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Sacubitril/valsartan for heart failure in adults with complex congenital heart disease

Susanne J Maurer1, Claudia Pujol Salvador1, Sandra Schiele1

  • 1Department of Congenital Heart Disease and Paediatric Cardiology, German Heart Centre Munich, Technical University of Munich, Munich, Germany.

International Journal of Cardiology
|June 28, 2019
PubMed

Insights

Sacubitril/valsartan did not improve heart function or NYHA class in adults with complex congenital heart disease (ACHD) and heart failure. Close monitoring of renal function is recommended due to increased creatinine levels during treatment.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Heart Failure Management

Background:

  • Heart failure significantly impacts morbidity and mortality in adults with congenital heart disease (ACHD).
  • Sacubitril/valsartan is a standard treatment for acquired heart failure with reduced ejection fraction.
  • Limited data exists on its efficacy in adults with complex congenital heart disease (CHD).

Purpose of the Study:

  • To evaluate the effectiveness of sacubitril/valsartan in adults with complex CHD and heart failure.
  • To assess changes in systemic ventricular function and functional status.
  • To monitor for adverse events and changes in renal function.

Main Methods:

  • Retrospective study including 23 adult patients with moderate/severe complex CHD and heart failure.
  • Patients were treated with sacubitril/valsartan.
  • Clinical data, including ventricular function, NYHA class, NT-proBNP, creatinine, and blood pressure, were collected from medical records.

Main Results:

  • No significant improvement was observed in systemic ventricular function or New York Heart Association class.
  • NT-proBNP levels showed no significant change, but creatinine levels increased (p=0.002).
  • A significant reduction in systolic and diastolic blood pressure was noted, and four out of five patients who discontinued therapy did so due to side effects.

Conclusions:

  • Sacubitril/valsartan did not improve systemic ventricular function or functional status in this cohort of complex ACHD patients.
  • Increased creatinine levels necessitate close renal function surveillance during treatment.
  • Further research is needed to establish the role of sacubitril/valsartan in this population.
Abstract

Keywords:
Adult congenital heart diseaseHeart failureSacubitril/valsartan

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