Sacubitril/Valsartan Improves Hemodynamic Parameters of Pulmonary and Systemic Circulation in Patients Awaiting Heart Transplantation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population, Measured Parameters
2.2. Right Heart Catheterization
2.3. Statistics
3. Results
3.1. Patient Characteristics
3.2. Effectiveness and Safety of ARNI—Changes in NYHA Class, LVEF and NT-proBNP
3.3. ARNI Significantly Improved Hemodynamic Parameters of Both Systemic and Pulmonary Circulation
3.4. Clinical Outcomes
4. Discussion
5. Study Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameter | Study Population (N = 13) |
---|---|
Age, n (%) | 56.4 ± 2.49 |
Female, n (%) | 3 (23) |
Male, n (%) | 10 (77) |
BMI, (kg/m2) | 27.9 ± 2.82 |
Time on ARNI therapy, (month, IQR) | 6.8 (4.9–16.1) |
Etiology, n (%) | |
Ischemic | 6 (46.2) |
Non-ischemic | 7 (53.8) |
NYHA class, n (%) | |
III | 11 (84.5) |
IV | 2 (15.5) |
GDMT, n (%) | |
ACEI/ARB | 13 (100) |
BB | 13 (100) |
MRA | 13 (100) |
SGLT2 inhibitor | 4 (31) |
≥50% of target GDMT, n (%) | |
ACEI/ARB | 13 (100) |
BB | 12 (92.7) |
MRA | 10 (76.9) |
SGLT2 inhibitor | 4 (31) |
Device therapy, n (%) | |
ICD | 12 (92.3) |
CRT-D | 1 (7.7) |
Comorbidities, risk factors n (%) | |
Hypertension | 7 (54) |
Diabetes mellitus (type-2) | 4 (31) |
Previous MI | 4 (31) |
Atrial fibrillation | 6 (46) |
CKD | 4 (31) |
COPD | 3 (23) |
Hyperlipidemia | 7 (54) |
Previous smoker | 5 (39) |
Previous alcohol consumption | 2 (15.5) |
Parameter | ACEI/ARB Therapy (N = 13) | ARNI Therapy (N = 13) | p-Value |
---|---|---|---|
NYHA class, n (%) | |||
I | 0 (0) | 1 (7.8) | |
II | 0 (0) | 6 (46.1) | <0.001 |
III | 11 (84.5) | 6 (46.1) | |
IV | 2 (15.5) | 0 | |
GDMT, n (%) | |||
ACEI | 13 (100) | 0 (0) | |
ARNI | 0 (0) | 13 (100) | n.a. |
BB | 13 (100) | 13 (100) | |
MRA | 13 (100) | 13 (100) | |
SGLT2 inhibitor | 4 (31) | 4 (31) | |
≥50% of target GDMT, n (%) | |||
ACEI | 13 (100) | 0 (0) | |
ARNI | 0 (0) | 10 (76.9) | n.a. |
BB | 12 (92.7) | 12 (92.7) | |
MRA | 10 (76.9) | 12 (92.7) | |
SGLT2 inhibitor | 4 (31) | 4 (31) | |
Target dose of ARNI, n (%) | |||
<50% | n.a. | 10 (76.9) | n.a. |
≥50% | n.a. | 3 (23.1) | n.a. |
Laboratory parameters | |||
NT-proBNP (pg/mL) | 2847 (1444–4977) | 2055 (1313–2754) | 0.092 |
eGFR (mL/min/1.73 m2) | 70.8 ± 5.18 | 67.9 ± 5.69 | 0.433 |
Serum creatinine (µmol/L) | 97.9 ± 7.32 | 103.1 ± 8.53 | 0.279 |
BUN (mmol/L) | 8.6 ± 1.07 | 9.5 ± 1.12 | 0.223 |
Potassium (mmol/L) | 4.39 ± 0.13 | 4.5 ± 0.11 | 0.533 |
Echocardiography | |||
LVEF (%) | 23.65 ± 1.02 | 27.27 ± 1.04 | 0.016 |
EDD (mm) | 75 ± 3.04 | 77.1 ± 2.61 | n.s. |
Hemodynamics | |||
sSBP (mmHg) | 116 (98–124.5) | 106 (101–116) | 0.197 |
dSBP (mmHg) | 67.9 ± 2.84 | 62.8 ± 1.85 | 0.193 |
mSBP (mmHg) | 85 (75–86.5) | 79 (72.5–84) | 0.260 |
sPAP (mmHg) | 46 ± 3.42 | 43.8 ± 3.52 | 0.421 |
dPAP (mmHg) | 22 ± 1.4 | 19.6 ± 1.6 | 0.118 |
mPAP (mmHg) | 32 (25.5–38.5) | 27.92 (17.5–35) | 0.168 |
SVR (dyn·s·cm−5) | 1600 ± 100.5 | 1188 ± 79.8 | 0.004 |
PVR (dyn·s·cm−5) | 278.9 ± 31.7 | 232.5 ± 34.8 | 0.04 |
SV (mL) | 55.5 ± 4.12 | 70.9 ± 5.9 | 0.013 |
CO (L/min) | 3.83 ± 0.24 | 4.9 ± 0.35 | 0.013 |
CI (L/min/m2) | 1.84 ± 0.1 | 2.35 ± 0.16 | 0.009 |
HR (1/min) | 70 ± 1.8 | 71 ± 2.71 | 0.593 |
CVP (mmHg) | 8.31 ± 1.62 | 6.62 ± 1.16 | 0.321 |
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Ráduly, A.P.; Saman Kothalawala, E.; Balogh, L.; Majoros, Z.; Pólik, Z.; Fülöp, L.; Győry, F.; Nagy, L.; Bódi, B.; Kovács, M.B.; et al. Sacubitril/Valsartan Improves Hemodynamic Parameters of Pulmonary and Systemic Circulation in Patients Awaiting Heart Transplantation. J. Clin. Med. 2025, 14, 2539. https://doi.org/10.3390/jcm14082539
Ráduly AP, Saman Kothalawala E, Balogh L, Majoros Z, Pólik Z, Fülöp L, Győry F, Nagy L, Bódi B, Kovács MB, et al. Sacubitril/Valsartan Improves Hemodynamic Parameters of Pulmonary and Systemic Circulation in Patients Awaiting Heart Transplantation. Journal of Clinical Medicine. 2025; 14(8):2539. https://doi.org/10.3390/jcm14082539
Chicago/Turabian StyleRáduly, Arnold Péter, Edward Saman Kothalawala, László Balogh, Zsuzsanna Majoros, Zsófia Pólik, László Fülöp, Ferenc Győry, László Nagy, Beáta Bódi, Máté Balázs Kovács, and et al. 2025. "Sacubitril/Valsartan Improves Hemodynamic Parameters of Pulmonary and Systemic Circulation in Patients Awaiting Heart Transplantation" Journal of Clinical Medicine 14, no. 8: 2539. https://doi.org/10.3390/jcm14082539
APA StyleRáduly, A. P., Saman Kothalawala, E., Balogh, L., Majoros, Z., Pólik, Z., Fülöp, L., Győry, F., Nagy, L., Bódi, B., Kovács, M. B., Csanádi, Z., Papp, Z., Muk, B., & Borbély, A. (2025). Sacubitril/Valsartan Improves Hemodynamic Parameters of Pulmonary and Systemic Circulation in Patients Awaiting Heart Transplantation. Journal of Clinical Medicine, 14(8), 2539. https://doi.org/10.3390/jcm14082539