How does sacubitril-valsartan (ARNI) affect myocardial injury in peritoneal dialysis patients with non-reduced ejection fraction (non-HFrEF)?

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Topic
Angiotensin receptor neprilysin inhibitor (ARNI) sacubitril-valsartan has been recommended as one of the first-line therapies in heart failure with reduced ejection fraction. However, the changes in myocardial injury, including strain and tissue characteristics in patients with peritoneal dialysis with non-HFrEF, are still unclear.

From: "Early results on the safety of stress ferumoxytol-enhanced cardiac magnetic resonance imaging", Journal of Cardiovascular Magnetic Resonance, Volume 27, Supplement 1, Spring 2025, 101220
Answer
After 3 months of treatment with sacubitril-valsartan, systolic blood pressure was significantly reduced, and signs and symptoms of heart failure were significantly relieved. The left ventricular global longitudinal strain (LVGLS) was significantly increased, indicating improved cardiac function. The native T1 value was significantly reduced, suggesting the reversal of ventricular fibrosis, and the T2 value was significantly reduced, indicating a reduction in myocardial edema. No significant differences were observed in serum creatinine, serum calcium, serum potassium, eGFR, and hemoglobin levels, and no adverse drug reactions occurred.
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