Sacubitril/valsartan affects pulmonary arterial pressure in heart failure with preserved ejection fraction and pulmonary hypertension

• DOI: 10.1002/ehf2.13952
• Publication Date: 2022-05-19T09:49:23Z
• Authors: Pau Codina; Mar Domingo; Elena Barceló; Paloma Gastelurrutia; Daniel Casquete; Joan Vila; Omar Abdul‐Jawad ...; Giosafat Spitaleri; Germán Cediel; Evelyn Santiago‐V...; Elisabet Zamora; María Ruiz‐Cueto; Javier Santesmases; Rafael de la Espr...; Domingo A. Pascua...; Julio Nuñez; Josep Lupón; Antoni Bayes‐Genis
• Keywords: Sacubitril; Sacubitril, Valsartan

Abstract Aims Prior studies have not fully characterized the haemodynamic effects of angiotensin receptor‐neprilysin inhibitor (ARNI) sacubitril/valsartan in heart failure with preserved ejection fraction and pulmonary hypertension (HFpEF–PH). The aim Treatment PH With Angiotensin II Receptor Blocker Neprilysin Inhibitor HFpEF Patients CardioMEMS Device (ARNIMEMS‐HFpEF) study is to assess artery pressure (PAP) dynamics by means implanted PAP monitors patients HFpEF–PH treated sacubitril/valsartan. Methods results This single‐arm, investigator‐initiated, interventional included 14 consecutive ambulatory symptomatic who underwent implantation prior enrolment [mean 60.4 ± 7.2%, baseline mean (mPAP) 33.9 7.6 mmHg]. Daily values were examined during three periods: a 6 week period after before treatment (pre‐ARNI), (ARNI ON), withdrawal OFF). primary endpoint was change mPAP without Secondary endpoints changes min walking distance, B‐line sum lung ultrasound, quality life (QoL). During period, 1717 measurements recorded. Between pre‐ARNI vs. ARNI ON, significantly declined −4.99 mmHg [95% confidence interval (CI) −5.55 −4.43]. ON OFF, increased +2.84 CI +2.26 +3.42]. we found an improvement B‐lines, QoL. Mean loop diuretic management did differ between periods. Conclusions Sacubitril/valsartan reduced HFpEF–PH, independent management, together functional capacity, congestion, may be therapeutic alternative HFpEF–PH.