The comparative effects of sacubitril/valsartan versus enalapril on pulmonary hypertension due to heart failure with a reduced ejection fraction

Abstract The purpose of this study was to investigate the effects of sacubitril/valsartan on right ventricular (RV) function in patients with pulmonary hypertension (PH) due to heart failure with reduced ejection fraction (HFrEF). We prospectively enrolled patients with HFrEF‐induced PH admitted to...

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Main Authors: Ying Zhao, Li‐guo Tian, Li‐xin Zhang, Tao Ma, Liang Di, Yan‐bo Wang, Xin‐shun Gu, Dan‐dan Wang, Shang Gao, Haiyan Wang
Format: Article
Language:English
Published: Wiley 2022-07-01
Series:Pulmonary Circulation
Subjects:
Online Access:https://doi.org/10.1002/pul2.12034
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author Ying Zhao
Li‐guo Tian
Li‐xin Zhang
Tao Ma
Liang Di
Yan‐bo Wang
Xin‐shun Gu
Dan‐dan Wang
Shang Gao
Haiyan Wang
author_facet Ying Zhao
Li‐guo Tian
Li‐xin Zhang
Tao Ma
Liang Di
Yan‐bo Wang
Xin‐shun Gu
Dan‐dan Wang
Shang Gao
Haiyan Wang
author_sort Ying Zhao
collection DOAJ
description Abstract The purpose of this study was to investigate the effects of sacubitril/valsartan on right ventricular (RV) function in patients with pulmonary hypertension (PH) due to heart failure with reduced ejection fraction (HFrEF). We prospectively enrolled patients with HFrEF‐induced PH admitted to the Department of Cardiology between August 2018 and December 2019. Patients were randomized to receive oral treatment with sacubitril/valsartan or enalapril. Epidemiological data were recorded before treatment. Echocardiography was performed at admission and 6 months of follow‐up, and all parameters were compared. Major adverse cardiac events (MACEs) were compared between baseline and 6 months follow‐up. There were no significant differences in the baseline characteristics between the two groups. After 6 months of treatment, both treatment groups improved the following parameters from baseline (mean ± SD): left atrium, left ventricle, the left ventricular ejection function (LVEF), RV systolic function (the tricuspid annular plane systolic excursion [TAPSE], the systolic pulmonary artery pressure [sPAP], and TAPSE/sPAP). After 6 months, sacubitril/valsartan improved significantly the following parameters compared with enalapril (all p < 0.05): LVEF (47.07 ± 6.93% vs. 43.47 ± 7.95%); TAPSE (15.33 ± 1.31 vs. 14.78 ± 1.36 mm); sPAP (36.76 ± 14.32 vs. 42.26 ± 12.07 mmHg); and TAPSE/sPAP ratio (0.50 ± 0.23 vs. 0.39 ± 0.14), respectively. There was no difference in readmissions due to recurrent heart failure. Sacubitril/valsartan seems to provide more beneficial effects among patients with HFrEF‐induced PH to improve RV function, along with a decrease in pulmonary pressure.
