Abstract: FR-PO518
Sacubitril/Valsartan Can Improve Vascular Access Flow in Patients on Hemodialysis with Heart Failure with Reduced Ejection Fraction
Session Information
- Dialysis Vascular Access
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 803 Dialysis: Vascular Access
Author
- Lin, Chih-Ching, Taipei Veterans General Hospital, Taipei, Taiwan
Background
Sacubitril/valsartan improves heart function in maintenance hemodialysis (HD) patients with heart failure with reduced ejection fraction<40% (HFrEF); however, the effect of sacubitril/valsartan on access flow (Qa) of vascular access in this population is unclear. Therefore, we conducted this study to evaluate this effect.
Methods
We retrospectively screened the HD patients in two hospitals. Patients with HFrEF receiving echocardiography and Qa measurement twice at 1 year apart were enrolled and divided into sacubitril/valsartan group and conventional treatment group. We compared the change of Qa(△Qa) and echocardiographic parameters after 1-year treatment. Correlations between △Qa and echocardiographic parameters were examined. Multiple linear regression analysis was applied to predict △Qa.
Results
Thirty-three HD patients with HFrEF were analyzed. Sixteen patients received sacubitril/valsartan treatment; their mean Qa increased significantly from 633.8 to 948.8 mL/min (P<0.001). There was no significant change of Qa for the conventional treatment group (from 637.7 to 621.8 mL/min, P=0.436). The change of left ventricular ejection fraction (△LVEF) significantly differed between the two groups. The △Qa had significant correlation with △LVEF(rs = 0.929, p<0.001) and with the change of interventricular septum thickness in diastole (△IVSd, rs = -0.736, p=0.001) in sacubitril/valsartan group. The △Qa was predicted as -44.034+15.868*△LVEF-25.072*△IVSd+ 145.964* (sacubitril/valsartan use or not), with R2 = 0.909 and adjusted R2 = 0.899.
Conclusion
Sacubitril/Valsartan improves Qa ~150 ml/min in HD patients with HFrEF. In addition, △Qa was ~15ml/min for each % increase of LVEF.