ArticleJACC. Case reports2025
Successful Management of HFpEF-Related Pulmonary Hypertension With Systemic-Level Pressures Using Sacubitril-Valsartan and Empagliflozin.
Article in JACC. Case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPulmonary hypertension (PH) is present in over two-thirds of patients who experience heart failure with preserved ejection fraction (HFpEF), and it worsens their prognosis, particularly when combined with right ventricular dysfunction. Effective treatments for HFpEF-related PH are limited. CASE SUMMARY: A 70-year-old woman presented with severe exertional dyspnea and hypoxia. Echocardiography revealed a preserved ejection fraction with advanced diastolic dysfunction, as well as severe PH. Right heart catheterization showed pulmonary pressures at systemic levels and elevated left-sided filling pressures. Significant symptom improvement and normalized pulmonary pressures were noted after treatment with sacubitril-valsartan and a sodium-glucose cotransporter 2 (SGLT2) inhibitor. DISCUSSION: Although sacubitril-valsartan and SGLT2 inhibitors have been proven effective in HFpEF, their specific role in HFpEF-PH remains unclear. This case highlights their potential to improve hemodynamics and symptoms in this challenging patient population. TAKE-HOME MESSAGE: Sacubitril-valsartan and SGLT2 inhibitors may be effective for treating PH in HFpEF; further investigation is warranted.
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