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A. Basics
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05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
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Differential impact of sodium-glucose cotransporter 2 inhibitors and sacubitril-valsartan in incidence of heart failure with improved ejection fraction
Session:
Sessão de Posters 49 - Insuficiência cardíaca para além da fração de ejeção do VE melhorada e recuperada: padrões de recuperação, preditores e marcadores de risco
Speaker:
Mauro Moreira
Congress:
CPC 2026
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.4 Chronic Heart Failure – Treatment
Session Type:
Posters Eletrónicos
FP Number:
---
Authors:
Mauro Moreira; Inês Bastos Castro; José Luís Ferraro; Inês Gomes Campos; Ana Rodrigo Costa; Joel Ponte Monteiro; Inês Almeida; Ana Leal Neto; Adriana Pereira; Patrícia Silva; Aurora Andrade
Abstract
<p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Introduction: </span></strong><span style="font-family:"Arial",sans-serif">Heart failure with improved ejection fraction (HFimpEF) is increasingly recognized as a meaningful phenotype. The impact of guideline directed medical therapy (GDMT) and its titration on HFimpEF incidence still needs to be clarified.</span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Methods: </span></strong><span style="font-family:"Arial",sans-serif">Single-center retrospective study with consecutive patients with chronic dilated cardiomyopathy and reduced ejection fraction from a heart failure clinic, between 2014-2024. Previous diseases, medication (including GDMT according to percentage of target dose), clinical status, biomarkers, electrocardiogram and echocardiogram findings were recorded. HFimpEF (left ventricle ejection fraction ≥40% with improvement of ≥10% from baseline) was the endpoint at 1-year post-admission. </span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Results: </span></strong><span style="font-family:"Arial",sans-serif">We included 189 patients (69.3% male; mean age 58.4±12.2 years-old), median LVEF of 26.8±10.7% at baseline. HFimpEF occurred in 37.1% of patients. Both at baseline and at 1-year, these patients were more likely to be on sodium-glucose cotransporter 2 inhibitors (SGLT2i) (66.1% vs 41.9%; p=0.002; 72.1% vs 51.4%; p=0.029, respectively) and on combined therapy with angiotensin-converting enzyme inhibitors (ACEi) or sacubitril-valsartan (ARNI), beta blocker (BB), SGLT2i and mineralocorticoid receptor antagonist (MRA), regardless of their doses (51.6% vs 34.4%; p=0.01; 62.3% vs 41.0%; p=0.008, respectively). Additionally, at 1-year, HFimpEF patients were also more often medicated with ARNI (60.7% vs 41.0%; p=0.014). A stronger association was evident for ARNI at target dose (37.7% vs 15.2%; p<0.001). </span></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-family:"Arial",sans-serif">Conclusion:</span></strong><span style="font-family:"Arial",sans-serif"> This study suggests that SGLT2i and ARNI, particularly when used at target dose, are the only HFrEF therapeutic pillars associated with HFimpEF in patients with dilated cardiomyopathy.</span></span></span></p>
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