Sarullo Filippo Maria, Nugara Cinzia, Sarullo Silvia, Iacoviello Massimo, Di Gesaro Gabriele, Miani Daniela, Driussi Mauro, Correale Michele, Bilato Claudio, Passantino Andrea, Carluccio Erberto, Villani Alessandra, Degli Esposti Luca, D'Agostino Chiara, Peruzzi Elena, Poli Simone, Di Lenarda Andrea
U.O.S.D. di Riabilitazione Cardiovascolare Ospedale Buccheri La Ferla Fatebenefratelli, Palermo, Italy.
School of Sport Medicine and Physical Exercise Medicine, Department of Biomedicine, Neurosciences and Advances Diagnostic, University of Palermo, Palermo, Italy.
Front Cardiovasc Med. 2024 May 10;11:1347908. doi: 10.3389/fcvm.2024.1347908. eCollection 2024.
Heart failure (HF) significantly affects the morbidity, mortality, and quality of life of patients. New therapeutic strategies aim to improve the functional capacity and quality of life of patients while controlling HF-related risks. Real-world data on both the functional and cardiopulmonary exercise capacities of patients with HF with reduced ejection fraction upon sacubitril/valsartan use are lacking.
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 (VCO) and oxygen consumption (VO).
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 VO peak (from 15.1 ± 3.7 ml/kg/min at baseline to 17.6 ± 4.7 ml/kg/min at follow-up, < 0.0001) and the predicted % VO peak (from 55.5 ± 14.1 to 65.5 ± 16.9, < 0.0001) significantly increased from baseline. The VO at the anaerobic threshold (AT-VO) increased from 11.5 ± 2.6 to 12.5 ± 3.3 ml/kg/min ( = 0.021), and the rate ratio between the oxygen uptake and the change in work (ΔVO/Δwork slope) improved from 9.1 ± 1.5 to 9.9 ± 1.6 ml/min/W ( < 0.0001).
Sacubitril/valsartan improves the cardiopulmonary capacity of patients with HFrEF in daily clinical practice in Italy.
心力衰竭（HF）严重影响患者的发病率、死亡率和生活质量。新的治疗策略旨在提高患者的功能能力和生活质量，同时控制与HF相关的风险。目前缺乏关于使用沙库巴曲缬沙坦后射血分数降低的HF患者的功能和心肺运动能力的真实世界数据。
一项名为REAL.IT的多中心、回顾性队列研究，基于从意大利9个专业HF中心的电子病历中收集的数据进行。在基线和沙库巴曲缬沙坦治疗12个月后进行心肺运动测试，监测二氧化碳产生量（VCO）和氧气消耗量（VO）。
对170例患者的功能能力进行了评估。最常见的合并症是高血压和糖尿病（分别为53.5%和32.4%）。随访时，峰值VO（从基线时的15.1±3.7 ml/kg/min增加到随访时的17.6±4.7 ml/kg/min，P<0.0001）和预测的峰值VO百分比（从55.5±14.1增加到65.5±16.9，P<0.0001）均较基线时显著增加。无氧阈值时的VO（AT-VO）从11.5±2.6增加到12.5±3.3 ml/kg/min（P=0.021），摄氧量与工作量变化的比率（ΔVO/Δ工作斜率）从9.1±1.5提高到9.9±1.6 ml/min/W（P<0.0001）。
在意大利的日常临床实践中，沙库巴曲缬沙坦可改善射血分数降低的HF患者的心肺功能。
