Resolution of Cheyne-Stokes Respiration after Treatment of Heart Failure with Sacubitril/Valsartan: A First Case Report.
Sleep-disordered breathing (SDB) is highly prevalent in patients with heart failure (HF), and is known to be associated with a worse prognosis. The severity of central sleep apnea is thought to mirror cardiac dysfunction. The novel angiotensin receptor-neprilysin inhibitor (ARNi) sacubitril has been shown to improve HF, but a relationship between treatment with ARNi and the severity of SDB has not yet been investigated. We report the case of a 71-year-old male with HF and SDB. Treatment with sacubitril/valsartan was associated with improved cardiac function, as shown by a reduction in the level of N-terminal prohormone of brain natriuretic peptide from 3,249 to 1,720 pg/mL, and an improvement in left-ventricular ejection fraction from 30 to 35%. This was accompanied by a marked reduction in the apnea-hypopnea index (from 41 to 19/h). To the best of our knowledge, this is the first case to document parallel improvements in HF and SDB after the initiation of ARNi treatment.
Clinic for Cardiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, Bad Oeynhausen, Germany.
Henrik
H
Fox
Thomas
T
Bitter
Dieter
D
Horstkotte
Olaf
O
Oldenburg
D000368:Aged; D000613:Aminobutyrates / Q000627:therapeutic use*; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D001713:Biphenyl Compounds; D002639:Cheyne-Stokes Respiration / Q000503:physiopathology*; D004338:Drug Combinations; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000187:drug effects; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000503:physiopathology*; D013318:Stroke Volume / Q000187:drug effects; D013777:Tetrazoles / Q000627:therapeutic use*; D000068756:Valsartan; D016277:Ventricular Function, Left / Q000187:drug effects
D000613:Aminobutyrates; D057911:Angiotensin Receptor Antagonists; D001713:Biphenyl Compounds; D004338:Drug Combinations; D013777:Tetrazoles; D020097:Natriuretic Peptide, Brain; D000068756:Valsartan; C549068:sacubitril and valsartan sodium hydrate drug combination
Angiotensin receptor-neprilysin inhibitor; Central sleep apnea; Cheyne-Stokes respiration; Heart failure; Sacubitril/valsartan; Sleep-disordered breathing