Study on the Efficacy of Sacubitril/Valsartan in Patients with Heart Failure with Preserved Ejection Fraction Undergoing Peritoneal Dialysis

Cardiology. 2023;148(5):385-394. doi: 10.1159/000531217. Epub 2023 May 30.

Abstract

Introduction: Cardiovascular disease is the most common cause of death and morbidity in patients with end-stage renal disease. Sacubitril/valsartan (SAC/VAL) can reduce the risk of cardiovascular mortality among patients with heart failure (HF). The present study set out to evaluate the efficacy of SAC/VAL in the treatment of patients with HF with preserved ejection fraction (HFpEF) undergoing peritoneal dialysis (PD) (HFpEF&PD).

Methods: A total of 160 patients with HFpEF&PD were enrolled and randomly divided into the control group (N = 80) and SAC/VAL group (N = 80). The cardiac function efficacy, HF scoring efficacy, echocardiographic parameters, serological indicators, and 6-minute walking test were compared before and after treatment.

Results: After 6 months of treatment, the total number of patients who responded to treatment in the SAC/VAL group was higher than that of the control group in terms of cardiac function and HF scoring efficacy. After treatment, levels of early diastolic/late diastolic filling velocity and left ventricular ejection fraction were increased in both groups, while the levels of left atrial diameter, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, inter-ventricular septal diameter, and left ventricular posterior wall diameter were decreased; the NT-proBNP levels were diminished in both groups, while hemoglobin levels and the 6-minute walk distance were increased; the systolic blood pressure, diastolic blood pressure, and 24-h ultrafiltration volume were lowered in all patients. The changes in these indexes in the SAC/VAL group were more obvious than those in the controls.

Conclusion: SAC/VAL can significantly improve cardiac function in patients with HFpEF&PD.

Keywords: 24‐h ultrafiltration volume; Cardiac function; Efficacy; Heart failure with preserved ejection fraction; N-Terminal pro-brain natriuretic peptide; Peritoneal dialysis; Sacubitril/valsartan; Volumetric loading.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Biphenyl Compounds
  • Drug Combinations
  • Heart Failure* / drug therapy
  • Humans
  • Stroke Volume / physiology
  • Valsartan* / therapeutic use
  • Ventricular Function, Left / physiology

Substances

  • Biphenyl Compounds
  • Drug Combinations
  • sacubitril
  • Valsartan