Effects of angiotensin-receptor neprilysin inhibitor on exercise capacity, quality of life, and cardiac function in heart failure with preserved ejection fraction

Abstract

Abstract Background: Nearly half of patients with heart failure have preserved ejection fraction (EF) and the mortality and morbidity of patients with heart failure with preserved EF (HFpEF) are high. Patients with HFpEF are often elderly and their primary chronic symptom is severe exercise intolerance that results in a reduced quality of life (QOL). Thus, improvement of exercise capacity presents another important clinical outcome in HFpEF patients. Left ventricular diastolic dysfunction is associated with the pathophysiology of HFpEF and it contributes importantly to exercise intolerance in HFpEF patients. The angiotensin-receptor neprilysin inhibitor (ARNI) sacubitril/valsartan was shown to be associated with better survival in HFpEF patients. However, there is insufficient evidence as to the effects of ARNI on exercise capacity and cardiac function in these patients. Accordingly, the purpose of this meta-analysis is to evaluate the effects of ARNI on exercise capacity and QOL as well as cardiac function in HFpEF patients. Methods: This meta-analysis will include randomized controlled trials examining the effects of ARNI on exercise capacity, health-related QOL, or cardiac function in HFpEF patients. Information of studies will be collected from PubMed, Web of Science, Cochrane Library, and ClinicalTrials.gov. The primary outcome will be exercise capacity (6-minute walking distance). The secondary outcomes will be health-related QOL and left ventricular structure and function. Discussion: This meta-analysis will evaluate the effects of ARNI on exercise capacity, QOL, and cardiac function in HFpEF patients, providing evidence regarding the clinical use of ARNI in these patients. Systematic review registration: INPLASY202170076