{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T14:21:20Z","timestamp":1771338080842,"version":"3.50.1"},"reference-count":22,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2021,4,25]],"date-time":"2021-04-25T00:00:00Z","timestamp":1619308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Evidence for effectiveness of early change from angiotensin II receptor blockers (ARBs) or angiotensin-converting enzyme inhibitors (ACEIs) to sacubitril\/valsartan is lacking. We aimed to investigate whether early changes to sacubitril\/valsartan could improve outcomes in patients with nonischemic dilated cardiomyopathy (DCM) in real-world practice. Materials and Methods: A total of 296 patients with nonischemic DCM who were treated with ARB or ACEI continuously (group A, n = 150) or had their medication switched to sacubitril\/valsartan (group S, n = 146) were included. The sacubitril\/valsartan group was divided into early change (within 60 days, group S\/E, n = 59) and late change (group S\/L, n = 87) groups. Changes in echocardiographic parameters from the time of initial diagnosis to the last follow-up were analyzed. Results: Patients in group S showed greater left ventricular (LV) end-diastolic dimension (EDD) (group A vs. S, 61.7 \u00b1 7.4 vs. 66.5 \u00b1 8.0, p &lt; 0.001) and lower LV ejection fraction (LVEF) (28.9 \u00b1 8.2% vs. 23.9 \u00b1 7.5%, p &lt; 0.001) than those in group A at initial diagnosis. During a median follow-up of 76 months, patients in group S\/E, \u2206 LVEF (%) and \u2206 LVESD (mm) were significantly improved compared with those in patients in group A (group A vs. S\/E, \u2206 LVEF, p = 0.036; \u2206 LVESD, p = 0.023) or S\/L (group S\/E vs. S\/L, \u2206 LVEF, p = 0.05; \u2206 LVESD, p = 0.005). Among patients whose medications were switched to sacubitril\/valsartan, those with an earlier change showed a significant correlation with greater LVEF improvement (r = \u22120.367, p &lt; 0.001) and LV reverse remodeling (r = 0.277, p &lt; 0.001). Conclusions: in patients with nonischemic DCM, an early switch to sacubitril\/valsartan was associated with greater improvement in LV function. Patients might benefit in terms of LV function by early switching to sacubitril\/valsartan.<\/jats:p>","DOI":"10.3390\/medicina57050416","type":"journal-article","created":{"date-parts":[[2021,4,25]],"date-time":"2021-04-25T22:31:39Z","timestamp":1619389899000},"page":"416","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Beneficial Effect of Left Ventricular Remodeling after Early Change of Sacubitril\/Valsartan in Patients with Nonischemic Dilated Cardiomyopathy"],"prefix":"10.3390","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7680-6690","authenticated-orcid":false,"given":"Hyue-Mee","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul 06973, Korea"},{"name":"Division of Cardiology, Heart Stroke Vascular Center, Incheon Sejong Hospital, 20, Gyeyangmunhwa-ro, Gyeyang-gu, Incheon 21080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0708-8685","authenticated-orcid":false,"given":"Kyung-Hee","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Heart Stroke Vascular Center, Incheon Sejong Hospital, 20, Gyeyangmunhwa-ro, Gyeyang-gu, Incheon 21080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin-Sik","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Heart Stroke Vascular Center, Incheon Sejong Hospital, 20, Gyeyangmunhwa-ro, Gyeyang-gu, Incheon 21080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Byung-Hee","family":"Oh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Heart Stroke Vascular Center, Incheon Sejong Hospital, 20, Gyeyangmunhwa-ro, Gyeyang-gu, Incheon 21080, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1136\/hrt.2003.025270","article-title":"Clinical epidemiology of heart failure","volume":"93","author":"Mosterd","year":"2007","journal-title":"Heart"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1002\/ehf2.12005","article-title":"Heart failure: Preventing disease and death worldwide","volume":"1","author":"Ponikowski","year":"2014","journal-title":"ESC Heart Fail."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1002\/ejhf.109","article-title":"Trends in prevalence from 1990 to 2007 of patients hospitalized with heart failure in Sweden","volume":"16","author":"Schaufelberger","year":"2014","journal-title":"Eur. J. Heart Fail."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1093\/eurheartj\/ehw128","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"37","author":"Ponikowski","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e003529","DOI":"10.1161\/CIRCHEARTFAILURE.116.003529","article-title":"Thirty Years of Evidence on the Efficacy of Drug Treatments for Chronic Heart Failure with Reduced Ejection Fraction","volume":"10","author":"Burnett","year":"2017","journal-title":"Circ. Heart Fail."