Effects of sacubitril/valsartan on the functional capacity of real-world patients in Italy: the REAL.IT study on heart failure with reduced ejection fraction

沙库巴曲/缬沙坦对意大利真实世界患者功能能力的影响:针对射血分数降低的心力衰竭的 REAL.IT 研究

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作者:Filippo Maria Sarullo, Cinzia Nugara, Silvia Sarullo, Massimo Iacoviello, Gabriele Di Gesaro, Daniela Miani, Mauro Driussi, Michele Correale, Claudio Bilato, Andrea Passantino, Erberto Carluccio, Alessandra Villani, Luca Degli Esposti, Chiara D'Agostino, Elena Peruzzi, Simone Poli, Andrea Di Lenarda

Background

Heart failure (HF) significantly affects the morbidity, mortality, and quality of life of patients. New therapeutic strategies

Conclusions

Sacubitril/valsartan improves the cardiopulmonary capacity of patients with HFrEF in daily clinical practice in Italy.

Methods

A multicenter, retrospective, cohort study, called REAL.IT, was performed based on the data collected from the electronic medical records of nine specialized HF centers in Italy. Cardiopulmonary exercise testing was performed at baseline and after 12 months of sacubitril/valsartan therapy, monitoring carbon dioxide production (VCO2) and oxygen consumption (VO2).

Results

The functional capacities of 170 patients were evaluated. The most common comorbidities were hypertension and diabetes (i.e., 53.5 and 32.4%, respectively). At follow-up, both the VO2 peak (from 15.1 ± 3.7 ml/kg/min at baseline to 17.6 ± 4.7 ml/kg/min at follow-up, p < 0.0001) and the predicted % VO2 peak (from 55.5 ± 14.1 to 65.5 ± 16.9, p < 0.0001) significantly increased from baseline. The VO2 at the anaerobic threshold (AT-VO2) increased from 11.5 ± 2.6 to 12.5 ± 3.3 ml/kg/min (p = 0.021), and the rate ratio between the oxygen uptake and the change in work (ΔVO2/Δwork slope) improved from 9.1 ± 1.5 to 9.9 ± 1.6 ml/min/W (p < 0.0001). Conclusions: Sacubitril/valsartan improves the cardiopulmonary capacity of patients with HFrEF in daily clinical practice in Italy.

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