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Brockmöller, Janine; Ivanoski, Stevan; Hundack, Lukas; Blohm, Jan-Henrik; Januszewski, Monika; Remppis, Bjoern Andrew; Burgdorf, Christof

Clinical and Hemodynamic Improvement in Pulmonary Hypertension After Switching to Sacubitril/Valsartan in Patients With Heart Failure With Preserved Ejection Fraction

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  • Media type: E-Article
  • Title: Clinical and Hemodynamic Improvement in Pulmonary Hypertension After Switching to Sacubitril/Valsartan in Patients With Heart Failure With Preserved Ejection Fraction
  • Contributor: Brockmöller, Janine; Ivanoski, Stevan; Hundack, Lukas; Blohm, Jan-Henrik; Januszewski, Monika; Remppis, Bjoern Andrew; Burgdorf, Christof
  • imprint: Ovid Technologies (Wolters Kluwer Health), 2023
  • Published in: Journal of Cardiovascular Pharmacology
  • Language: English
  • DOI: 10.1097/fjc.0000000000001477
  • ISSN: 0160-2446
  • Keywords: Cardiology and Cardiovascular Medicine ; Pharmacology
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract:</jats:title> <jats:p>Patients with heart failure with preserved ejection fraction (HFpEF) and pulmonary hypertension have poor survival, and established medical therapies for both conditions are not available. In this retrospective study of 69 patients with HFpEF and either isolated postcapillary pulmonary hypertension (IpcPH, n = 53) or combined postcapillary and precapillary pulmonary hypertension (CpcPH, n = 16), we investigated the effects of sacubitril/valsartan on pulmonary hypertension measured using right heart catheterization at baseline (ie, presacubitril/valsartan) and 99 (94–123) days after switching to sacubitril/valsartan. After switching to sacubitril/valsartan, right heart catheterization showed significantly lower pulmonary artery pressures (systolic/diastolic/mean) in both patient groups compared with presacubitril/valsartan [IpcPH: 44 (38–52)/15 (12–19)/28 (22–33) mm Hg vs. 47 (40–55)/18 (15–23)/31 (26–35) mm Hg, <jats:italic toggle="yes">P</jats:italic> &lt; 0.01; CpcPH: 54 (43–57)/18 (12–23)/34 (30–36) mm Hg vs. 61 (50–79)/24 (19–30)/40 (31–53) mm Hg, <jats:italic toggle="yes">P</jats:italic> &lt; 0.05]. The median sacubitril/valsartan dose at follow-up was 24/26 (24/26–49/51) mg twice daily in both patients with IpcPH and CpcPH. Clinically, the New York Heart Association functional class improved by at least 1 class in 32 of 69 patients (<jats:italic toggle="yes">P</jats:italic> &lt; 0.01). In conclusion, sacubitril/valsartan therapy improves pulmonary hypertension in patients with HFpEF and either IpcPH or CpcPH. Further prospective randomized trials are needed for confirmation of our results.</jats:p>