Impact of sacubitril/valsartan on chronic heart failure patients with sleep-disordered breathing: a systematic review and meta-analysis.

Publisher: Nature Publishing Group Country of Publication: England NLM ID: 101563288 Publication Model: Electronic Cited Medium: Internet ISSN: 2045-2322 (Electronic) Linking ISSN: 20452322 NLM ISO Abbreviation: Sci Rep Subsets: MEDLINE

Original Publication: London : Nature Publishing Group, copyright 2011-

Heart Failure*/drug therapy ; Heart Failure*/complications ; Aminobutyrates*/therapeutic use ; Valsartan*/therapeutic use ; Biphenyl Compounds*/therapeutic use ; Sleep Apnea Syndromes*/drug therapy ; Sleep Apnea Syndromes*/complications ; Angiotensin Receptor Antagonists*/therapeutic use; Humans ; Drug Combinations ; Chronic Disease ; Treatment Outcome

Chronic heart failure (CHF) affects 1-2% of adults in developed countries, with up to 50% experiencing sleep-disordered breathing (SDB). Sacubitril/valsartan (sac/val) has shown potential benefits on respiratory function, but its effect on SDB remains uncertain. This study aims to evaluates the effectiveness of sac/val on SDB and respiratory function in CHF patients. Electronic searches were conducted based on MEDLINE, EMBASE, Cochrane Library, and Web of Science using MeSH terms and relevant keywords. Apnea-hypopnea index (AHI) and central apnea index (CAI) were used as primary outcome. Statistical analysis was performed using Stata 15.1 SE, with Cochrane Q and I² statistics used for heterogeneity assessment. Publication bias and sensitivity analyses were conducted using various methods. Risk of bias was assessed using the MINORS and ROB 2.0 tools. Seven studies met inclusion criteria. Results indicated that sac/val significantly reduced AHI (mean difference [MD], -3.56; P < 0.001) and increased mean oxygen saturation (MD = 0.61; P < 0.001), although there was a modest rise in CAI (MD = 0.30; P = 0.049). The pooled analysis indicated a 22% reduction in CSA patients. The analysis demonstrated a statistically significant reduction in AHI and an improvement in SpO2 during sleep after using sac/val. While these findings suggest improvements in SDB, further high-quality research is needed to confirm these results and explore underlying mechanisms.
(© 2025. The Author(s).)

Declarations. Competing interests: The authors declare no competing interests.

JACC Heart Fail. 2024 Oct;12(10):1704-1706. (PMID: 39207326)
J Card Fail. 2013 Jun;19(6):431-44. (PMID: 23743494)
Biometrics. 1994 Dec;50(4):1088-101. (PMID: 7786990)
Syst Rev. 2021 Mar 29;10(1):89. (PMID: 33781348)
Front Cardiovasc Med. 2022 Sep 15;9:971108. (PMID: 36186983)
Eur Heart J. 2015 Jun 14;36(23):1463-9. (PMID: 25636743)
Expert Opin Drug Deliv. 2021 Apr;18(4):515-526. (PMID: 33280447)
Cardiology. 2017;137(2):96-99. (PMID: 28178694)
N Engl J Med. 2014 Sep 11;371(11):993-1004. (PMID: 25176015)
J Clin Epidemiol. 2024 Oct;174:111492. (PMID: 39098563)
JACC Heart Fail. 2024 Oct;12(10):1692-1703. (PMID: 38842957)
J Am Coll Cardiol. 2015 Jan 6;65(1):72-84. (PMID: 25572513)
Nat Rev Cardiol. 2016 Jul;13(7):389-403. (PMID: 27173772)
Sleep Breath. 2019 Sep;23(3):815-824. (PMID: 30523557)
Can Respir J. 2018 Nov 18;2018:1206217. (PMID: 30581512)
J Am Coll Cardiol. 2019 Mar 26;73(11):1264-1272. (PMID: 30846338)
Chest. 2016 Apr;149(4):900-4. (PMID: 26836904)
J Prosthet Dent. 2016 Sep;116(3):328-335.e2. (PMID: 27061627)
Am J Cardiovasc Drugs. 2021 Mar;21(2):241-254. (PMID: 32978755)
ESC Heart Fail. 2018 Jun;5(3):222-230. (PMID: 29469206)
Front Cardiovasc Med. 2019 Sep 06;6:125. (PMID: 31555667)
Environ Res. 1993 May;61(2):337-48. (PMID: 8495675)
Exp Physiol. 2015 Feb 01;100(2):130-5. (PMID: 25398715)
Eur J Heart Fail. 2019 Mar;21(3):337-341. (PMID: 30741494)
Am J Respir Crit Care Med. 2016 Mar 1;193(5):482-3. (PMID: 26930431)
J Heart Lung Transplant. 2018 Nov;37(11):1361-1371. (PMID: 30195831)
J Clin Sleep Med. 2024 May 1;20(5):835-836. (PMID: 38252066)
J Card Fail. 2021 Dec;27(12):1466-1471. (PMID: 34428592)
BMJ. 1997 Sep 13;315(7109):629-34. (PMID: 9310563)
Chest. 2007 Nov;132(5):1463-71. (PMID: 17646230)
J Am Coll Cardiol. 2017 Sep 12;70(11):1351-1364. (PMID: 28882233)
Circulation. 2010 Jul 27;122(4):352-60. (PMID: 20625114)
Eur J Heart Fail. 2019 May;21(5):598-605. (PMID: 30520545)
Circulation. 2019 Oct 22;140(17):1369-1379. (PMID: 31510768)
BMJ. 2019 Aug 28;366:l4898. (PMID: 31462531)
ESC Heart Fail. 2021 Aug;8(4):2513-2526. (PMID: 34102018)
Int J Cardiol. 2021 May 1;330:112-119. (PMID: 33581182)
Front Cardiovasc Med. 2022 Apr 05;9:861663. (PMID: 35449875)
CNS Neurol Disord Drug Targets. 2022;21(6):492-499. (PMID: 34719367)
J Card Fail. 2015 Feb;21(2):126-33. (PMID: 25451705)
Circulation. 2007 Jun 26;115(25):3140-2. (PMID: 17592088)
Respir Physiol Neurobiol. 2002 Sep 4;132(3):239-51. (PMID: 12208083)
Sleep Breath. 2023 Mar;27(1):283-289. (PMID: 35486312)
J Card Fail. 2009 May;15(4):279-85. (PMID: 19398074)
Acta Cardiol Sin. 2020 Mar;36(2):125-132. (PMID: 32201463)

No.B202319019225 Scientific Research Project of Hunan Provincial Health Commission; 2022JJ30972, 2024JJ5584 Natural Science Foundation of Hunan Province; No.2023B0185, No.2022A281 Traditional Chinese Medicine Project in Jiangxi Province

Keywords: Heart failure; Meta-analysis; Sacubitril/valsartan; Sleep-disordered breathing

0 (Aminobutyrates)
80M03YXJ7I (Valsartan)
0 (Biphenyl Compounds)
0 (Drug Combinations)
WB8FT61183 (sacubitril and valsartan sodium hydrate drug combination)
0 (Angiotensin Receptor Antagonists)

Date Created: 20250812 Date Completed: 20250826 Latest Revision: 20250829

20260130

PMC12344083

10.1038/s41598-025-14458-2

40796619