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1056\/NEJMoa1409077","article-title":"Angiotensin\u2013Neprilysin Inhibition versus Enalapril in Heart Failure","volume":"371","author":"McMurray","year":"2014","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"100418","DOI":"10.1016\/j.ijcha.2019.100418","article-title":"Impact of sacubitril\/valsartan on echo parameters in heart failure patients with reduced ejection fraction a prospective evaluation","volume":"25","author":"Bayard","year":"2019","journal-title":"IJC Heart Vasc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/j.jjcc.2019.08.005","article-title":"Recovery of left ventricular dysfunction after sacubitril\/valsartan: Predictors and management","volume":"75","author":"Chang","year":"2020","journal-title":"J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.jjcc.2019.03.010","article-title":"Sacubitril\/valsartan in heart failure with reduced ejection fraction patients: Real world experience on advanced chronic kidney disease, hypotension, and dose escalation","volume":"74","author":"Chang","year":"2019","journal-title":"J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1159\/000505148","article-title":"Left Ventricular Ejection Fraction Recovery in Patients with Heart Failure and Reduced Ejection Fraction Treated with Sacubitril\/Valsartan","volume":"145","author":"Vicent","year":"2020","journal-title":"Cardiology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1001\/jama.2019.12821","article-title":"Association of Change in N-Terminal Pro\u2013B-Type Natriuretic Peptide Following Initiation of Sacubitril-Valsartan Treatment with Cardiac Structure and Function in Patients with Heart Failure with Reduced Ejection Fraction","volume":"322","author":"Januzzi","year":"2019","journal-title":"JAMA"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1001\/jamacardio.2019.4665","article-title":"for the PIONEER-HF Investigators Initiation of Angiotensin-Neprilysin Inhibition after Acute Decompensated Heart Failure","volume":"5","author":"DeVore","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1001\/jamacardio.2019.4822","article-title":"Early Implementation of Sacubitril\/Valsartan for Patients with Heart Failure","volume":"5","author":"Wilcox","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/S0735-1097(01)01738-7","article-title":"A standardized definition of ischemic cardiomyopathy for use in clinical research","volume":"39","author":"Felker","year":"2002","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s00380-015-0648-2","article-title":"Time course of left ventricular reverse remodeling in response to pharmacotherapy: Clinical implication for heart failure prognosis in patients with idiopathic dilated cardiomyopathy","volume":"31","author":"Ikeda","year":"2015","journal-title":"Heart Vessel."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.echo.2014.10.003","article-title":"Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"28","author":"Lang","year":"2015","journal-title":"J. Am. Soc. Echocardiogr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.jacc.2010.05.011","article-title":"Quantitative Evaluation of Drug or Device Effects on Ventricular Remodeling as Predictors of Therapeutic Effects on Mortality in Patients with Heart Failure and Reduced Ejection Fraction","volume":"56","author":"Kramer","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Romano, G., Vitale, G., Ajello, L., Agnese, V., Bellavia, D., Caccamo, G., Corrado, E., Di Gesaro, G., Falletta, C., and La Franca, E. (2019). The Effects of Sacubitril\/Valsartan on Clinical, Biochemical and Echocardiographic Parameters in Patients with Heart Failure with Reduced Ejection Fraction: The \u201cHemodynamic Recovery\u201d. J. Clin. Med., 8.","DOI":"10.20944\/preprints201911.0039.v1"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e12435","DOI":"10.1111\/1755-5922.12435","article-title":"The reverse remodeling response to sacubitril\/valsartan therapy in heart failure with reduced ejection fraction","volume":"36","author":"Martens","year":"2018","journal-title":"Cardiovasc. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jchf.2018.10.014","article-title":"NT-proBNP Goal Achievement Is Associated with Significant Reverse Remodeling and Improved Clinical Outcomes in HFrEF","volume":"7","author":"Daubert","year":"2019","journal-title":"JACC Heart Fail."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1038\/nrcardio.2016.200","article-title":"Long-term neprilysin inhibition\u2013implications for ARNIs","volume":"14","author":"Campbell","year":"2017","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.jchf.2019.06.004","article-title":"Imaging, Biomarker, and Clinical Predictors of Cardiac Remodeling in Heart Failure with Reduced Ejection Fraction","volume":"7","author":"Aimo","year":"2019","journal-title":"JACC Heart Fail."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/5\/416\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:52:34Z","timestamp":1760161954000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/57\/5\/416"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,25]]},"references-count":22,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["medicina57050416"],"URL":"https:\/\/doi.org\/10.3390\/medicina57050416","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,25]]}}}