{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:34:57Z","timestamp":1791506097129,"version":"4.3.4"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,7,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The angiotensin\u2010receptor neprilysin inhibitor (ARNI) sacubitril\/valsartan was shown to be superior to the angiotensin\u2010converting enzyme inhibitor enalapril in terms of reducing cardiovascular mortality in the PARADIGM\u2010HF (Prospective Comparison of ARNI with angiotensin\u2010converting enzyme inhibitor to Determine Impact on Global Mortality and Morbidity in Heart Failure) study. However, the impact of ARNI on cardiac reverse remodeling (CRR) has not been established.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We conducted a meta\u2010analysis to compare the effects of ARNI versus angiotensin\u2010converting enzyme inhibitors or angiotensin receptor blockers on CRR indices. We searched databases for studies published between 2010 and 2019 that reported CRR indices following ARNI administration. Effect size was expressed as mean difference (MD) with 95% CIs. Twenty studies enrolling 10\u00a0175 patients were included. ARNI improved functional capacity in patients with heart failure (HF) and a reduced ejection fraction (EF), including increasing New York Heart Association functional class (MD \u22120.79, 95% CI \u22120.86, \u22120.71) and 6\u2010minute walking distance (MD 27.62\u00a0m, 95% CI 15.76, 39.48). ARNI outperformed angiotensin\u2010converting enzyme inhibitors\/angiotensin receptor blockers in terms of CRR indices, with striking changes in left ventricular EF, diameter, and volume. However, there were no significant improvements in indices except left ventricular mass index (MD \u22123.25\u00a0g\/m\n                      <jats:sup>2<\/jats:sup>\n                      , 95% CI \u22123.78, \u22122.72) and left atrial volume (MD \u22127.20\u00a0mL, 95% CI \u221214.11, \u22120.29) in HF patients with preserved EF treated with ARNI. Improvements in CRR indices were observed at 3\u00a0months and became more significant with\u00a0longer follow\u2010up to 12\u00a0months. The regression equation\u00a0for the relationship between left ventricular EF and end\u2010diastolic dimension was y=0.041+0.071x+0.045x\n                      <jats:sup>2<\/jats:sup>\n                      +0.006x\n                      <jats:sup>3<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">ARNI distinctly improved left ventricular size and hypertrophy compared with angiotensin\u2010converting enzyme inhibitors\/angiotensin receptor blockers in HF with reduced EF patients, even after short\u2010term follow\u2010up. Patients appeared to benefit more in terms of CRR treated with ARNI as early as possible and for at least 3\u00a0months. Further large sample trials are required to determine the effects of ARNI on CRR in HF with preserved EF patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.012272","type":"journal-article","created":{"date-parts":[[2019,6,26]],"date-time":"2019-06-26T05:04:14Z","timestamp":1561525454000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":211,"title":["Effects of the Angiotensin\u2010Receptor Neprilysin Inhibitor on Cardiac Reverse Remodeling: Meta\u2010Analysis"],"prefix":"10.1161","volume":"8","author":[{"given":"Yiwen","family":"Wang","sequence":"first","affiliation":[{"name":"Institute of Cardiovascular Disease Research Xuzhou Medical University Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Zhou","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Disease Research Xuzhou Medical University Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi","family":"Lu","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Disease Research Xuzhou Medical University Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology The Affiliated Hospital of Xuzhou Medical University Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongda","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiology The Affiliated Hospital of Xuzhou Medical University Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongye","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Disease Research Xuzhou Medical University Xuzhou Jiangsu China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61889-4"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-017-0876-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.592"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.76.1.44"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.10.007"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.10.2573"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2000.105302"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198706043162301"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14282-1"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00059-015-4346-8"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1409077"},{"key":"e_1_3_2_13_2","first-page":"e282","article-title":"2016 ACC\/AHA\/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF\/AHA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America","volume":"134","author":"Yancy CW","year":"2016","unstructured":"Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, Drazner MH, Filippatos G, Fonarow GC, Givertz MM, Hollenberg SM, Lindenfeld J, Masoudi FA, McBride PE, Peterson PN, Stevenson LW, Westlake C. 2016 ACC\/AHA\/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF\/AHA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. 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