Sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailty
Abstract Aims The aim of this study was to investigate prospectively the effect of sacubitril/valsartan in advanced heart failure (HF) patients in waiting list for heart transplantation (HT) and the effect on physical frailty (PF). Methods and results We treated 37 consecutive patients with advanced...
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doaj-3531b9bfac11405882638e4e88e2177b2021-06-09T10:10:55ZengWileyESC Heart Failure2055-58222020-04-017275776210.1002/ehf2.12610Sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailtyFrancesco Cacciatore0Cristiano Amarelli1Ciro Maiello2Irene Mattucci3Gemma Salerno4Marco Di Maio5Vittorio Palmieri6Francesco Curcio7Flora Pirozzi8Valentina Mercurio9Giuditta Benincasa10Paolo Golino11Domenico Bonaduce12Claudio Napoli13Pasquale Abete14Department of Translational Medical Sciences University of Naples ‘Federico II’ 80131 Naples ItalyDepartment of Cardiovascular Surgery and Transplant Monaldi Hospital, Azienda dei Colli 80131 Naples ItalyDepartment of Cardiovascular Surgery and Transplant Monaldi Hospital, Azienda dei Colli 80131 Naples ItalyDepartment of Cardiovascular Surgery and Transplant Monaldi Hospital, Azienda dei Colli 80131 Naples ItalyDepartment of Cardiovascular Surgery and Transplant Monaldi Hospital, Azienda dei Colli 80131 Naples ItalyDepartment of Cardiology Università degli Studi della Campania ‘Luigi Vanvitelli’, Monaldi Hospital 80131 Naples ItalyDepartment of Cardiovascular Surgery and Transplant Monaldi Hospital, Azienda dei Colli 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples ‘Federico II’ 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples ‘Federico II’ 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples ‘Federico II’ 80131 Naples ItalyUniversity Department of Advanced Medical and Surgical Sciences, Clinical Department of Internal and Specialty Medicine (DAI) Università degli Studi della Campania ‘Luigi Vanvitelli’ 80138 Naples ItalyDepartment of Cardiology Università degli Studi della Campania ‘Luigi Vanvitelli’, Monaldi Hospital 80131 Naples ItalyDepartment of Translational Medical Sciences University of Naples ‘Federico II’ 80131 Naples ItalyUniversity Department of Advanced Medical and Surgical Sciences, Clinical Department of Internal and Specialty Medicine (DAI) Università degli Studi della Campania ‘Luigi Vanvitelli’ 80138 Naples ItalyDepartment of Translational Medical Sciences University of Naples ‘Federico II’ 80131 Naples ItalyAbstract Aims The aim of this study was to investigate prospectively the effect of sacubitril/valsartan in advanced heart failure (HF) patients in waiting list for heart transplantation (HT) and the effect on physical frailty (PF). Methods and results We treated 37 consecutive patients with advanced HF with sacubitril/valsartan. Patients were followed up until HT, device implant, or last follow‐up visit after 2 years of follow‐up. At baseline, mean New York Heart Association (NYHA) class was 3.1 ± 0.4, with 64.9% in NYHA III and 35.1% NYHA IIIB. Left ventricular ejection fraction was 23.5 ± 5.8%, VO2 max was 10.3 ± 2.3 mL/kg/min, cardiac index was 2.3 ± 0.5 L/min/m2, and N‐terminal pro‐brain natriuretic peptide (NT‐pro‐BNP) was 4943.0 ± 5326.8 pg/mL. After a mean follow‐up of 17.1 ± 4.4 months, no deaths were observed, but NYHA class improved significantly with 56.8% in NYHA II, 40.5% in NYHA III, and 2.7% in NYHA IIIB (P < 0.001). VO2 max and 6 min walk test (6MWT) increased, whereas pulmonary systolic blood pressure, E/E′, VE/VCO2 slope, and NT‐pro‐BNP decreased. At right heart catheterization performed after 1 year of follow‐up, cardiac index and pulmonary vascular resistance remained stable, while a decrease in systolic pulmonary artery pressure and pulmonary capillary wedge pressure is observed. Furosemide dosage decrease from 102.7 ± 69.4 to 78.7 ± 66.3 mg (P = 0.040). PF decreased from 3.35 ± 1.0 at