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Does Entresto improve ejection fraction?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on April 19, 2024.

Official Answer by Drugs.com

Yes, Entresto has been shown to increase left ventricular ejection fraction (LVEF) in the PROVE-HF trial in patients with heart failure. Entresto is usually administered with other heart failure therapies in place of an ACE inhibitor or other ARB medication. Heart failure occurs when your heart cannot pump blood properly.

The PROVE-HF trial was a Phase IV prospective study of 794 patients with heart failure with reduced ejection fraction (HFrEF).

What is a normal ejection fraction?

Ejection fraction (EF) is a term that describes how well your heart chambers (the left or right ventricles) can pump blood. The left ventricle is responsible for most of your heart's main pumping action. When your left ventricle is weak or diseased, a lower amount of blood is pumped out when it contracts (squeezes from a heart beat).

Ejection fraction is most commonly measured using an echocardiogram (echo), a painless outline of your heart’s movements using an ultrasound machine.

A normal ejection fraction ranges from 55% to 70%. For example, if your left ventricle ejection fraction (LVEF) is 60%, that means that 60% of the amount of blood in the left ventricle is pumped out with each contraction of your heart. Patients with heart failure typically have ejection fractions of 40% or less.

What happens in heart failure?

Heart failure, also called congestive heart failure, occurs when your heart cannot pump blood properly. This leads to a back-up of blood in the heart as well as kidney problems. Less oxygen-rich blood is pumped out to the body.

Fluid retention (swelling) can occur in your body’s tissues, like the legs (extremities) or lungs. When this happens in the lungs, it becomes harder to breath. Heart failure with reduced ejection fraction, often abbreviated HFrEF, is also known as systolic heart failure.

The level of heart failure you have is often classified based on the New York Heart Association (NYHA) classification:

How is Entresto used?

Entresto (sacubitril/valsartan), from Novartis, is used for the treatment of patients with heart failure and reduced ejection fraction (HFrEF) to lower the risk of cardiovascular death and hospitalization for heart failure. Entresto relaxes blood vessels, improves blood flow, and reduces stress on the heart.

How does it come?

Entresto comes as an oral tablet, as an oral pellet Sprinkle capsule, or it can be compounded into an oral suspension by your pharmacist. The oral pellets or oral suspension may be easier for children to take.

In April 2024, the FDA approved Entresto Sprinkle oral pellets, which contains medicine inside of the capsule. The capsule must be opened and sprinkled onto 1 to 2 teaspoonfuls of soft food (such as applesauce, yogurt, or pudding) and taken right away. Do not chew or crush the oral pellets found inside the capsule. The capsule should not be swallowed. Throw away the empty capsule shell.

When did the FDA approve Entresto?

Entresto was first approved by the FDA in 2015.

Bottom Line

Entresto has been shown to increase left ventricular ejection fraction (LVEF), the volume of blood that your left ventricle pumps out of your heart when it contracts. This helps to supply more blood and oxygen to your body.

Entresto is recommended in heart treatment guidelines to reduce the risk of cardiovascular death and hospitalization for heart failure in patients with chronic heart failure (NYHA Class II-IV) and reduced ejection fraction.

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