AUTHOR=Sarullo Filippo Maria , Nugara Cinzia , Sarullo Silvia , Iacoviello Massimo , Di Gesaro Gabriele , Miani Daniela , Driussi Mauro , Correale Michele , Bilato Claudio , Passantino Andrea , Carluccio Erberto , Villani Alessandra , Degli Esposti Luca , D’Agostino Chiara , Peruzzi Elena , Poli Simone , Di Lenarda Andrea 

TITLE=Effects of sacubitril/valsartan on the functional capacity of real-world patients in Italy: the REAL.IT study on heart failure with reduced ejection fraction

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=11

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1347908

DOI=10.3389/fcvm.2024.1347908

ISSN=2297-055X

ABSTRACT=<sec><title>Background</title><p>Heart failure (HF) significantly affects the morbidity, mortality, and quality of life of patients. New therapeutic strategies aim to improve the functional capacity and quality of life of patients while controlling HF-related risks. Real-world data on both the functional and cardiopulmonary exercise capacities of patients with HF with reduced ejection fraction upon sacubitril/valsartan use are lacking.</p></sec><sec><title>Methods</title><p>A multicenter, retrospective, cohort study, called REAL.IT, was performed based on the data collected from the electronic medical records of nine specialized HF centers in Italy. Cardiopulmonary exercise testing was performed at baseline and after 12 months of sacubitril/valsartan therapy, monitoring carbon dioxide production (VCO<sub>2</sub>) and oxygen consumption (VO<sub>2</sub>).</p></sec><sec><title>Results</title><p>The functional capacities of 170 patients were evaluated. The most common comorbidities were hypertension and diabetes (i.e., 53.5 and 32.4%, respectively). At follow-up, both the VO<sub>2</sub> peak (from 15.1 ± 3.7 ml/kg/min at baseline to 17.6 ± 4.7 ml/kg/min at follow-up, <italic>p</italic> &lt; 0.0001) and the predicted % VO<sub>2</sub> peak (from 55.5 ± 14.1 to 65.5 ± 16.9, <italic>p</italic> &lt; 0.0001) significantly increased from baseline. The VO<sub>2</sub> at the anaerobic threshold (AT-VO<sub>2</sub>) increased from 11.5 ± 2.6 to 12.5 ± 3.3 ml/kg/min (<italic>p</italic> = 0.021), and the rate ratio between the oxygen uptake and the change in work (ΔVO<sub>2</sub>/Δwork slope) improved from 9.1 ± 1.5 to 9.9 ± 1.6 ml/min/W (<italic>p</italic> &lt; 0.0001).</p></sec><sec><title>Conclusions</title><p>Sacubitril/valsartan improves the cardiopulmonary capacity of patients with HFrEF in daily clinical practice in Italy.</p></sec>