Heart failure & cardiomyopathiesRandomised controlled trial
Angiotensin Receptor Neprilysin Inhibitor in Heart Failure With Preserved Ejection Fraction and Secondary Mitral Regurgitation: The PRAISE-MR Randomized Trial
- Randomised controlled trial
- multicentre
- open-label
- blinded primary endpoint assessment
Authors' conclusion
In HFpEF and AFMR, sacubitril/valsartan was associated with improvements in exercise hemodynamics and peak VO2, along with attenuation of the exercise-induced increase in AFMR.
Study context
- Population
- Symptomatic heart failure with preserved ejection fraction (HFpEF) with at least moderate atrial functional mitral regurgitation within the previous year
- Participants
- 84 participants
- Comparison
- Sacubitril/valsartan vs standard of care
- Sacubitril/valsartann = 41
- Standard-of-care (SOC)n = 43reference
- Primary endpoint
- Change in exercise mPAP/CO slope (CPET with simultaneous echocardiography)
- Follow-up
- 6 months
Primary result
mPAP/CO slope
Adjusted between-group difference in change
−0.93 mm Hg/L/min
95% CI −1.80 to −0.07
P = 0.035
Sacubitril/valsartan vs SOC
adjusted between-group difference in change −0.93 mm Hg/L/min (95% CI −1.80 to −0.07); P = 0.035
As reported in the abstract
Secondary outcomes
KCCQ · 6 months
P = 0.002
Mean change, mL/kg/min
| Outcome | Sacubitril/valsartan | SOC | P value |
|---|---|---|---|
| Peak VO2 · 6 months | +0.9 | −0.6 | P = 0.002 |
NT-proBNP and left atrial (LA) volume
- Significant reductions in NT-proBNP and LA volume
- P < 0.001 for both
Dynamic mitral regurgitation (MR) increase during exercise
- Significant blunting of the dynamic MR increase during exercise
- P = 0.020
Safety
Dose titration
- Target dose achieved
- 60%
- Symptomatic hypotension was the primary titration-limiting factor
Original publication
Angiotensin Receptor Neprilysin Inhibitor in Heart Failure With Preserved Ejection Fraction and Secondary Mitral Regurgitation: The PRAISE-MR Randomized Trial. Circulation. Published 9 May 2026. doi:10.1161/circulationaha.126.080833
Summarised from the published abstract; every number is checked against it