Heart failure & cardiomyopathiesRandomised controlled trial
Short-Term Effects of Sacubitril/Valsartan Therapy on Myocardial Oxygen Consumption and Energetic Efficiency of Cardiac Work in Heart Failure with Reduced Ejection Fraction: A Randomized Controlled Study
- Randomised controlled trial
- phase IV
- prospective
- double-blind
- parallel-group
- 6-week valsartan run-in
Authors' conclusion
We found no differences in the energetic efficiency of cardiac work between ARNI and valsartan-only groups in HFrEF patients. However, ARNI appears to have haemodynamic and cardiac mechanical effects over valsartan in heart failure patients.
Study context
- Population
- Heart failure with reduced ejection fraction (HFrEF), NYHA class II–III, left ventricular ejection fraction (LVEF) ≤35%
- Participants
- 55 participants
- Comparison
- Sacubitril/valsartan vs valsartan
- Angiotensin receptor-neprilysin inhibitor (ARNI)n = 27
- Valsartan-onlyn = 28reference
- Primary endpoint
- Energetic efficiency of cardiac work (echocardiography and 11 C-acetate PET)
- Follow-up
- 6 weeks of therapy
Primary result
As reported in the abstract
Energetic efficiency of cardiac work · 6 weeks
- Unchanged in both treatment arms
Further findings
| Outcome | ARNI | Valsartan-only | Estimate | P value |
|---|---|---|---|---|
| DBP, SBP, myocardial perfusion, LV mechanical work · 6 weeks · DBP | difference −4.5 mmHg | P = 0.026 | ||
| DBP, SBP, myocardial perfusion, LV mechanical work · 6 weeks · SBP | difference −9.8 mmHg | P = 0.0007 | ||
| DBP, SBP, myocardial perfusion, LV mechanical work · 6 weeks · myocardial perfusion | difference −0.054 ml/g/min | P = 0.045 | ||
| DBP, SBP, myocardial perfusion, LV mechanical work · 6 weeks · LV mechanical work | difference −296 | P = 0.038 | ||
| Myocardial oxygen consumption (change vs run-in) · 6 weeks · not significant | −5.4% | +0.5% | P = 0.088 |
Original publication
Short-Term Effects of Sacubitril/Valsartan Therapy on Myocardial Oxygen Consumption and Energetic Efficiency of Cardiac Work in Heart Failure with Reduced Ejection Fraction: A Randomized Controlled Study. Eur J Heart Fail. Published 16 November 2023. doi:10.1002/ejhf.3072
Summarised from the published abstract; every number is checked against it