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Dattilo G, Bitto R, Correale M, Morabito C, Vaccaro V, Laterra G, Casale M, Crea P, DI Bella G, Luzza F, Migliorato A, Katsiki N, DE Gregorio C. 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. Minerva Cardiol Angiol 2021; 70:555-562. [PMID: 33823573 DOI: 10.23736/s2724-5683.20.05494-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
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.
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Affiliation(s)
- Giuseppe Dattilo
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Roberto Bitto
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Michele Correale
- Cardiology Unit, Policlinico Riuniti University Hospital, Foggia, Italy -
| | - Claudia Morabito
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vittoria Vaccaro
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giulia Laterra
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Matteo Casale
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Pasquale Crea
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gianluca DI Bella
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Francesco Luzza
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alessandro Migliorato
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Niki Katsiki
- Second Department of Propaedeutic Internal Medicine, Medical School, Hippocration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Cesare DE Gregorio
- Section of Cardiology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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