Sacubitril/valsartan can improve the cardiac function in heart failure patients with a history of cancer: An

Zhulu Chen1, Chuan Zhang1, Yuxi Zhu2

  • 1Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Medicine
|March 22, 2024
PubMed

Insights

Sacubitril/Valsartan improved cardiac function in elderly cancer patients with heart failure (HF). This combination therapy showed benefits across all HF types, including reduced cardiac remodeling and improved ejection fraction.

Area of Science:

  • Cardiology
  • Oncology
  • Pharmacology

Background:

  • Sacubitril/Valsartan is recommended for heart failure with reduced ejection fraction (HFrEF).
  • Limited evidence exists on Sacubitril/Valsartan's efficacy in elderly cancer patients with different types of heart failure (HFmrEF and HFpEF).

Purpose of the Study:

  • To investigate the effects of Sacubitril/Valsartan on cardiac function in elderly cancer patients with various forms of heart failure.
  • To compare Sacubitril/Valsartan treatment against conventional therapy in this specific patient population.

Main Methods:

  • Retrospective study of cancer patients over 65 with heart failure.
  • Patients were divided into Sacubitril/Valsartan group and a control group receiving conventional HF therapy.
  • Data collected for up to 9 months, analyzing cardiac parameters and clinical outcomes.

Main Results:

  • The Sacubitril/Valsartan group showed significant improvements in left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), and NT-proBNP levels at 3, 6, and 9 months.
  • Better New York Heart Association (NYHA) functional classification was observed post-treatment in the Sacubitril/Valsartan group.
  • Fewer cases of deterioration in left atrial diameter (LAD) and left ventricular end-diastolic diameter (LVEDD) were noted in the Sacubitril/Valsartan group.

Conclusions:

  • Sacubitril/Valsartan improves cardiac function and benefits cardiac remodeling in elderly cancer patients across all three types of heart failure.
  • This study provides novel evidence supporting the use of Sacubitril/Valsartan in this vulnerable patient group.

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
424
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
370
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
337
Cancer Survival Analysis01:21

Cancer Survival Analysis

Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
345
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.6K
Heart Failure Drugs: Inotropic Agents01:26

Heart Failure Drugs: Inotropic Agents

Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
578