A randomized clinical trial on the short‐term effects of 12‐week sacubitril/valsartan vs. enalapril on peak oxygen consumption in patients with heart failure with reduced ejection fraction: results from the <scp>ACTIVITY‐HF</scp> study

Halle, Martin; Schöbel, Christoph; Winzer, Ephraim B; Bernhardt, Peter; Sieder, Christian; Lecker, Laura S.M.

doi:10.1002/ejhf.2355

Cited by 26 publications

(36 citation statements)

References 32 publications

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“…ACTIVITY‐HF is a randomized controlled trial that enrolled 201 patients with HFrEF and aimed at comparing the effects of sacubitril/valsartan versus enalapril on exercise capacity. The primary endpoint of change from baseline to 12 weeks in peak oxygen consumption did not differ between groups 7 . Results are consistent with previous findings form the OUTSTEP‐HF trial 8 …”

Section: Guideline‐directed Medical Therapysupporting

confidence: 90%

December 2021 at a glance: focus on medical treatment, valvular heart disease and prognostic models

Tomasoni

Adamo

Metra

2021

European J of Heart Fail

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Section: Guideline‐directed Medical Therapysupporting

confidence: 90%

December 2021 at a glance: focus on medical treatment, valvular heart disease and prognostic models

Tomasoni

Adamo

Metra

2021

European J of Heart Fail

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“…A blockade showed positive effects on the ventricular geometry, morbidity and mortality in HFrEF [14]. Interestingly, no short-term effect on maximal exercise capacity could be proven [15]. With ischemia and hypertension as leading causes of CHF in general, a positive in uence of a blockade of the renin-angiotensin-aldosterone system on cardiac remodeling could be assumed independently of the ejection fraction.…”

Section: Discussionmentioning

confidence: 99%

Myocardial Deformation Parameters Assessed By CMR Feature Tracking In Chronic Heart Failure: The Influence of An Optimal Medical Therapy On Myocardial Remodeling

Kersten

Hackenbroch

Gann³

et al. 2021

Preprint

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Background: Myocardial deformation parameters have been shown to yield early detection of pathological changes in chronic heart failure (CHF). Aim of our study was to evaluate myocardial deformation changes under optimal medical therapy (OMT) in CHF patients.Methods: CHF patients were examined longitudinally with two cardiac magnetic resonance imaging (CMR) examinations at a median time interval of 140 days. Left and right ventricular volumes were quantified, and deformation analysis was performed using feature tracking, respectively.Results: 57 patients were included into the study. There was a high rate of OMT with a prescription of beta blockers in 98.2% and ACE-inhibitors/Angiotensin receptor blockers in 93.0%. In the total cohort, there were indications of positive remodeling with a significant improvement in left ventricular (LV) ejection fraction (38.9% ± 11.6 vs. 43.0% ± 12.7, p=0.009), LV enddiastolic volume indexed (92.1ml/m2 ± 23.5 vs. 87.2ml/m2 ± 21.2, p=0.007), LV mass (140.3g ± 35.7 vs. 128.0g ± 34.4, p=0.001) and right ventricular global longitudinal strain (RV GLS) (-18.1% ± 5.1 vs. -20.3% ± 4.5, p<0.001) during follow-up. Discussion: Patients with CHF and OMT show positive reverse remodeling with improvement of LV volumes and function and RV GLS. This has a potential impact on the surveillance of this patient group, which should be further investigated in larger prospective studies.

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“…The detailed characteristics of 16 studies (10,19,20,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38) are shown in Table 1. Most of the data are come from ClinicalTrials.gov, 14 trials are multi-center and 12 trials are aimed at patients with HF.…”

Section: Study Characteristicsmentioning

confidence: 99%

Effect of Sacubitril/Valsartan on Reducing the Risk of Arrhythmia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Wang

et al. 2022

Front. Cardiovasc. Med.

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Background and ObjectiveRelevant data of PARADIGM-HF reveals sacubitril/valsartan (SV) therapy led to a greater reduction in the risks of arrhythmia, and sudden cardiac death than angiotensin converting enzyme inhibitor (ACEI)/angiotensin receptor inhibitor (ARB) therapy in HFrEF, however, inconsistent results were reported in subsequent studies. Here, we conduct a meta-analysis of related randomized controlled trials (RCTs) to evaluate the protective effect of SV on reducing the risk of arrhythmias.Methods and ResultsRCTs focused on the difference in therapeutic outcomes between SV and ACEI/ARB were searched from PUBMED, EMBASE, ClinicalTrials.gov, and Cochrane Library. The results were extracted from each individual study, expressed as binary risk, 95% confidence interval (CI) and relative risk (RR). Sixteen RCTs including 22, 563 patients met the study criteria. Compared with ACEI/ARB therapy, SV therapy did significantly reduce in the risks of severe arrhythmias among patients with heart failure with reduced ejection fraction (HFrEF) (RR 0.83, 95% CI 0.73–0.95, p = 0.006), ventricular tachycardia (VT) among patients with HFrEF (RR 0.69, 95% CI 0.51–0.92, p = 0.01), cardiac arrest among patients with heart failure (HF) (RR 0.52, 95% CI 0.37–0.73, p = 0.0002), cardiac arrest among patients with HFrEF (RR 0.49, 95% CI 0.32–0.76, p = 0.001), cardiac arrest or ventricular fibrillation (VF) among patients with HF (RR 0.63, 95% CI 0.48–0.83, p = 0.001), and cardiac arrest or VF among patients with HFrEF (RR 0.65, 95% CI 0.47–0.89, p = 0.008), but reduced the risks of arrhythmias (RR 0.87, 95% CI 0.74–1.01, p = 0.07), atrial arrhythmias (RR 0.98, 95% CI 0.83–1.16, p = 0.85), and atrial fibrillation (RR 0.98, 95% CI 0.82–1.17, p = 0.82) among all patients with no significant between-group difference. The merged result was robust after sensitivity analysis, and there was no publication bias.ConclusionOur meta-analysis provides evidence that, compared with ACEI/ARB, SV can additionally reduce the risks of most arrhythmias, just the significant differences are revealed in reducing the risks of VT, severe arrhythmias, and cardiac arrest in patients with HFrEF. Besides, the positive effect of SV on VF according to statistical result of combining VF with cardiac arrest in patients with HFrEF is credibility.

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A randomized clinical trial on the short‐term effects of 12‐week sacubitril/valsartan vs. enalapril on peak oxygen consumption in patients with heart failure with reduced ejection fraction: results from the ACTIVITY‐HF study

Abstract: ACTIVITY-HF was a randomized, double-blind, active-controlled study, which assessed the short-term effect of sacubitril/valsartan compared with the active comparator enalapril on improving maximal exercise capacity in patients with heart failure with reduced ejection fraction (HFrEF).

Cited by 26 publications

References 32 publications

December 2021 at a glance: focus on medical treatment, valvular heart disease and prognostic models

December 2021 at a glance: focus on medical treatment, valvular heart disease and prognostic models

Myocardial Deformation Parameters Assessed By CMR Feature Tracking In Chronic Heart Failure: The Influence of An Optimal Medical Therapy On Myocardial Remodeling

Effect of Sacubitril/Valsartan on Reducing the Risk of Arrhythmia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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