Lukas von Stuelpnagel, Fabian Theurl, Michael Schreinlechner, Bianca C. Dobre, Bernhard M. Kaess, Axel Bauer, Joachim R. Ehrlich
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 15 (2024)
Druh dokumentu: article
ISSN: 2047-9980
84636904
DOI: 10.1161/JAHA.123.033538
Popis: Background Heart failure with reduced ejection fraction is associated with potentially deleterious imbalance of the cardiac autonomic nervous system. Sacubitril/valsartan (angiotensin receptor‐neprilysin inhibitor [ARNI]) reduces cardiovascular mortality and hospitalization for heart failure with reduced ejection fraction. Whether ARNI affects the cardiac autonomic nervous system has not been studied. Methods and Results This investigator‐initiated, prospective, single‐center cohort study compared heart rate (HR) variability, HR, deceleration capacity, and periodic repolarization dynamics as noninvasive measures of the cardiac autonomic nervous system before and after initiation of ARNI therapy. Patients underwent standardized 12‐lead Holter‐ECG, echocardiography and laboratory testing before and 3 months after start of therapy. End points were changes in HR variability (SD of normal‐to‐normal intervals, mean square of differences between consecutive R‐R intervals), HR, deceleration capacity, and periodic repolarization dynamics as well as ventricular function and NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide). Of 63 patients with heart failure with reduced ejection fraction enrolled, 48 (76.2%) patients were still on ARNI at follow‐up. SD of normal‐to‐normal intervals increased from 25 to 36 milliseconds (P
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