Sacubitril/Valsartan vs. Standard Medical Therapy on Exercise Capacity in HFrEF Patients
Sacubitril/valsartan (Sac/Val) reduces mortality in patients with heart failure with reduced ejection fraction (HFrEF) compared to enalapril. However, its effects on functional capacity remain uncertain; consequently, we sought to compare Sac/Val vs. standard medical therapy, in terms of effects on...
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MDPI AG
2023-05-01
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| Online Access: | https://www.mdpi.com/2075-1729/13/5/1174 |
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| author | Alfonso Campanile Valeria Visco Stefania De Carlo Germano Junior Ferruzzi Costantino Mancusi Carmine Izzo Felice Mongiello Paola Di Pietro Nicola Virtuoso Amelia Ravera Domenico Bonadies Carmine Vecchione Michele Ciccarelli |
| author_facet | Alfonso Campanile Valeria Visco Stefania De Carlo Germano Junior Ferruzzi Costantino Mancusi Carmine Izzo Felice Mongiello Paola Di Pietro Nicola Virtuoso Amelia Ravera Domenico Bonadies Carmine Vecchione Michele Ciccarelli |
| author_sort | Alfonso Campanile |
| collection | DOAJ |
| description | Sacubitril/valsartan (Sac/Val) reduces mortality in patients with heart failure with reduced ejection fraction (HFrEF) compared to enalapril. However, its effects on functional capacity remain uncertain; consequently, we sought to compare Sac/Val vs. standard medical therapy, in terms of effects on prognostically significant CPET parameters, in HFrEF patients during a long follow-up period. We conducted a single-center, observational study in an HF clinic; specifically, we retrospectively identified that 12 patients switched to Sac/Val and 13 patients that managed with standard, optimal medical therapy (control group). At each visit, baseline, and follow-up (median time: 16 months; IQ range: 11.5–22), we collected demographic information, medical history, vital signs, cardiopulmonary exercise testing, standard laboratory data, pharmacological treatment information, and echocardiographic parameters. The study’s primary end-point was the change from baseline in peak VO<sub>2</sub> (adjusted to body weight). We did not observe significant differences between the two study groups at baseline. Similarly, we did not observe any significant differences during the follow-up in mean values of peak VO<sub>2</sub> corrected for body weight: Sac/Val baseline: 12.2 ± 4.6 and FU: 12.7 ± 3.3 vs. control group: 13.1 ± 4.2 and 13.0 ± 4.2 mL/kg/min; <i>p</i> = 0.49. No significant treatment differences were observed for changes in VE/VCO<sub>2</sub> slope: Sac/Val baseline: 35.4 ± 7.4 and FU: 37.2 ± 13.1 vs. control group: 34.6 ± 9.1 and 34.0 ± 7.3; <i>p</i> = 0.49. In conclusion, after a median follow-up period of 16 months, there was no significant benefit of Sac/Val on peak VO<sub>2</sub> and other measures of CPET compared with standard optimal therapy in patients with HFrEF. |
| first_indexed | 2024-03-11T03:33:50Z |
| format | Article |
| id | doaj.art-c73a91c2f2394e51bd3817953096adcb |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-11T03:33:50Z |
| publishDate | 2023-05-01 |
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| series | Life |
| spelling | doaj.art-c73a91c2f2394e51bd3817953096adcb2023-11-18T02:09:42ZengMDPI AGLife2075-17292023-05-01135117410.3390/life13051174Sacubitril/Valsartan vs. Standard Medical Therapy on Exercise Capacity in HFrEF PatientsAlfonso Campanile0Valeria Visco1Stefania De Carlo2Germano Junior Ferruzzi3Costantino Mancusi4Carmine Izzo5Felice Mongiello6Paola Di Pietro7Nicola Virtuoso8Amelia Ravera9Domenico Bonadies10Carmine Vecchione11Michele Ciccarelli12Cardiology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, ItalyDepartment of Medicine and Surgery, University of Perugia, 06123 Perugia, ItalyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, ItalyDepartment of Advanced Biomedical Sciences, Federico II University of Naples, 80138 Naples, ItalyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, ItalyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, ItalyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, ItalyCardiology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyCardiology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyCardiology Unit, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84131 Salerno, ItalyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, ItalyDepartment of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, ItalySacubitril/valsartan (Sac/Val) reduces mortality in patients with heart failure with reduced ejection fraction (HFrEF) compared to enalapril. However, its effects on functional capacity remain uncertain; consequently, we sought to compare Sac/Val vs. standard medical therapy, in terms of effects on prognostically significant CPET parameters, in HFrEF patients during a long follow-up period. We conducted a single-center, observational study in an HF clinic; specifically, we retrospectively identified that 12 patients switched to Sac/Val and 13 patients that managed with standard, optimal medical therapy (control group). At each visit, baseline, and follow-up (median time: 16 months; IQ range: 11.5–22), we collected demographic information, medical history, vital signs, cardiopulmonary exercise testing, standard laboratory data, pharmacological treatment information, and echocardiographic parameters. The study’s primary end-point was the change from baseline in peak VO<sub>2</sub> (adjusted to body weight). We did not observe significant differences between the two study groups at baseline. Similarly, we did not observe any significant differences during the follow-up in mean values of peak VO<sub>2</sub> corrected for body weight: Sac/Val baseline: 12.2 ± 4.6 and FU: 12.7 ± 3.3 vs. control group: 13.1 ± 4.2 and 13.0 ± 4.2 mL/kg/min; <i>p</i> = 0.49. No significant treatment differences were observed for changes in VE/VCO<sub>2</sub> slope: Sac/Val baseline: 35.4 ± 7.4 and FU: 37.2 ± 13.1 vs. control group: 34.6 ± 9.1 and 34.0 ± 7.3; <i>p</i> = 0.49. In conclusion, after a median follow-up period of 16 months, there was no significant benefit of Sac/Val on peak VO<sub>2</sub> and other measures of CPET compared with standard optimal therapy in patients with HFrEF.https://www.mdpi.com/2075-1729/13/5/1174sacubitril/valsartanheart failureHFrEFCPETexercise capacitypeak VO<sub>2</sub> |
| spellingShingle | Alfonso Campanile Valeria Visco Stefania De Carlo Germano Junior Ferruzzi Costantino Mancusi Carmine Izzo Felice Mongiello Paola Di Pietro Nicola Virtuoso Amelia Ravera Domenico Bonadies Carmine Vecchione Michele Ciccarelli Sacubitril/Valsartan vs. Standard Medical Therapy on Exercise Capacity in HFrEF Patients Life sacubitril/valsartan heart failure HFrEF CPET exercise capacity peak VO<sub>2</sub> |
| title | Sacubitril/Valsartan vs. Standard Medical Therapy on Exercise Capacity in HFrEF Patients |
| title_full | Sacubitril/Valsartan vs. Standard Medical Therapy on Exercise Capacity in HFrEF Patients |
| title_fullStr | Sacubitril/Valsartan vs. Standard Medical Therapy on Exercise Capacity in HFrEF Patients |
| title_full_unstemmed | Sacubitril/Valsartan vs. Standard Medical Therapy on Exercise Capacity in HFrEF Patients |
| title_short | Sacubitril/Valsartan vs. Standard Medical Therapy on Exercise Capacity in HFrEF Patients |
| title_sort | sacubitril valsartan vs standard medical therapy on exercise capacity in hfref patients |
| topic | sacubitril/valsartan heart failure HFrEF CPET exercise capacity peak VO<sub>2</sub> |
| url | https://www.mdpi.com/2075-1729/13/5/1174 |
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