{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T04:58:03Z","timestamp":1768539483405,"version":"3.49.0"},"reference-count":29,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T00:00:00Z","timestamp":1744070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Debrecen Program for Scientific Publication"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Heart transplantation (HTX) is the definitive treatment for advanced heart failure (AdHF). The angiotensin receptor neprilysin inhibitor (ARNI) sacubitril\/valsartan (S\/V) has been shown to reduce heart failure (HF) hospitalizations and mortality when compared to conventionally administered HF medications (i.e. angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs)). Nevertheless, limited data are available on the hemodynamic (HD) effects of ARNI in patients with AdHF. Therefore, the aim of the present study was to compare echocardiographic, laboratory, and HD parameters relevant to HF before and after switching to ARNI in patients with AdHF awaiting HTX. Methods: A retrospective analysis was conducted utilizing available data on HD parameters, N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, data on kidney function, HF therapy, and comorbidities. The study cohort comprised 13 AdHF patients (3 women, 10 men; mean age 56.4 \u00b1 9 years) of whom 53.8% presented with non-ischemic and 46.2% with ischemic etiology. All patients were awaiting heart transplantation (HTX) and were transitioned to ARNI therapy between 2018 and 2021. Results: After switching to ARNI, we observed significant improvements: in left ventricular ejection fraction (LVEF: 27.27 \u00b1 1.04% vs. 23.65 \u00b1 1.02%, p = 0.03; data are given as mean \u00b1 SEM after vs. before ARNI therapy, respectively), cardiac output (CO: 4.90 \u00b1 0.35 L\/min vs. 3.83 \u00b1 0.24 L\/min, p = 0.013), and stroke volume (SV: 70.9 \u00b1 5.9 mL vs. 55.5 \u00b1 4.12 mL, p = 0.013). Significant reductions in systemic vascular resistance (SVR: 1188 \u00b1 79.8 vs. 1600 \u00b1 100 DS\/cm5, p = 0.004) and pulmonary vascular resistance (PVR: 232.5 \u00b1 34.8 vs. 278.9 \u00b1 31.7 DS\/cm5, p = 0.04) were also noted. Central venous pressure (CVP), pulmonary arterial systolic and diastolic pressures (PAPs and PAPd), pulmonary capillary wedge pressure (PCWP), and NT-proBNP levels did not exhibit significant changes upon ARNI administration. Conclusions: Early transition to ARNI therapy offers significant benefits for invasively measured hemodynamic parameters in patients with AdHF, potentially aiding in the stabilization and improvement of this vulnerable patient population.<\/jats:p>","DOI":"10.3390\/jcm14082539","type":"journal-article","created":{"date-parts":[[2025,4,8]],"date-time":"2025-04-08T05:59:00Z","timestamp":1744091940000},"page":"2539","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sacubitril\/Valsartan Improves Hemodynamic Parameters of Pulmonary and Systemic Circulation in Patients Awaiting Heart Transplantation"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0616-8405","authenticated-orcid":false,"given":"Arnold P\u00e9ter","family":"R\u00e1duly","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"K\u00e1lm\u00e1n Laki Doctoral School, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Saman Kothalawala","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Balogh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"K\u00e1lm\u00e1n Laki Doctoral School, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zsuzsanna","family":"Majoros","sequence":"additional","affiliation":[{"name":"Cardiology Department, Central Hospital of Northern Pest-Military Hospital, 1134 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zs\u00f3fia","family":"P\u00f3lik","sequence":"additional","affiliation":[{"name":"Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"F\u00fcl\u00f6p","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferenc","family":"Gy\u0151ry","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L\u00e1szl\u00f3","family":"Nagy","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"K\u00e1lm\u00e1n Laki Doctoral School, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Be\u00e1ta","family":"B\u00f3di","sequence":"additional","affiliation":[{"name":"Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"K\u00e1lm\u00e1n Laki Doctoral School, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M\u00e1t\u00e9 Bal\u00e1zs","family":"Kov\u00e1cs","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"Csan\u00e1di","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"K\u00e1lm\u00e1n Laki Doctoral School, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4675-1542","authenticated-orcid":false,"given":"Zolt\u00e1n","family":"Papp","sequence":"additional","affiliation":[{"name":"Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"K\u00e1lm\u00e1n Laki Doctoral School, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0821-484X","authenticated-orcid":false,"given":"Bal\u00e1zs","family":"Muk","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, Gottsegen National Cardiovascular Center, 1096 Budapest, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Attila","family":"Borb\u00e9ly","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"K\u00e1lm\u00e1n Laki Doctoral School, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global Burden of Heart Failure: A Comprehensive and Updated Review of Epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc. 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Heart Fail."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/8\/2539\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:12:05Z","timestamp":1760029925000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/8\/2539"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,8]]},"references-count":29,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["jcm14082539"],"URL":"https:\/\/doi.org\/10.3390\/jcm14082539","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,8]]}}}