Heart Failure, Prosthetic Heart Valve, Reduced Ejection Fraction, Sacubitril/Valsartan
Conditions
Brief summary
This study aims to evaluate the effect of sacubitril/valsartan in patients with prosthetic heart valves with heart failure with reduced ejection fraction (HFrEF).
Detailed description
Heart failure (HF) is the end stage of various types of cardiovascular disease. The prevalence of HF continues to rise, and the rates of readmission and mortality also continue to increase significantly. There are three types of HF, heart failure with preserved ejection fraction (HFpEF), heart failure with mid-range ejection fraction (HFmrEF), and heart failure with reduced ejection fraction (HFrEF). Sacubitril/valsartan, the first angiotensin receptor-neprilysin inhibitor (ARNI) approved by the FDA for the treatment of HFrEF, demonstrated significant benefits in the PARADIGM-HF trial. PARADIGM-HF trial was a large multicenter, randomized clinical trial comparing sacubitril/ valsartan with enalapril in patients with LVEF \< 40%. This trial showed 20% reduction in composite Cardiovascular (CV) death (including sudden cardiac death) and hospitalization for HF patients with S/V.
Interventions
DRUGSacubitril/Valsartan
Patients will be treated with conventional anti-heart failure therapy plus sacubitril/valsartan (oral administration of an initial dose of 24/26 mg twice daily, gradually increasing to 97/103 mg, depending on follow-up blood pressure) \[Entresto, 100 mg (sacubitril 49 mg/valsartan 51 mg)\].
DRUGConventional anti-heart failure therapy
Patients will be treated only with conventional anti-heart failure therapy as a control group.
Sponsors
Kafrelsheikh University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years old. * Both sexes. * Patients with a history of prosthetic heart valves. * Patients diagnosed with heart failure with reduced ejection fraction (HFrEF), defined as left ventricular ejection fraction (LVEF) ≤ 40% with New York Heart Association (NYHA) functional class II-IV.
Exclusion criteria
* Hemodynamic instability. * Use of a circulatory auxiliary circulation device. * Severe hepatic \[alanine aminotransferase (ALT) \>120 U/L\] and renal insufficiency \[estimated glomerular filtration rate (eGFR) \<30 mL/min\]. * Blood pressure \<100/60 mmHg. * Serum potassium \>5.3 mmol/L. * Severe pulmonary hypertension. * Malignant arrhythmia. * Malignant tumor. * Known history of hereditary or primary angioedema. * Serious adverse drug reactions or serious complications over the course of treatment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Effective rate | 6 months post-procedure | Effectiveness is defined as an New York Heart Association (NYHA) cardiac function grade improved by 1 grade or more. Effective rate= Effectiveness/total quantity\*(100%). |
Countries
Egypt
Contacts
Primary ContactMohammed A Hammad, MD
Outcome results
None listed