Paola Beltrán1, Patricia Palau2, Eloy Domínguez2, Mercedes Faraudo1, Eduardo Núñez3, Olga Guri1, Anna Mollar3, Juan Sanchis3, Antoni Bayés-Genís4, Julio Núñez5. 1. Cardiology Service and Heart Failure Unit, Hospital Moisès Broggi/Hospital General de Hospitalet, Spain. 2. Cardiology Department, Hospital General Universitario de Castellón, Universitat Jaume I, Castellón, Spain. 3. Cardiology Department, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain. 4. Cardiology Service and Heart Failure Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Autonomous University of Barcelona, CIBERCV, Barcelona, Spain. 5. Cardiology Department, Hospital Clínico Universitario, INCLIVA, Universitat de València, CIBERCV, Valencia, Spain. Electronic address: yulnunez@gmail.com.
Abstract
BACKGROUND: Impaired exercise capacity is the most disabling symptom in patients with heart failure with reduced ejection fraction (HFrEF). Despite sacubitril/valsartan showing reduced long-term morbidity and mortality over enalapril in HFrEF, its effects on short-term functional capacity remain uncertain. We sought to evaluate the effects of sacubitril/valsartan on a 30-day six-minute walk test in eligible patients with HFrEF. METHODS AND RESULTS: From November 1, 2016 to February 1, 2017, a total of 58 stable symptomatic patients with HFrEF were eligible for sacubitril/valsartan and underwent 6-MWT before and 30days after initiation of sacubitril/valsartan therapy. A mixed-effects model for repeated-measures was used to analyze the changes. Mean age was 70±11years. 72.4% males, 46.6% with ischemic heart disease, and 51.7% on NYHA functional class III were included. The mean (SD) values of baseline LVEF and 6MWT were 30±7%, and 300±89m, respectively. The median (IQR) of NT-proBNP at baseline was 2701pg/ml (1087-4200). Compared with baseline, the 6-MWT distance increased significantly at 30days by 13.9% (+∆=41.8m (33.4-50.2); p<0.001). CONCLUSIONS: In this pilot study, sacubitril/valsartan was associated with an improvement in exercise tolerance in symptomatic patients with HFrEF.
BACKGROUND: Impaired exercise capacity is the most disabling symptom in patients with heart failure with reduced ejection fraction (HFrEF). Despite sacubitril/valsartan showing reduced long-term morbidity and mortality over enalapril in HFrEF, its effects on short-term functional capacity remain uncertain. We sought to evaluate the effects of sacubitril/valsartan on a 30-day six-minute walk test in eligible patients with HFrEF. METHODS AND RESULTS: From November 1, 2016 to February 1, 2017, a total of 58 stable symptomatic patients with HFrEF were eligible for sacubitril/valsartan and underwent 6-MWT before and 30days after initiation of sacubitril/valsartan therapy. A mixed-effects model for repeated-measures was used to analyze the changes. Mean age was 70±11years. 72.4% males, 46.6% with ischemic heart disease, and 51.7% on NYHA functional class III were included. The mean (SD) values of baseline LVEF and 6MWT were 30±7%, and 300±89m, respectively. The median (IQR) of NT-proBNP at baseline was 2701pg/ml (1087-4200). Compared with baseline, the 6-MWT distance increased significantly at 30days by 13.9% (+∆=41.8m (33.4-50.2); p<0.001). CONCLUSIONS: In this pilot study, sacubitril/valsartan was associated with an improvement in exercise tolerance in symptomatic patients with HFrEF.
Authors: Kanokwan Bunsawat; Stephen M Ratchford; Jeremy K Alpenglow; Soung Hun Park; Catherine L Jarrett; Josef Stehlik; Adam S Smith; Russell S Richardson; D Walter Wray Journal: J Appl Physiol (1985) Date: 2020-11-19
Authors: Elena Revuelta-López; Julio Núñez; Paloma Gastelurrutia; Germán Cediel; James L Januzzi; Nasrien E Ibrahim; Michele Emdin; Roland VanKimmenade; Domingo Pascual-Figal; Eduardo Núñez; Frank Gommans; Josep Lupón; Antoni Bayés-Genís Journal: ESC Heart Fail Date: 2020-02-11
Authors: Rebabonye B Pharithi; Maria Ferre-Vallverdu; Alan S Maisel; Eoin O'Connell; Myra Walshe; Claire Sweeney; James Barton; Kathrine McDonald; Daniel O'Hare; Chris Watson; Joe Gallagher; Mark Ledwidge; Kenneth McDonald Journal: ESC Heart Fail Date: 2020-01-05