Sacubitril/Valsartan Improves Heart and Lung Blood Flow in Patients Awaiting Heart Transplant | Research

The takeaway

Switching to sacubitril/valsartan improved both pulmonary and systemic hemodynamics in advanced heart failure patients on the heart transplant waiting list.

Improved
pulmonary and systemic hemodynamics after switching to sacubitril/valsartan

What the researchers found

Sacubitril/valsartan improved hemodynamic parameters of both pulmonary and systemic circulation compared to conventional ACE inhibitors/ARBs in patients with advanced heart failure awaiting transplantation.

Why it matters

Improving hemodynamics while waiting for transplant can reduce complications, improve quality of life, and potentially improve transplant candidacy and outcomes.

The numbers in context

Retrospective analysis; improved echocardiographic and hemodynamic parameters; reduced NT-proBNP; patients awaiting HTX.

How the study worked

Retrospective analysis comparing echocardiographic, laboratory, and hemodynamic parameters before and after switching to sacubitril/valsartan in advanced heart failure patients awaiting heart transplantation.

Who was studied

Advanced heart failure patients awaiting heart transplantation

What this study cannot tell us

Retrospective study design limits causal conclusions; single-center data; no randomized control group; small sample size typical for transplant-waitlist populations.

How to read the evidence

Retrospective single-center study; provides useful clinical data but lacks the rigor of a randomized controlled trial.

When this study was published

Published in 2025, adding to the evidence for sacubitril/valsartan in the most severe heart failure populations.

The bigger picture

Sacubitril/valsartan works partly by preventing the breakdown of natriuretic peptides (via neprilysin inhibition), demonstrating how peptide-pathway modulation can have profound effects on cardiovascular hemodynamics.

Questions still open

Does sacubitril/valsartan-related hemodynamic improvement translate to better post-transplant outcomes?
Could some patients improve enough on this therapy to be delisted from transplant waiting lists?

Common questions

What is sacubitril/valsartan?

Sacubitril/valsartan (Entresto) is a combination medication that boosts beneficial natriuretic peptides (by inhibiting the enzyme neprilysin that breaks them down) while blocking harmful angiotensin II signaling. It is a cornerstone treatment for heart failure.

How does this help transplant patients?

By improving blood flow through both the lungs and body, sacubitril/valsartan can stabilize patients during the often lengthy wait for a donor heart, potentially reducing hospitalizations and improving overall condition before surgery.

Read the original research

Sacubitril/Valsartan Improves Hemodynamic Parameters of Pulmonary and Systemic Circulation in Patients Awaiting Heart Transplantation.

Journal of clinical medicine, 14(8)

View on PubMed ↗Publisher’s paper ↗

Citation

Ráduly, Arnold Péter; Saman Kothalawala, Edward; Balogh, László; Majoros, Zsuzsanna; Pólik, Zsófia; Fülöp, László; Győry, Ferenc; Nagy, László; Bódi, Beáta; Kovács, Máté Balázs; Csanádi, Zoltán; Papp, Zoltán; Muk, Balázs; Borbély, Attila. (2025). Sacubitril/Valsartan Improves Hemodynamic Parameters of Pulmonary and Systemic Circulation in Patients Awaiting Heart Transplantation.. Journal of clinical medicine, 14(8). https://doi.org/10.3390/jcm14082539