RAW DATA of the paper IMPROVEMENT OF FUNCTIONAL CAPACITY IN SACUBITRIL-VALSARTAN TREATED PATIENTS ASSESSED BY CARDIOPULMONARY EXERCISE TEST

Neprilisin and angiotensin receptor inhibition (Sacubitril/Valsartan, i.e. ARNI) is recommended in heart failure guidelines for patients in NYHA class II-III with reduced left ventricular ejection fraction (LVEF). ARNI increase survival and quality of life; due to their hemodynamic effects, ARNI could also affect exercise tolerance. We studied the effects of ARNI on cardiopulmonary test (CPET) after six months of treatment in 35 patients [67±11 years; LVEF 31±6%; NT-proBNP 1822±1651 pg/ml; ICD/CRT since at least 6 months in 26/35], treated with increasing doses of Sacubitril/Valsartan up to 318±36 mg/die. In addition, levels of NT-proBNP, renal function, electrolytes, and echocardiocolorDoppler were assessed in the same time periods. No variations of renal function and/or potassium levels were observed; NT-proBNP decreased. Most CPET variables were improved by ARNI (p<0.05): peak VO₂ and O₂ pulse increased (from 15.8±3.4 to 17.0±4.0 ml/Kg/min and from 11.5±2.5 to 12.6±2.4 ml/beat, respectively), while VEVCO₂ slope decreased from 35.2±11.2 to 33.1±12.3. A significant relationship (p<0.05) was observed between the amount of increase in LVEF and that of O₂ pulse in all patients, and between the amount of decrease in PAPs and that of VEVCO₂ slope in patients showing pulmonary hypertension in baseline. In a subgroup of 22 patients who already completed A 1 year follow-up, overall CPET improvement was maintained. In conclusion, already in the short term ARNI favorably affect cardiopulmonary response to exercise in heart failure patients; such a change seems to be preserved on a longer period.