Effect of Sacubitril/valsartan combined with dapagliflozin on right ventricular function in patients with pulmonary hypertension associated with left heart disease
Zhao Ying
Ma Tao
Zhang Lixin
Tian Liguo
Di Liang
Wang Yanbo
Gu Xinshun
Wang Dandan
Gao Shang
Zhu Xiaoling
Abstract：Objective This study aimed to investigate the impact of combined administration of Sacubitril/valsartan and dapagliflozin on right ventricular function in patients with pulmonary hypertension associated with left heart disease.Methods The study included patients with pulmonary hypertension(PH)caused by heart failure with reduced ejection fraction(HFr EF)who were hospitalized in the Cardiology Department of Haigang Hospital,Qinhuangdao,between June 2021 and December 2022.The patients were randomly assigned to either the observation group or the control group.The observation group received gradual titration of sacubitril/valsartan up to 100 mg 2/d and dapagliflozin 10 mg 1/d.The control group received gradual titration of enalapril up to 10 mg 1/d and dapagliflozin 10 mg 1/d.Baseline data and echocardiographic examination data were recorded after 6 months of treatment,including left atrium(LA),left ventricle(LV),left ventricular ejection fraction(LVEF),tricuspid annular plane systolic excursion(TAPSE),tricuspid annular velocity(S'),fractional area change(FAC),systolic pulmonary artery pressure(sPAP),and TAPSE/sPAP.Major adverse cardiac events(MACE)were compared after a 6-month follow-up.Results There were no significant differences in baseline characteristics between the two groups.After 6 months of treatment,the observation group showed higher LVEF,S',FAC,TAPSE,and TAPSE/sPAP compared to the control group,while LA,LV,LVESV,sPAP,and PA/AO were lower in the observation group compared to the control group.These differences were statistically significant(P<0.05).The observation group also exhibited lower levels of NT-proBNP,heart rate,SBP,DBP,and higher 6-minute walking distance(6MWD)compared to the control group,with statistically significant differences(P<0.05).There were no statistically significant differences in treatment duration,mortality,or rehospitalization within 6 months between the two groups(P>0.05).Conclusion The combined administration of Sacubitril/valsartan and dapagliflozin significantly improves right ventricular function in patients with pulmonary hypertension related to left heart disease.
Keywords：Heart failure with reduced ejection fractionSacubitril/valsartanPH-LHDRight ventricle
Publication Date：2023-08-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 958-961,966 )