The myocardial injury efficacy of ARNI in peritoneal dialysis patients with heart failure：a multiparametric magnetic resonance study (RF_FR_361)

multiparametric cardiac MR was used to preliminarily evaluate the changes in myocardial injury in peritoneal dialysis patients with non-HFrEF before and after treatment with sacubitril-valsartan.

Methods:

Patients diagnosed with ESRD on peritoneal dialysis with non-HFrEF were randomly selected from December 2019 to December 2022. They underwent CMR examination and laboratory tests before and 3 months after medication. CMR-based left ventricular function indexes, global myocardial strain indexes, tissue characteristic parameter indexes and adverse events were evaluated. The changes of relevant indicators before and after medication were compared.

Results:

After 3 months of treatment with sacubitril/valsartan, systolic blood pressure (SBP) was significantly reduced (146.05±17.37 vs. 137.71±17.36, p < 0.05), signs and symptoms of heart failure were significantly relieved, and LVGLS was significantly increased compared with pre-treatment (-10.05±3.50 vs. -12.10±3.33, p < 0.01), while LVGRS, LVGCS were not statistically different. Compared with the baseline level, the native T1 value was significantly reduced (1358.8±60.0 vs. 1321.5±51.3, p </span>< 0.05), and the T2 value was significantly reduced (45.36±1.81 vs. 42.95±1.56, p < 0.001). There were no significant differences in serum creatinine, serum calcium, serum potassium, eGFR, and hemoglobin before and after treatment, and no adverse drug reactions occurred in all patients.

Conclusion:

For patients on peritoneal dialysis with non-HFrEF, treatment with ARNI can rapidly and effectively improve systolic blood pressure. The reduction of native T1 value may represent the effect of reversing ventricular fibrosis, and the T2 value can sensitively detect changes in myocardial edema, which has unique application value in the efficacy evaluation of patients on peritoneal dialysis non-HFrEF.