baseline to 1.57 ± 1.3 at the end of follow‐up (P < 0.001), with a reduction in all PF domains. Conclusions Our study showed a rapid improvement in PF in HT waiting list patients treated with sacubitril/valsartan. The improvement in all PF domains was paralleled by VO2 and 6MWT increase and together with an NT‐pro‐BNP reduction constant over the follow‐up.https://doi.org/10.1002/ehf2.12610Heart FailureSacubitril/ValsartanFrailty |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Francesco Cacciatore Cristiano Amarelli Ciro Maiello Irene Mattucci Gemma Salerno Marco Di Maio Vittorio Palmieri Francesco Curcio Flora Pirozzi Valentina Mercurio Giuditta Benincasa Paolo Golino Domenico Bonaduce Claudio Napoli Pasquale Abete |
spellingShingle |
Francesco Cacciatore Cristiano Amarelli Ciro Maiello Irene Mattucci Gemma Salerno Marco Di Maio Vittorio Palmieri Francesco Curcio Flora Pirozzi Valentina Mercurio Giuditta Benincasa Paolo Golino Domenico Bonaduce Claudio Napoli Pasquale Abete Sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailty ESC Heart Failure Heart Failure Sacubitril/Valsartan Frailty |
author_facet |
Francesco Cacciatore Cristiano Amarelli Ciro Maiello Irene Mattucci Gemma Salerno Marco Di Maio Vittorio Palmieri Francesco Curcio Flora Pirozzi Valentina Mercurio Giuditta Benincasa Paolo Golino Domenico Bonaduce Claudio Napoli Pasquale Abete |
author_sort |
Francesco Cacciatore |
title |
Sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailty |
title_short |
Sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailty |
title_full |
Sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailty |
title_fullStr |
Sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailty |
title_full_unstemmed |
Sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailty |
title_sort |
sacubitril/valsartan in patients listed for heart transplantation: effect on physical frailty |
publisher |
Wiley |
series |
ESC Heart Failure |
issn |
2055-5822 |
publishDate |
2020-04-01 |
description |
Abstract Aims The aim of this study was to investigate prospectively the effect of sacubitril/valsartan in advanced heart failure (HF) patients in waiting list for heart transplantation (HT) and the effect on physical frailty (PF). Methods and results We treated 37 consecutive patients with advanced HF with sacubitril/valsartan. Patients were followed up until HT, device implant, or last follow‐up visit after 2 years of follow‐up. At baseline, mean New York Heart Association (NYHA) class was 3.1 ± 0.4, with 64.9% in NYHA III and 35.1% NYHA IIIB. Left ventricular ejection fraction was 23.5 ± 5.8%, VO2 max was 10.3 ± 2.3 mL/kg/min, cardiac index was 2.3 ± 0.5 L/min/m2, and N‐terminal pro‐brain natriuretic peptide (NT‐pro‐BNP) was 4943.0 ± 5326.8 pg/mL. After a mean follow‐up of 17.1 ± 4.4 months, no deaths were observed, but NYHA class improved significantly with 56.8% in NYHA II, 40.5% in NYHA III, and 2.7% in NYHA IIIB (P < 0.001). VO2 max and 6 min walk test (6MWT) increased, whereas pulmonary systolic blood pressure, E/E′, VE/VCO2 slope, and NT‐pro‐BNP decreased. At right heart catheterization performed after 1 year of follow‐up, cardiac index and pulmonary vascular resistance remained stable, while a decrease in systolic pulmonary artery pressure and pulmonary capillary wedge pressure is observed. Furosemide dosage decrease from 102.7 ± 69.4 to 78.7 ± 66.3 mg (P = 0.040). PF decreased from 3.35 ± 1.0 at baseline to 1.57 ± 1.3 at the end of follow‐up (P < 0.001), with a reduction in all PF domains. Conclusions Our study showed a rapid improvement in PF in HT waiting list patients treated with sacubitril/valsartan. The improvement in all PF domains was paralleled by VO2 and 6MWT increase and together with an NT‐pro‐BNP reduction constant over the follow‐up. |
topic |
Heart Failure Sacubitril/Valsartan Frailty |
url |
https://doi.org/10.1002/ehf2.12610 |
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