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EFFECT OF SACUBITRIL/VALSARTAN ON HEART RATE VARIABILITY HRV AND QT DISPERSION IN HEART FAILURE WITH REDUCED EJECTION FRACTION
Waleed Shehab Aladib* and Houssam Balleh
Background: Treatment of heart failure with reduced ejection fraction(HFrEF) by using Sacubitril/Valsartan reduces sudden cardiac death, but the precise mechanism underlying the beneficial effect on reducing cardiovascular mortality is still not clear. Objective: the present study aims to assess effects of Sacubitril/Valsartan on QT dispersion and HR variability in symptomatic patients with HFrEF. Materials and Methods: This is prospective study conducted in the department of Cardiology in Tishreen University Hospital-Lattakia -Syria from September 2019 to September 2020. Patients with HFrEF classified according to the NYHA in II-IV who aged 39 to 82 years were enrolled in the study. QT dispersion, SDNN were reordered before starting Sacubitril/Valsartan and after one month of the therapy. Results: A total of 22 patients were included, Median age was 50 years, 13 (59.10%) were female, hypertension was present in 15(68.2%) of the patients. Sacubitril/Valsartan reduced QTd (65.09±25.3 vs 51.72±21.7, p:0.004), OTc(435.04±27.6 vs 425.40±27.1.p:0.1), QRS(94.54±19.22 vs 93.40±16.39,p:0.6), and increased SDNN(93.22±24.7 vs 111.81±37.2,p:0.01) in the study participants. Spearman's correlation analysis revealed negative correlation between changes in SDNN and dyspnea degree (Spearman's = -0.2, P:0.04) and a positive correlation between changes in QTD and dyspnea degree (Spearman's = 0.3, P:0.01). Increased dose of drug was correlated with decreased QTd(Spearman's = - 0.1, P:0.5) and increased SDNN(Spearman's = 0.1, P:0.4). Conclusion: Based on our results, Sacubitril/Valsartan alters ventricular repolarization indices which associated with clinical improvement, so it could be an effective approach in treating patients with HFrEF.[Full Text Article]