PMID- 30791533 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20200929 IS - 2077-0383 (Print) IS - 2077-0383 (Electronic) IS - 2077-0383 (Linking) VI - 8 IP - 2 DP - 2019 Feb 20 TI - Early Effects of Sacubitril/Valsartan on Exercise Tolerance in Patients with Heart Failure with Reduced Ejection Fraction. LID - 10.3390/jcm8020262 [doi] LID - 262 AB - BACKGROUND: Sacubitril/valsartan in heart failure (HF) with reduced ejection fraction (HFrEF) was shown to be superior to enalapril in reducing the risk of death and hospitalization for HF. Our aim was to evaluate the cardiopulmonary effects of sacubitril/valsartan in patients with HFrEF. METHODS: We conducted an observational study. Ninety-nine ambulatory patients with HFrEF underwent serial cardiopulmonary exercise tests (CPET) after initiation of sacubitril/valsartan in addition to recommended therapy. RESULTS: At baseline, 37% of patients had New York Heart Association (NYHA) class III. After a median follow-up of 6.2 months (range 3(-)14.9 months) systolic blood pressure decreased from 117 +/- 14 to 101 +/- 12 mmHg (p < 0.0001), left ventricular ejection fraction (LVEF) increased from 27 +/- 6 to 29.7 +/- 7% (p < 0.0001), peak oxygen consumption (VO(2)) improved from 14.6 +/- 3.3 (% of predicted = 53.8 +/- 14.1) to 17.2 +/- 4.7 mL/kg/min (% of predicted = 64.7 +/- 17.8) (p < 0.0001), minute ventilation/carbon dioxide production relationship (VE/VCO(2) Slope) decreased from 34.1 +/- 6.3 to 31.7 +/- 6.1 (p = 0.006), VO(2) at anaerobic threshold increased from 11.3 +/- 2.6 to 12.6 +/- 3.5 mL/kg/min (p = 0.007), oxygen pulse increased from 11.5 +/- 3.0 to 13.4 +/- 4.3 mL/kg/min (p < 0.0001), and ∆VO(2)/∆Work increased from 9.2 +/- 1.5 to 10.1 +/- 1.8 mL/min/watt (p = 0.0002). CONCLUSION: Sacubitril/valsartan improved exercise tolerance, LVEF, peak VO(2), and ventilatory efficiency at 6.2 months follow-up. Further studies are necessary to better clarify underlying mechanisms of this functional improvement. FAU - Vitale, Giuseppe AU - Vitale G AD - Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy. giuseppevit@hotmail.com. FAU - Romano, Giuseppe AU - Romano G AD - Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation IRCCS (-) ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90127 Palermo, Italy. gromano@ismett.edu. FAU - Di Franco, Antonino AU - Di Franco A AD - Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY 10065, USA. and2052@med.cornell.edu. FAU - Caccamo, Giuseppa AU - Caccamo G AD - Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy. caccamo.giuseppa@libero.it. FAU - Nugara, Cinzia AU - Nugara C AUID- ORCID: 0000-0001-9415-2360 AD - Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy. cinzianugara@gmail.com. AD - Biomedical Department of Internal Medicine and Specialities (DIBIMIS), University of Palermo (-) IRCSS Bonino Pulejo, 98124 Messina, Italy. cinzianugara@gmail.com. FAU - Ajello, Laura AU - Ajello L AD - Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation IRCCS (-) ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90127 Palermo, Italy. lajello1305@libero.it. FAU - Storniolo, Salvo AU - Storniolo S AD - Cardiology Unit, University Hospital, Policlinico Paolo Giaccone, 90127 Palermo, Italy. salvo.storniolo@gmail.com. FAU - Sarullo, Silvia AU - Sarullo S AD - Cardiology Unit, University Hospital, Policlinico Paolo Giaccone, 90127 Palermo, Italy. silvia.sarullo@libero.it. FAU - Agnese, Valentina AU - Agnese V AUID- ORCID: 0000-0002-0548-0926 AD - Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation IRCCS (-) ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90127 Palermo, Italy. vagnese@ismett.edu. FAU - Giallauria, Francesco AU - Giallauria F AUID- ORCID: 0000-0003-4119-9397 AD - Department of Translational Medical Sciences, Division of Internal Medicine, Metabolic and Cardiac Rehabilitation Unit, Federico II University, 80138 Naples, Italy. francesco.giallauria@unina.it. FAU - Novo, Giuseppina AU - Novo G AD - Cardiology Unit, University Hospital, Policlinico Paolo Giaccone, 90127 Palermo, Italy. giuseppina.novo@unipa.it. FAU - Clemenza, Francesco AU - Clemenza F AUID- ORCID: 0000-0002-8099-568X AD - Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation IRCCS (-) ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), 90127 Palermo, Italy. fclemenza@ismett.edu. FAU - Sarullo, Filippo M AU - Sarullo FM AUID- ORCID: 0000-0003-2046-8316 AD - Cardiovascular Rehabilitation Unit, Buccheri La Ferla Fatebenefratelli Hospital, 90123 Palermo, Italy. fsarullo@neomedia.it. LA - eng PT - Journal Article DEP - 20190220 PL - Switzerland TA - J Clin Med JT - Journal of clinical medicine JID - 101606588 PMC - PMC6406731 OTO - NOTNLM OT - cardiopulmonary test OT - exercise tolerance OT - heart failure OT - sacubitril/valsartan COIS- The authors declare no conflict of interest. EDAT- 2019/02/23 06:00 MHDA- 2019/02/23 06:01 PMCR- 2019/02/20 CRDT- 2019/02/23 06:00 PHST- 2019/01/22 00:00 [received] PHST- 2019/02/17 00:00 [revised] PHST- 2019/02/18 00:00 [accepted] PHST- 2019/02/23 06:00 [entrez] PHST- 2019/02/23 06:00 [pubmed] PHST- 2019/02/23 06:01 [medline] PHST- 2019/02/20 00:00 [pmc-release] AID - jcm8020262 [pii] AID - jcm-08-00262 [pii] AID - 10.3390/jcm8020262 [doi] PST - epublish SO - J Clin Med. 2019 Feb 20;8(2):262. doi: 10.3390/jcm8020262.