Efficacy of Sacubitril/Valsartan in Treating Hemodialysis Patients with Reduced Ejection Fraction Heart Failure: A Retrospective Study.

INTRODUCTION

Heart failure with reduced ejection fraction (HFrEF) is a prevalent and challenging complication among patients undergoing hemodialysis. Sacubitril/Valsartan (Sac-Val), an angiotensin receptor-neprilysin inhibitor, has shown promise in improving cardiac outcomes in HFrEF patients. This study aims to evaluate the efficacy and safety of Sac-Val in treating HFrEF in patients undergoing hemodialysis.

METHODS

This retrospective analysis was conducted on 30 patients with HFrEF undergoing regular hemodialysis at Beijing Shijingshan Hospital between January 2019 and January 2023. The patients were divided into two groups: the Sac-Val group (14 patients) and the control group (16 patients). The Sac-Val group received an initial dose of 50 mg, titrated over four weeks to a maximum tolerated dose of 100 mg, while the control group received conventional heart failure treatment without Sac-Val. Both groups continued regular hemodialysis three times weekly. Statistical analysis included independent t-tests or Mann-Whitney U tests for continuous variables, and chi-square or Fisher's exact tests for categorical variables. Heart failure improvements, blood pressure, NT-proBNP levels, biochemical markers, and echocardiographic changes were assessed after one year.

RESULTS

The Sac-Val group showed significant improvements in systolic blood pressure (P = .027), NT-proBNP levels (P < .05), left ventricular ejection fraction (LVEF) (P < .04) compared to the control group. The Sac-Val group also had a higher total effective rate (85.71%) in alleviating heart failure symptoms compared to the control group (69%, P = .023).

CONCLUSION

Sac-Val is a safe and effective treatment for HFrEF patients undergoing hemodialysis, potentially improving their quality of life, heart function and clinical outcomes.