The aim of this study is to know if the Sacubitril-Valsartan treatment improves the T-wave alternans in those patients that begin its treatment, which would indirectly show a lower risk of malignant ventricular arrythmias.
Sacubitril-Valsartan has shown to reduce sudden death in its principal clinical trial, PARADIGM-HF. A T wave alternans (TWA) is an electrophysiological phenomenon that acts as an independent predictor of sudden death and ventricular arrhythmias in postinfarct myocardial. TWA is measured by using a special software and electrodes during a treadmill test, that analyse small changes in the microvolt of the T wave consecutive with a complex algorithm in three dimensions. The TWA could be negative (normal), positive (pathological) or indeterminate. If a TWA is pathological it reflects an electric instability in depolarization. Our hypothesis is that the treatment with Sacubitril-Valsartan in heart failure patients with reduced ejection fraction, could improved the TWA.
Study Type
OBSERVATIONAL
Enrollment
20
After signing the Informed Consent, in the shortest possible time, the study investigator will carry out an ergometric test for the T-wave alternans (TWA) while still taking the basal medication. The patient will also sign the prototype Informed Consent for carrying out a stress test on a treadmill. It will also be carried out a basal life quality questionnaire, an analytical determination and a colour doppler echocardiography.
Hospital de Alta Resolución de Utrera
Utrera, Sevilla, Spain
RECRUITINGHospital de Alta Resolución de Sierra Norte
Constantina, Seville, Spain
NOT_YET_RECRUITINGHospital de Alta Resolución de Écija
Écija, Seville, Spain
ACTIVE_NOT_RECRUITINGAnalyze the changes in the T-wave alternans
Comparison of the results in the same patient just before the beginning of the Sacubitril-Valsartan pharmacological treatment versus 6 months after its beginning, in patients with grade II heart failure and left systolic disfunction (left ventricle ejection fraction\<40%).
Time frame: Up to 6 months after the beginning of the Sacubitril-Valsartan treatment
Evaluate the results in the life quality questionnaire.
Comparison of the life quality questionnaires results before and after the Sacubitril-Valsartan treatment.
Time frame: Up to 6 months after the beginning of the Sacubitril-Valsartan treatment
Study the levels of the n-terminal type B natriuretic propeptide
Comparison of the n-terminal type B natriuretic propeptide levels before and after the Sacubitril-Valsartan treatment.
Time frame: Up to 6 months after the beginning of the Sacubitril-Valsartan treatment
Evaluate the echocardiographic results
The echocardiographic results will be assessed by a combination of the measurement of the parameters: left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end systolic volume (LVESV) and left ventricle diastolic function, that will be compared before and after the Sacubitril-Valsartan treatment to evaluate its effect in patients with heart failure.
Time frame: Up to 6 months after the beginning of the Sacubitril-Valsartan treatment
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Hospital de Alta Resolución de Lebrija
Lebrija, Seville, Spain
ACTIVE_NOT_RECRUITING