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Heart FailureSeptember 2019Summary reviewed June 2026

What Researchers Found Testing Sacubitril-Valsartan vs. Enalapril for Heart Failure

Researchers compared two heart failure drugs in 464 patients with weak heart pumps. After 12 weeks, sacubitril-valsartan didn't reduce artery stiffness more than enalapril, but it did shrink the heart's chambers and improve filling pressure better.

What the trial was testing

The trial enrolled 465 patients with heart failure. The study was sponsored by Novartis Pharmaceuticals and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was long-term safety (phase 4). Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

Sacubitril-valsartan reduced left atrial volume by 2.8 mL/m² more than enalapril in 12 weeks.

JAMA · 2019 · NCT02874794

These findings — that sacubitril-valsartan shrank the upper heart chamber more than enalapril — were published in the JAMA and represent the headline result of the study.

Researchers tracked outcomes across 465 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with heart failure, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Both sacubitril-valsartan and enalapril are FDA-approved for heart failure with reduced ejection fraction. This study showed sacubitril-valsartan may help the heart remodel better. Talk to your cardiologist about which medication is right for your type of heart failure.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.