Comparison of the effect of Sacubitril/Valsartan with Losartan and Captopril in improving right ventricular function in patients with right heart failure, a randomized clinical controlled trial.

Background: There is evidence supporting the efficacy of Sacubitril /Valsartan for improving left heart failure, but few studies have examined its effects on right ventricular (RV) dysfunction. The current study aimed to investigate the effects of Sacubitril /Valsartan on RV dysfunction in patients with right heart failure.

Methods: The current study was a randomized and parallel clinical trial study. Patients over 18 years with any degree of right heart failure regardless of Left ventricular ejection fraction (LVEF) were included. The included patients were assigned randomly to three study arms using simple random allocation, i.e. the intervention group (Sacubitril Valsartan recipients) and the control groups (Losartan and Captopril recipients). The SPSS software version 19 was used for data analysis.

Results: The changes in LVEF, RV FAC, RV diameter, DOE grade, and TAPSE in the Sacubitril/Valsartan group were significantly higher than the other two groups. The severity of RV dysfunction, as well as TR (Tricuspid Regurgitation) severity, decreased significantly three months after the intervention compared to the beginning of the intervention in all groups especially in the Sacubitril/Valsartan group (p: 0.006). The mortality rate in the Sacubitril/Valsartan, Losartan, and Captopril groups, were 2 (6.7%), 2 (11.2%), and 1 (7.7%) respectively (p: 0.83). Also, 27.6, 62.5, and 7.7% of cases in the Sacubitril/Valsartan, Losartan, and Captopril reached to optimum dose (p: 0.006).

Conclusions: Considering the results, it seems that Sacubitril/Valsartan has a positive effect on improving RV dysfunction in patients with right heart disorders.