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Peer-reviewedCC BY 4.0Frontiers in Cardiovascular Medicine

Mechanisms and clinical outcomes of sacubitril-valsartan and SGLT2 inhibitors in heart failure patients: a retrospective cohort study

  • Xuzheng Zhong1
  • Lei Xia2
  • Li Li1
  • Bei Tang1
  1. 1Department of Intensive Care Unit, The First People’s Hospital of Jiande
  2. 2Department of Emergency, The First People’s Hospital of Jiande
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Abstract

Background: Heart failure represents a challenging cardiovascular disorder among the elderly, repeatedly exacerbating cardiac dysfunction and a reduced capacity for activity, thereby presenting significant therapeutic challenge.

Objective: To analyse mechanisms of action and outcomes of combined therapy with sacubitril-valsartan and SGLT2 inhibitors for heart failure patients.

Method: From October 2023 to October 2025, 150 heart failure patients were recruited and categorized them to the SV group (sacubitril-valsartan) and the SS group (sacubitril-valsartan and SGLT2 inhibitor) according to their treatment regimens. Both groups of patients received treatment with sacubitril-valsartan; the SS group additionally received SGLT2 inhibitor supplementation. The main parameters pre- and post- treatment were assessed and analyzed among both groups, including changes in cardiac function related indicators [left ventricle ejection fraction (LVEF), left ventricle end-diastolic diameter (LVEDD), left ventricle end-systolic diameter (LVESD), and cardiac output (CO)], serum indicators [β-endorphin (β-EP), cardiotrophin-1 (CT-1), N-terminal pro-B-type natriuretic peptide (NT-proBNP) changes], inflammatory indicators (IL-1β), interleukin-6 (IL-6), tumor necrosis factors-α (TNF-α), and clinical efficacy. Secondary indicators include heart failure quality of life scale scores, complication incidences, and adverse events incidences.

Result: No marked discrepancy existed in the baseline clinical data among both groups ( P > 0.05). Post-treatment, the indicators in both groups demonstrated remarkable improvement ( P < 0.05). The LVEDD, LVESD, serum markers, inflammatory markers and MLHFQ scores in SS group were markedly below those in the SV group, whilst LVEF, CO and the overall clinical response rate were markedly increased ( P < 0.05). The complications and adverse reactions incidences were markedly reduced in SS group vs. SV group ( P < 0.05).

Conclusion: The combined use sacubitril-valsartan and SGLT2 inhibitors demonstrates efficacy in improving cardiac function indicators, downregulate neuroendocrine and inflammatory factor levels, enhance clinical efficacy in heart failure patients, and can serve as an important reference for comprehensive treatment of such patients.

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Cite

BibTeXRIS
BibTeX
@article{zhong2026mechanisms,
  title = {{Mechanisms and clinical outcomes of sacubitril-valsartan and SGLT2 inhibitors in heart failure patients: a retrospective cohort study}},
  author = {Xuzheng Zhong and Lei Xia and Li Li and Bei Tang},
  journal = {Frontiers in Cardiovascular Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fcvm.2026.1931636},
  url = {https://www.frontiersin.org/articles/10.3389/fcvm.2026.1931636/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Mechanisms and clinical outcomes of sacubitril-valsartan and SGLT2 inhibitors in heart failure patients: a retrospective cohort study
AU  - Xuzheng Zhong
AU  - Lei Xia
AU  - Li Li
AU  - Bei Tang
PY  - 2026
DA  - 2026/10/20
JO  - Frontiers in Cardiovascular Medicine
DO  - 10.3389/fcvm.2026.1931636
UR  - https://www.frontiersin.org/articles/10.3389/fcvm.2026.1931636/full
AB  - Background: Heart failure represents a challenging cardiovascular disorder among the elderly, repeatedly exacerbating cardiac dysfunction and a reduced capacity for activity, thereby presenting significant therapeutic challenge.  Objective: To analyse mechanisms of action and outcomes of combined therapy with sacubitril-valsartan and SGLT2 inhibitors for heart failure patients.  Method: From October 2023 to October 2025, 150 heart failure patients were recruited and categorized them to the SV group (sacubitril-valsartan) and the SS group (sacubitril-valsartan and SGLT2 inhibitor) according to their treatment regimens. Both groups of patients received treatment with sacubitril-valsartan; the SS group additionally received SGLT2 inhibitor supplementation. The main parameters pre- and post- treatment were assessed and analyzed among both groups, including changes in cardiac function related indicators [left ventricle ejection fraction (LVEF), left ventricle end-diastolic diameter (LVEDD), left ventricle end-systolic diameter (LVESD), and cardiac output (CO)], serum indicators [β-endorphin (β-EP), cardiotrophin-1 (CT-1), N-terminal pro-B-type natriuretic peptide (NT-proBNP) changes], inflammatory indicators (IL-1β), interleukin-6 (IL-6), tumor necrosis factors-α (TNF-α), and clinical efficacy. Secondary indicators include heart failure quality of life scale scores, complication incidences, and adverse events incidences.  Result: No marked discrepancy existed in the baseline clinical data among both groups ( P > 0.05). Post-treatment, the indicators in both groups demonstrated remarkable improvement ( P < 0.05). The LVEDD, LVESD, serum markers, inflammatory markers and MLHFQ scores in SS group were markedly below those in the SV group, whilst LVEF, CO and the overall clinical response rate were markedly increased ( P < 0.05). The complications and adverse reactions incidences were markedly reduced in SS group vs. SV group ( P < 0.05).  Conclusion: The combined use sacubitril-valsartan and SGLT2 inhibitors demonstrates efficacy in improving cardiac function indicators, downregulate neuroendocrine and inflammatory factor levels, enhance clinical efficacy in heart failure patients, and can serve as an important reference for comprehensive treatment of such patients.
SN  - 2297-055X
ER  -