Assessment of Left Atrial Function Using Speckle Tracking Imaging in Patients with Heart Failure Receiving Sacubitril Valsartan

doi:10.21608/ejhm.2025.444919

Assessment of Left Atrial Function Using Speckle Tracking Imaging in Patients with Heart Failure Receiving Sacubitril Valsartan

Document Type : Original Article

10.21608/ejhm.2025.444919

Abstract

Background:Speckle-tracking echocardiography (STE) is a non-invasive ultrasound imaging method that enables an objective and quantitative assessment of both global and localised myocardial function. Sacubitril-Valsartan represents a breakthrough class of medications added to the arsenal of drugs used in Heart Failure therapy.
Objective: To study the function of the left atrium (LA) using two-dimensional (2-D) speckle tracking echocardiography (STE) among individuals with heart failure and reduced ejection fraction (HFrEF) who were undergoing treatment with Sacubitril/ Valsartan, also known as angiotensin receptor blocker -neprilysin inhibitor (ARNI). Methods:This randomised clinical study was performed on 123 HFrEF patients of both sexes and aged above 18 years. Only 100 HFrEF patients agreed to complete the study follow-up period. They were randomized into two equal groups according to the treatment plan: Group I (study group) received the traditional treatment for HF plus ARNI (Sacubitril/Valsartan replacing ACE inhibitors / ARBs). Group II (control group) received traditional treatment for HF without ARNI (ACE inhibitors / ARBs were given). Conventional echocardiography and 2D STE were performed to assess LA and LV strain functions at baseline and after 12 months using GE vivid 9 echo machine equipped with a M5S (1.7-4MHz) phased array transducer.
Results: Speckle tracking echocardiography strain findings after 12 months follow up revealed statistically significant enhancements of the LA conduit, LA reservoir, and LA contractile strain values in addition to improved global LV longitudinal strain (LS) and LV EF in ARNI group in comparison with non-ARNI group (p < 0.001).
Conclusions: STE showed that Sacubitril/Valsartan for a period of 12 months led to significant improvements in LA and LV strain parameters when added to standard Heart Failure therapy.

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