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\title{The first symptoms of cardiac reverse remodeling and clinical
improvement after one-month, low-dose of Sacubitril-Valsartan therapy}



\author[1]{Wioletta Sacharczuk}%
\author[1]{Rafał Dankowski}%
\author[1]{Anna Sowińska}%
\author[1]{Artur Baszko}%
\author[1]{Andrzej Szyszka}%
\affil[1]{Poznan University of Medical Sciences}%


\vspace{-1em}



  
  \date{May 26, 2024}


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\begin{abstract}
Introduction: Little is known about reverse cardiac remodeling (CRR)
under the low-dose S/V therapy. Methods: In 37 patients (mean age
64.5\selectlanguage{ngerman}±17.5 years, five females) 24/26mg S/V BID was started. After one
month of observation, the following CRR parameters improved: LVEDD
(-\selectlanguage{english}[?]2,9+-2.6mm, p\textless{}0.01), LVESD (-\selectlanguage{english}[?] 2,4+-2.5mm, p\textless{}0.01),
LVEDV(-\selectlanguage{english}[?]14.6+-33.1ml, p=0.04), LVESV (-\selectlanguage{english}[?]13.4+-30.6ml, p=0.04), LAVI
(-\selectlanguage{english}[?]8.7+-37.7ml/m2, p\textless{}0.01), and EROA (-\selectlanguage{english}[?] 0.09 +- 0,01cm2;
p=0.03). In opposite to LVEF global longitudinal strain (GLS) changed
from -6.6\% to -7.9\% (absolute improvement of 16\%, p
\textless{}0.001). Walked distance in 6-MWT ( +\selectlanguage{english}[?]65.4 +- 75.8 m, p
\textless{}0.001), and the quality of life (MLHFQ 22 vs 16 scores,
p\textless{}0.01) improved. Decreasing NT-proBNP (-\selectlanguage{english}[?]
1,203,1+-3,121,4pg/ml, p=0.03) and troponin T (-\selectlanguage{english}[?] 4.7+-9.4pg/ml, p=0.004)
were observed. Correlation between GLS and LVESV (r = -0,43, p = 0.027)
was found. ROC curve analysis showed that GLS cut-off value -8\% is a
good predictor of clinical improvement (6MWT: AUC 0.69 p=0.04) and CRR
(MRvol: AUC:0.74 p=0.01; LAVI: AUC 0.71 p=0.04). Conclusion: One-month,
low-dose (24/26 mg BID) S/V therapy initiates CRR. GLS's ability to
evaluate LV function is better than LVEF's. S/V should be started early
as patients with symptomatic HFrEF and less impaired LV systolic
function (GLS \textless{}-8\%) are more likely to develop CRR and
clinical improvement.%
\end{abstract}\selectlanguage{ngerman}%



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