Pre–heart failure with preserved ejection fraction (pre-HFpEF) is common and has no specific therapy aside from cardiovascular risk factor management.
This RCT study sought out to investigate the hypothesis that sacubitril/valsartan vs valsartan would reduce left atrial volume index using volumetric cardiac magnetic resonance imaging in patients with pre-HFpEF.
Results found that sacubitril/valsartan vs valsartan was associated with a reduction in blood pressure, pulse pressure, and N-terminal pro-b type natriuretic peptide; an increase in maximal left atrial volume index measured by cardiac magnetic resonance imaging despite lower filling pressures; less decline in kidney function; and fewer serious adverse cardiovascular events.
These findings could reflect improved cardiac and vascular compliance or adverse cardiac remodeling, and more work is required to understand the long-term implications.
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