Role of Speckle Tracking Echocardiography in Early Detection of Left Ventricular Systolic Function Improvement in Heart Failure Patients with Reduced Ejection Fraction Taking Sacubi-tril/Valsartan.

Background:We investigated the early improvement signs of LV systolic functions in symptomatic patients with heart failure (HF) with reduced left ventricular ejection fraction (LVEF) at 3 months and 6 months after taking sacubitril/valsartan (S/V) therapy. Materials and Methods: Prospective study was done on 51 HFrEF patients receiving S/V. Baseline, 3- and 6-months evaluations were performed with routine 2D echocardiography and STE. LVEF and global longitudinal strain (GLS) were measured. Predictive value of STE was compared with routine echocardiography. Results: After three months, 71.1% of patients revealed LV function improvement by STE, compared to only 56.25% detected by standard 2d echo. 2d speckle tracking detected early improvement in 43.75% of patients who were not yet manifested by conventional 2d Echo. After 6 months, STE continued to identify improvement in 15.6% of patients not detected by standard echocardiography. The agreement between STE and standard echocardiography was very good (k=0.892). Moreover, 28.9% of study population didn’t show response to SV by STE, and also none of them showed response by standard echocardiography, indicating that STE has a very good negative predictive value. Conclusion: STE is effective tool in early detection of LV systolic function improvement in comparison to standard 2D echocardiography, among patients with HFrEF receiving Sacubitril/valsartan therapy.