{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T20:31:57Z","timestamp":1788294717706,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T00:00:00Z","timestamp":1669680000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["?????U1904134"],"award-info":[{"award-number":["?????U1904134"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009101","name":"Education Department of Henan Province","doi-asserted-by":"publisher","award":["grant no. YXKC2020014"],"award-info":[{"award-number":["grant no. YXKC2020014"]}],"id":[{"id":"10.13039\/501100009101","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Pulmonary hypertension (PH) is a common complication of end-stage renal disease which is associated with adverse outcomes including all-cause mortality and cardiovascular events. Recent studies have demonstrated that Sacubitril\/Valsartan (Sac\/Val) as an enkephalinase inhibitor and angiotensin II receptor blocker could reduce pulmonary artery systolic pressure (PASP) and improve the prognosis of patients with heart failure. However, whether Sac\/Val is effective in hemodialysis (HD) patients with PH is essentially unknown. In this retrospective study, we aimed to evaluate the efficacy and safety of Sac\/Val in the treatment of PH in HD patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 122 HD patients with PH were divided into Sac\/Val group (<jats:italic>n<\/jats:italic> = 71) and ARBs group (<jats:italic>n<\/jats:italic> = 51) based on the treatment regimen. The PASP, other cardiac parameters measured by echocardiography, and cardiac biomarkers including N-terminal fragment of BNP (NT-proBNP) and cardiac troponin I (cTnI) were observed at baseline and 3 months after treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no significant differences in the baseline characteristics between the two groups. PASP decreased significantly from 45(38, 54) to 28(21, 40) mmHg in Sac\/Val group (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). PASP reduced from 41(37, 51) to 34(27, 44) mmHg in ARBs group (<jats:italic>p<\/jats:italic> &amp;lt; 0.001), and the decrease was more pronounced in the Sac\/Val group (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). In addition, improvements in the right atrial diameter (RAD), left ventricular diameter (LVD), left ventricular posterior wall thickness (LVPWT), left atrial diameter (LAD), pulmonary artery diameter (PAD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), and fractional shortening (FS) were found in Sac\/Val group (p<jats:sub>s<\/jats:sub> &amp;lt; 0.05). After 3 months, LVD, LAD, LVEDV, LVESV, LVEF, SV, and PASP were significantly improved in Sac\/Val group compared with ARBs group (p<jats:sub>s<\/jats:sub> &amp;lt;0.05). Significant reduction in NT-proBNP [35,000 (15,000, 70,000) pg\/ml vs. 7,042 (3,126, 29,060) pg\/ml, <jats:italic>p<\/jats:italic> &amp;lt; 0.001] and cTnI [0.056(0.031, 0.085) ng\/ml vs. 0.036 (0.012, 0.056) ng\/ml, <jats:italic>p<\/jats:italic> &amp;lt; 0.001) were observed in Sac\/Val group. No significant differences were observed in adverse events between the two groups (p<jats:sub>s<\/jats:sub> &amp;gt; 0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sac\/Val seems to be an efficacious regimen in PH with favorable safety and has huge prospects for treating PH in HD patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.1055330","type":"journal-article","created":{"date-parts":[[2022,11,29]],"date-time":"2022-11-29T05:59:15Z","timestamp":1669701555000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["The efficacy and safety of Sacubitril\/Valsartan on pulmonary hypertension in hemodialysis patients"],"prefix":"10.3389","volume":"9","author":[{"given":"Cong","family":"Zhao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liuwei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihan","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1053\/j.ajkd.2012.07.029","article-title":"Pulmonary hypertension in CKD","volume":"61","author":"Bolignano","year":"2013","journal-title":"Am J Kidney Dis."},{"key":"B2","doi-asserted-by":"publisher","first-page":"105905","DOI":"10.1016\/j.rmed.2020.105905","article-title":"Pulmonary hypertension in end-stage renal disease","volume":"164","author":"Devasahayam","year":"2020","journal-title":"Respir Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1111\/j.1525-139X.2006.00186.x","article-title":"Pulmonary hypertension in hemodialysis patients: an unrecognized threat","volume":"19","author":"Yigla","year":"2006","journal-title":"Semin Dial."},{"key":"B4","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1053\/j.ajkd.2019.08.027","article-title":"Pulmonary hypertension subtypes and mortality in CKD","volume":"75","author":"Edmonston","year":"2020","journal-title":"Am J Kidney Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e015708","DOI":"10.1161\/JAHA.119.015708","article-title":"Angiotensin receptor-neprilysin inhibition attenuates right ventricular remodeling in pulmonary hypertension","volume":"9","author":"Sharifi Kia","year":"2020","journal-title":"J Am Heart Assoc."},{"key":"B6","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.ccl.2021.04.004","article-title":"Pulmonary hypertension in chronic kidney disease","volume":"39","author":"Travers","year":"2021","journal-title":"Cardiol Clin."},{"key":"B7","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1053\/j.ajkd.2017.11.018","article-title":"pulmonary hypertension, mortality, and cardiovascular disease in CKD and ESRD patients: a systematic review and meta-analysis","volume":"72","author":"Tang","year":"2018","journal-title":"Am J Kidney Dis."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1016\/j.jacc.2009.01.004","article-title":"ACCF\/AHA 2009 expert consensus document on pulmonary hypertension a report of the American college of cardiology foundation task force on expert consensus documents and the American heart association developed in collaboration with the American college of chest physicians; American thoracic society. 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