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Minerva Cardiology and Angiology 2021 Apr 07

DOI: 10.23736/S2724-5683.20.05494-8


language: English

Trend of perceived quality of life and functional capacity in outpatients with chronic heart failure and in treatment with sacubitril/valsartan: a real-life experience

Giuseppe DATTILO 1, Roberto BITTO 1, Michele CORREALE 2 , Claudia MORABITO 1, Vittoria VACCARO 1, Giulia LATERRA 1, Matteo CASALE 1, Pasquale CREA 1, Gianluca DI BELLA 1, Francesco LUZZA 1, Alessandro MIGLIORATO 1, Niki KATSIKI 3, Cesare DE GREGORIO 1

1 Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; 2 Cardiology Unit, Policlinico Riuniti University Hospital, Foggia, Italy; 3 Second Department of Propaedeutic Internal Medicine, Medical School, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece


BACKGROUND: Despite the use of optimal medical therapy, HFrEF remains a leading cause of morbidity, mortality and health care costs. The introduction of angiotensin receptor/neprilysin inhibitors (ARNIs) had a revolutionary impact on the treatment of patients with heart failure and reduced left ventricular ejection fraction (HFrEF).
METHODS: The aim of the study was to monitor over time the perceived quality of life, the physical performance, the trend of BNP and NT-ProBNP and the NYHA functional class in patients with HFrEF during treatment with sacubitril/valsartan. We enrolled 37 patients (63 ± 10 years old, 76% men) who underwent a total of one year follow-up. All patients underwent clinical evaluation, 6MWT, blood analysis (in particular NT-pro-BNP and BNP, renal function test); Kansas City Cardiomyopathy Questionnaire (KCCQ) and the NYHA functional class assessment were also performed, at the beginning of the study and after 3, 6 and 12 months of therapy.
RESULTS: We observed at each follow-up a significant improvement of KCCQ score, 6MWT, NTProBNP, BNP and of NYHA class. However, analyzing the Δ % of variation of each single parameter, the improvement was not uniform in time. We also observed that only 37% of patients tolerated the full recommended dose of sacubitril/valsartan (97/103 mg b.i.d.); of the remaining, 40% tolerated the intermediate dose (49/51 mg b.i.d.) and 23% the minimum (24/26 md b.i.d.).
CONCLUSIONS: Sacubitril/valsartan therapy improves significantly quality of life, physical effort resistance, BNP and NT-ProBNP and NYHA functional class in patients with HFrEF. Although not all the patients tolerated the maximum recommended dose, the beneficial effects were significant even at lower doses.

KEY WORDS: Heart failure with reduced ejection fraction; Sacubitril/Valsartan; Kansas City cardiomyopathy questionnaire; 6-minutes walking test; Natriuretic peptides

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