The University of Toledo Translation Journal of Medical Sciences 
Internal Medicine Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

The Impact of Sacubitril / Valsartan Versus ACE/ARB 
Therapy on Functional Capacity in Heart Failure with 
Reduced Ejection Fraction 

Mohammad Yassen, MD1* 

1Division of Cardiovascular Medicine, Department of Medicine, The University of 
Toledo, Toledo, OH 43614 

*Corresponding author: Mohammad.Yassen@utoledo.edu

Published: 05 May 2023 

Introduction: Angiotensin Receptor Neprilysin Inhibitors (ARNI) have emerged as a promising 
pharmacological therapy with heart failure-related hospitalization and mortality benefits in patients with 
heart failure with reduced ejection fraction. Given the correlation between subjective, patient-oriented 
measures and objective outcomes (for example, perceived symptomatic benefits promoting medication 
compliance), we sought to investigate the effect of ARNIs on exercise capacity in a patient-defined 
manner.    

Methods: We performed a literature search using PubMed, Embase, and Cochrane Library from 
inception through May 2022 to assess the impact of Sacubitril/Valsartan versus ACE therapy on physical 
activity tolerance in patients with heart failure with reduced ejection fraction. The co-primary outcomes 
were change from baseline mean KCCQ-23 scores and the 6-minute walk test (6MWT).   

Results: 2 studies (both randomized control trials) involving 8539 patients were included in the meta-
analysis. Compared to patients receiving ACE therapy, the ARNI group showed no statistically 
significant difference in either change from mean baseline KCCQ-23 scores (MD 4.23, CI, -0.88, 0.93, p 
=0.10) or the 6MWT (MD 2.09, CI -11.60, 15.79, p = 0.76).    

Conclusion: The use of ARNI compared to standard ACE therapy confers no statistically significant 
improvement in functional capacity in patients with heart failure with reduced ejection fraction. Further 
trials with large sample sizes are needed to confirm our findings. 

https://dx.doi.org/10.46570/utjms.vol11-2023-729 

https://dx.doi.org/10.46570/utjms.vol11-2023-729
mailto:Mohammad.Yassen@utoledo.edu