MUTATION OF DELTA-SARCOGLYCAN GENE IN DILATED CARDIOMYOPATHY PATIENTS IN NORTH INDIA POPULATION

Royana Singh

ABSTRACT

Background

There is robust evidence on mortality benefit after initiation of sacubitril/valsartan in patients with HFrEF;however, the effect on LV function is unknown or is yet to be reported. To our knowledge, this is the first study to report the effect of sacubitril/valsartan on LV function assessed by using 2D speckle strain echocardiography.

Method

We assessed LV function in 27 patients with HFrEF before and after initiation of sacubitril/valsartan to their maximum tolerated dose. Myocardial strain was assessed using a 2-dimensional speckle-tracking software. Among these patients, changes in ejection fraction, mitral annular velocity (MAV) were also measured.

Results

Treatment with sacubitril/valsartan improved the Longitudinal Strain (LS) score (mean = -11.929, SD + 2.875) relative to pre-treatment (mean = -10.270, SD + 2.677) (t26 = 2.895, p = 0.008). On the other hand, treatment with sacubitril/valsartan did not lead to a statistically significant change in MAV and EF. The mean MAV value of 3.96 (pre-treatment) was close to 3.98 (post-treatment)(Z = -0.443, p = 0.658). Similarly, mean EF was 34.07% and 39.86% (Z = -1.411, p = 0.158) for pre-treatment and post-treatment respectively.

Conclusion

After a 4-week treatment with sacubitril/valsartan, there was a statistically significant change in longitudinal strain which may be an early sign of improvement in LV function in patients with HFrEF. The echocardiographic evaluation had shown an improvement in MAV and EF, though not statistically significant. Our findings in this study clearly show that sacubitril/valsartan has a direct effect on LV leading to improvement in LV function and thereby reduced mortality and morbidity in patients with HFrEF.

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