PhD Scientific Days 2026

Poster Session 2.Q - Cardiovascular Medicine and Research

Sacubitril/Valsartan and Myocardial Expression of Reverse Cardio-Oncology–Related Markers in End-Stage Heart Failure

Name of the presenter

Bálint, Tímea

Institute/workplace of the presenter

Semmelweis University, Heart and Vascular Center

Authors

Tímea Bálint¹, Dávid Nagy¹, Zoltán Horváth¹, Petra Kocsis-Balogh¹, Dóra Ivanics¹, Attila Oláh¹, Alex Ali Sayour¹, Bálint András Barta¹, Béla Merkely¹, Tamás Radovits¹, Mihály Ruppert¹
1: Semmelweis University, Heart and Vascular Center

Text of the abstract

Introduction
Myocardial remodeling in heart failure (HF) involves activation of extracellular matrix and profibrotic pathways, which have been implicated in reverse cardio-oncology, whereby HF–related processes may influence tumor-associated mechanisms. This interaction may be mediated, at least in part, by factors expressed in the myocardium and released into the circulation. Given the established antifibrotic effects of sacubitril/valsartan in HF, its potential impact on the expression of these markers in advanced human HF remains unclear.
Aims
The aim of this study was to investigate myocardial expression of selected reverse cardio-oncology-related markers in end-stage HF patients and their association with sacubitril/valsartan therapy.
Methods
Human left ventricular myocardial samples from patients with end-stage HF were obtained from the Transplantation Biobank of the Heart and Vascular Center at Semmelweis University. Tissue samples were homogenized, followed by RNA isolation and cDNA synthesis. Quantitative real-time PCR (qRT-PCR) analysis was performed to assess the expression of four candidate markers potentially involved in reverse cardio-oncology pathways: fibronectin 1 (FN1), periostin (POSTN), connective tissue growth factor (CTGF), and serpin family A member 3 (SERPINA3).
Results
A total of 93 patients with end-stage HF were included (mean age 52 [46–61] years), of whom 61 (66%) were male. Sacubitril/valsartan therapy was administered in 41 (44%) patients. Myocardial gene expression analysis revealed significant differences between patients receiving sacubitril/valsartan and those not receiving sacubitril/valsartan therapy. FN1 expression was lower in the sacubitril/valsartan-treated group (0.034 [0.023–0.084] vs. 0.159 [0.071–0.309], P < 0.0001), as was POSTN (0.0109 [0.0035–0.0293] vs. 0.0336 [0.0185–0.1033], P < 0.0001). Similarly, CTGF expression was reduced (0.0305 [0.014–0.067] vs. 0.0834 [0.0498–0.160], P = 0.0006), along with SERPINA3 (0.0040 [0.0021–0.0113] vs. 0.0111 [0.0063–0.0332], P = 0.0001).
Conclusion
Patients receiving sacubitril/valsartan therapy exhibited lower myocardial expression of selected reverse cardio-oncology–related markers in end-stage HF.

Funding: EKÖP-2025-383 (T.B.), STARTING 150923 (M.R.)
balint.timea09@gmail.com
Semmelweis University
Supervisors: Mihály Ruppert, MD, PhD and Prof. Tamás Radovits, MD, PhD