Neijenhuis Ralph M L, Nederend Marieke, van Groningen Anna E, Jongbloed Monique R M, Vliegen Hubert W, Jukema J Wouter, Kiès Philippine, Egorova Anastasia D
Center for Congenital Heart Disease Amsterdam Leiden (CAHAL), Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands.
Department of Cardiology, Leiden University Medical Center, Leiden, Zuid-Holland, Netherlands.
Open Heart. 2025 Jan 30;12(1):e003009. doi: 10.1136/openhrt-2024-003009.
Short-term improvements in quality of life (QOL) have been reported in adult congenital heart disease patients with systemic right ventricle (sRV) failure after treatment with sacubitril/valsartan. This study aimed to evaluate the medium-term QOL changes in sRV failure patients treated with sacubitril/valsartan.
In this single-centre, prospective cohort study, patients with symptomatic sRV failure completed the Netherlands Organisation for Applied Scientific Research/Academic Hospital Leiden Questionnaire for Adult's Health-Related Quality of Life (TAAQOL) at baseline and after starting treatment with sacubitril/valsartan. The TAAQOL was taken at structured outpatient follow-up moments after 6, 12, 24 and 36 months of treatment. Linear mixed effects models were used to evaluate the medium-term changes in 12 QOL domains.
Of 40 sRV failure patients initiated on sacubitril/valsartan, 35 completed the titration phase, and 31 filled in a total of 98 TAAQOL questionnaires (response rate 77.5%). Significant improvements in gross motoric functioning (p=0.008), cognitive function (p=0.002), sleep (p=0.041), social functioning (p<0.001) and daily activities (p=0.001) were observed during follow-up. No significant changes were observed in fine motoric functioning, pain, sexuality, vitality, positive, depressive or aggressive emotions. Of interest, periods with restrictions relating to the COVID-19 pandemic did not significantly influence changes over time in any of the 12 QOL domains.
Sacubitril/valsartan treatment was associated with persistent medium-term QOL improvements in gross motoric functioning, cognitive function, sleep, social functioning and daily activities domains in sRV failure patients. Self-perceived QOL of sRV failure patients may be amenable to improvement with sacubitril/valsartan.
已有报道称，接受沙库巴曲缬沙坦治疗的患有系统性右心室（sRV）衰竭的成人先天性心脏病患者的生活质量（QOL）在短期内有所改善。本研究旨在评估接受沙库巴曲缬沙坦治疗的sRV衰竭患者的中期QOL变化。
在这项单中心前瞻性队列研究中，有症状的sRV衰竭患者在基线时以及开始接受沙库巴曲缬沙坦治疗后，完成了荷兰应用科学研究组织/莱顿大学医学中心成人健康相关生活质量问卷（TAAQOL）。TAAQOL在治疗6、12、24和36个月后的结构化门诊随访时进行。使用线性混合效应模型评估12个QOL领域的中期变化。
在40例开始接受沙库巴曲缬沙坦治疗的sRV衰竭患者中，35例完成了滴定阶段，31例共填写了98份TAAQOL问卷（应答率77.5%）。随访期间观察到粗大运动功能（p=0.008）、认知功能（p=0.002）、睡眠（p=0.041）、社交功能（p<0.001）和日常活动（p=0.001）有显著改善。精细运动功能、疼痛、性功能、活力、积极情绪、抑郁情绪或攻击情绪未观察到显著变化。有趣的是，与2019冠状病毒病大流行相关的限制期并未对12个QOL领域中的任何一个随时间的变化产生显著影响。
沙库巴曲缬沙坦治疗与sRV衰竭患者在粗大运动功能、认知功能、睡眠、社交功能和日常活动领域的中期QOL持续改善相关。sRV衰竭患者的自我感知QOL可能通过沙库巴曲缬沙坦得到改善。
