Comparative efficacy of medication and cardiac resynchronization therapy in patients with heart failure with reduced ejection fraction

Abstract

Aim. To compare the effectiveness of standard conservative therapy for heart failure (HF) with the inclusion of sacubitril/valsartan combination and device therapy.Material and methods. The study included 64 patients from 38 to 73 years old (45 men and 19 women; mean age, 59,5±0,9 years) hospitalized in Baku (Azerbaijan) hospital due to NYHA class II-IV HF. The patients were divided into the experimental (group 1) and control (group 2) groups. The experimental group included 33 patients who took sacubitril/valsartan twice a day in combination with other drugs for standard HF therapy. The control group included 31 patients after cardiac resynchronization therapy. We compared clinical and hemodynamic parameters (including 6-minute walk test and echocardiography data) before and 6 months after treatment, as well as blood concentration of brain natriuretic peptide (BNP). In addition, Kaplan-Meier survival curves were analyzed.Results. As a result of 6-month therapy, clinical condition of patients in both groups was improved. In the experimental group, some parameters were significantly better than in the control one. So, the differences regarded distance in 6-minute walk test (pu=0,002), changes in HF class (pu=0,017), LV ESD (pu=0,006), LV EDD (pu=0,001) and blood BNP concentrations (pu<0,001).Conclusion. The use of sacubitril/valsartan combination as part of standard HF therapy was accompanied by a significant improvement in the clinical, hemodynamic and biochemical parameters of patients with HF compared with device therapy.