{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:13:05Z","timestamp":1789416785129,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Heart Failure"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Treatment with sacubitril-valsartan reduces mortality and heart failure (HF) events in HF with reduced ejection fraction and may reduce HF hospitalization in women with HF with preserved ejection fraction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>\n              EVALUATE-HF randomized 464 participants (109 women) with HF with reduced ejection fraction to sacubitril-valsartan or enalapril for 12 weeks. Documented left ventricular ejection fraction (LVEF) \u22640.40 within the prior 12 months was required, although core laboratory LVEF&gt;0.40 was permitted. Assessments of aortic stiffness (pulse pressure and characteristic impedance, Z\n              <jats:sub>c<\/jats:sub>\n              ) were performed at baseline and at trough and 4 hours postdose at weeks 4 and 12.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              In models of change from baseline adjusted for baseline value, treatment with sacubitril-valsartan produced greater overall reductions in mean arterial pressure (treatment group difference, \u22123.0\u00b10.8 mm\u2009Hg,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and pulse pressure (\u22123.0\u00b10.8 mm\u2009Hg,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Postdose reductions in Z\n              <jats:sub>c<\/jats:sub>\n              were greater in the sacubitril-valsartan group (\u221216\u00b16 dyne\u00d7second\/cm\n              <jats:sup>5<\/jats:sup>\n              ,\n              <jats:italic>P<\/jats:italic>\n              =0.012). Post hoc analyses found evidence of effect modification by LVEF (interaction\n              <jats:italic>P<\/jats:italic>\n              =0.036). With LVEF&lt;0.40, postdose reductions in Z\n              <jats:sub>c<\/jats:sub>\n              were greater in the sacubitril-valsartan group (trough, \u22123\u00b18 dyne\u00d7second\/cm\n              <jats:sup>5<\/jats:sup>\n              versus post-dose, \u221217\u00b18 dyne\u00d7second\/cm\n              <jats:sup>5<\/jats:sup>\n              ; interaction\n              <jats:italic>P<\/jats:italic>\n              =0.024) with no sex difference (treatment\u00d7sex interaction,\n              <jats:italic>P<\/jats:italic>\n              =0.3). With LVEF\u22650.40, treatment with sacubitril-valsartan was associated with greater overall reductions in Z\n              <jats:sub>c<\/jats:sub>\n              in women (women, \u221280\u00b121 dyne\u00d7second\/cm\n              <jats:sup>5<\/jats:sup>\n              versus men, \u221220\u00b113 dyne\u00d7second\/cm\n              <jats:sup>5<\/jats:sup>\n              ; interaction\n              <jats:italic>P<\/jats:italic>\n              =0.019).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>\n              In prespecified analyses that include pre- and postdose assessments at 4 and 12 weeks, treatment with sacubitril-valsartan was associated with greater postdose reductions in aortic Z\n              <jats:sub>c<\/jats:sub>\n              . In a post hoc analysis, sacubitril-valsartan was associated with sustained reductions in Z\n              <jats:sub>c<\/jats:sub>\n              in women with LVEF\u22650.40.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique Identifier: NCT02874794.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circheartfailure.120.007891","type":"journal-article","created":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T10:00:20Z","timestamp":1614938420000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Hemodynamic Effects of Sacubitril-Valsartan Versus Enalapril in Patients With Heart Failure in the EVALUATE-HF Study"],"prefix":"10.1161","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct02874794","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5643-3145","authenticated-orcid":true,"given":"Gary F.","family":"Mitchell","sequence":"first","affiliation":[{"name":"Cardiovascular Engineering, Inc, Norwood, MA (G.F.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3698-9597","authenticated-orcid":true,"given":"Scott D.","family":"Solomon","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and Women\u2019s Hospital, Boston, MA (S.D.S., A.M.S., B.L.C., A.S.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1056-4451","authenticated-orcid":true,"given":"Amil M.","family":"Shah","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Brigham and 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