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首页> 外文期刊>Journal of Clinical Medicine >Early Effects of Sacubitril/Valsartan on Exercise Tolerance in Patients with Heart Failure with Reduced Ejection Fraction
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Early Effects of Sacubitril/Valsartan on Exercise Tolerance in Patients with Heart Failure with Reduced Ejection Fraction

机译：沙比特比/缬沙坦对射血分数降低的心力衰竭患者运动耐量的早期影响

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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.
机译：背景。在降低心衰（HFrEF）的心力衰竭（HF）中，沙库比利/缬沙坦在减少HF的死亡和住院风险方面优于依那普利。我们的目的是评估沙比特利/缬沙坦对HFrEF患者的心肺功能。方法。我们进行了一项观察性研究。 99名门诊HFrEF的患者除推荐的治疗方法外，在开始使用沙比特利/缬沙坦后还进行了系列心肺运动试验（CPET）。结果。在基线时，37％的患者患有纽约心脏协会（NYHA）的III级。中位随访6.2个月（范围为3–14.9个月）后，收缩压从117±14毫米汞柱降至101±12毫米汞柱（p <0.0001），左心室射血分数（LVEF）从27±6升高至29.7± 7％（p <0.0001），峰值耗氧量（VO 2）从14.6±3.3（预计的百分比= 53.8±14.1）提高到17.2±4.7 mL / kg / min（预测的百分比= 64.7±17.8）（p < 0.0001），分钟通气量/二氧化碳产生量的关系（VE / VCO 2斜率）从34.1±6.3降低到31.7±6.1（p = 0.006），无氧阈值的VO 2从11.3±2.6增加到12.6±3.5 mL / kg / min（p = 0.007），氧气脉冲从11.5±3.0增加到13.4±4.3 mL / kg / min（p <0.0001）,? VO 2 /？功从9.2±1.5增加到10.1±1.8 mL / min / watt （p ＝ 0.0002）。结论。在6.2个月的随访中，沙库比特/缬沙坦改善了运动耐力，LVEF，VO 2峰值和通气效率。为了更好地弄清这种功能改善的潜在机制，有必要进行进一步的研究。

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