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spelling doaj.art-ac22841f02d74e5f844430dba32bfeeb2022-12-22T03:49:37ZengWileyPulmonary Circulation2045-89402022-07-01123n/an/a10.1002/pul2.12034The comparative effects of sacubitril/valsartan versus enalapril on pulmonary hypertension due to heart failure with a reduced ejection fractionYing Zhao0Li‐guo Tian1Li‐xin Zhang2Tao Ma3Liang Di4Yan‐bo Wang5Xin‐shun Gu6Dan‐dan Wang7Shang Gao8Haiyan Wang9Department of Cardiology the Hai‐gang Hospital of Qinhuangdao Qinhuangdao Hebei ChinaDepartment of Cardiology the Hai‐gang Hospital of Qinhuangdao Qinhuangdao Hebei ChinaDepartment of Cardiology the Hai‐gang Hospital of Qinhuangdao Qinhuangdao Hebei ChinaDepartment of Cardiology the Hai‐gang Hospital of Qinhuangdao Qinhuangdao Hebei ChinaDepartment of Cardiology the Hai‐gang Hospital of Qinhuangdao Qinhuangdao Hebei ChinaDepartment of Cardiology the Second Hospital of Hebei Medical University Shijiazhuang Hebei ChinaDepartment of Cardiology the Second Hospital of Hebei Medical University Shijiazhuang Hebei ChinaDepartment of Cardiology the Hai‐gang Hospital of Qinhuangdao Qinhuangdao Hebei ChinaDepartment of Cardiology the Hai‐gang Hospital of Qinhuangdao Qinhuangdao Hebei ChinaDepartment of Cardiology Handan Central Hospital Handan Hebei ChinaAbstract The purpose of this study was to investigate the effects of sacubitril/valsartan on right ventricular (RV) function in patients with pulmonary hypertension (PH) due to heart failure with reduced ejection fraction (HFrEF). We prospectively enrolled patients with HFrEF‐induced PH admitted to the Department of Cardiology between August 2018 and December 2019. Patients were randomized to receive oral treatment with sacubitril/valsartan or enalapril. Epidemiological data were recorded before treatment. Echocardiography was performed at admission and 6 months of follow‐up, and all parameters were compared. Major adverse cardiac events (MACEs) were compared between baseline and 6 months follow‐up. There were no significant differences in the baseline characteristics between the two groups. After 6 months of treatment, both treatment groups improved the following parameters from baseline (mean ± SD): left atrium, left ventricle, the left ventricular ejection function (LVEF), RV systolic function (the tricuspid annular plane systolic excursion [TAPSE], the systolic pulmonary artery pressure [sPAP], and TAPSE/sPAP). After 6 months, sacubitril/valsartan improved significantly the following parameters compared with enalapril (all p < 0.05): LVEF (47.07 ± 6.93% vs. 43.47 ± 7.95%); TAPSE (15.33 ± 1.31 vs. 14.78 ± 1.36 mm); sPAP (36.76 ± 14.32 vs. 42.26 ± 12.07 mmHg); and TAPSE/sPAP ratio (0.50 ± 0.23 vs. 0.39 ± 0.14), respectively. There was no difference in readmissions due to recurrent heart failure. Sacubitril/valsartan seems to provide more beneficial effects among patients with HFrEF‐induced PH to improve RV function, along with a decrease in pulmonary pressure.https://doi.org/10.1002/pul2.12034heart failure with reduced ejection fractionPH‐LHDright ventriclesacubitril/valsartanTAPSE/sPAP
spellingShingle Ying Zhao
Li‐guo Tian
Li‐xin Zhang
Tao Ma
Liang Di
Yan‐bo Wang
Xin‐shun Gu
Dan‐dan Wang
Shang Gao
Haiyan Wang
The comparative effects of sacubitril/valsartan versus enalapril on pulmonary hypertension due to heart failure with a reduced ejection fraction
Pulmonary Circulation
heart failure with reduced ejection fraction
PH‐LHD
right ventricle
sacubitril/valsartan
TAPSE/sPAP
title The comparative effects of sacubitril/valsartan versus enalapril on pulmonary hypertension due to heart failure with a reduced ejection fraction
title_full The comparative effects of sacubitril/valsartan versus enalapril on pulmonary hypertension due to heart failure with a reduced ejection fraction
title_fullStr The comparative effects of sacubitril/valsartan versus enalapril on pulmonary hypertension due to heart failure with a reduced ejection fraction
title_full_unstemmed The comparative effects of sacubitril/valsartan versus enalapril on pulmonary hypertension due to heart failure with a reduced ejection fraction
title_short The comparative effects of sacubitril/valsartan versus enalapril on pulmonary hypertension due to heart failure with a reduced ejection fraction
title_sort comparative effects of sacubitril valsartan versus enalapril on pulmonary hypertension due to heart failure with a reduced ejection fraction
topic heart failure with reduced ejection fraction
PH‐LHD
right ventricle
sacubitril/valsartan
TAPSE/sPAP
url https://doi.org/10.1002/pul2.12034
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