Effect of ARNi (Angiotensin Receptor–Neprilysin Inhibitors) in Post Mitral Valve Replacement / Repair patients with Heart Failure: A Retrospective Analysis

Authors

  • Amit Srivastava Senior Cardio Thoracic & Vascular Surgeon, Apex Super Speciality Hospital, Varanasi. Author
  • Sanjay Kumar Associate Professor & Chairperson, Department of Cardiothoracic Surgery, SSH & IMS, BHU, Varanasi. Author
  • Mohd Azam Haseen Associate Professor & Chairperson, Department of Cardiothoracic Surgery, JNMC & AMU, Aligarh. Author
  • Arvind Kumar Pandey Assistant Professor, Department of Cardiothoracic Surgery, SSH & IMS, BHU, Varanasi. Author

DOI:

https://doi.org/10.21276/sj370795

Keywords:

Mitral Valve replacement, Angiotensin receptor inhibitor

Abstract

  

Background: Arrhythmias Induced Cardiomyopathy (AiCM) is generally a reversible condition triggered by Tachycardia, Atrial fibrillation (AF) or Premature Ventricular Contractions (PVC). The most important pillar in the Management of the AiCM remains the initiation of therapy for control of Arrhythmias (Medical management or Ablations) with the optimization of HF management

Methods: We had Seven patient of mitral valve disease who underwent open heart surgery. Post-surgery they developed signs and symptoms of heart failure along with arrhythmias (AF) and deteriorating Ejection Fraction (EF)Results: When even after optimal drug therapy their symptoms were not controlled, they were switched to ARNi from ACEi. On 6 months of therapy their symptoms improved along with their EF, QOL and arrhythmias Conclusions: So, we concluded that in these subset of patients ARNi can be tried to manage AiCM with good clinical results.

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References

Huizar JF, Ellenbogen KA, Tan AY, Kaszala K. Arrhythmia-Induced Cardiomyopathy: JACC State-of-the-Art Review. J Am Coll Cardiol. 2019;73(18):2328-2344. doi:10.1016/j.jacc.2019.02.045.

Rakesh Gopinathannair, Susan P. Etheridge, Francis E. Marchlinski, Francis G. Spinale, DhanunjayaLakkireddy, Brian Olshansky,Arrhythmia-Induced Cardiomyopathies: Mechanisms, Recognition, and Management, Journal of the American College of Cardiology,Volume 66, Issue 15,2015,Pages 1714-1728,ISSN 0735-1097.

McMurray JJ, Packer M, Desai AS, et al. Angiotensin-neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371(11):993-1004. doi:10.1056/NEJMoa1409077.

Januzzi JL Jr, Camacho A, Piña IL, et al. Reverse Cardiac Remodeling and Outcome After Initiation of Sacubitril/Valsartan. Circ Heart Fail. 2020;13(6):e006946. doi:10.1161/CIRCHEARTFAILURE.119.006946.

Published

15.03.2024

Issue

Section

ORIGINAL ARTICLES ~ Cardiothoracic Surgery

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