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Cardiopulmonary exercise testing as a fundamental tool in the assessment of the functional class in treating sacubitril / valsartan. Results at 3 months

Session Poster Session 2

Speaker Cristina BELTRAN HERRERA

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Pharmacotherapy
  • Session type : Poster Session

Authors : C Beltran Herrera (Madrid,ES), V Suberviola Sanchez-Caballero (Madrid,ES), S Briongos (Madrid,ES), C Cortina (Madrid,ES), M Sarrion (Madrid,ES), A Sanchez (Madrid,ES), E Gomez (Madrid,ES), A Estevez (Madrid,ES), I Ponz (Madrid,ES), D Vaqueriza (Madrid,ES), M Dominguez (Madrid,ES), ML Giganto (Madrid,ES), S Jimenez (Madrid,ES), L Mora (Madrid,ES), R Munoz (Madrid,ES)

C Beltran Herrera1 , V Suberviola Sanchez-Caballero1 , S Briongos1 , C Cortina1 , M Sarrion1 , A Sanchez1 , E Gomez1 , A Estevez1 , I Ponz1 , D Vaqueriza1 , M Dominguez1 , ML Giganto1 , S Jimenez1 , L Mora1 , R Munoz1 , 1University Hospital Infanta Leonor - Madrid - Spain ,

Chronic Heart Failure: Pharmacotherapy


Sacubitril-Valsartan (ARNI) has demonstrated to improve the functional class (FC) measured by NYHA in patients (pts) with heart failure (HF) and ventricular dysfunction. The most objective method of assessing FC in HF is the peak oxygen uptake (Vo2) in a cardiopulmonary exercise test (CPET). Our objective is to assess whether the use of ARNI in pts with HF also improves the FC measured by peakVo2.


We analyzed 20 pts with HF and left ventricular dysfunction, treated with ARNI according to ESC guideliness. FC was determined before ARNI (basal) and 3 months after treatment by NYHA and by CPET. According to the % peakVo2 reached, by the Wasseman predicted values, the FC estimated was: normal FC> 80% predicted, FC slightly reduced 60-79%, FC moderately reduced 59-50% and FC severely reduced <50%


85% males, 69 ± 9 years, LVEF 31 ± 4%, NTproBNP 2039 ± 2020, 45% ischemic C., 50% C idiopathic C. 100% use of beta-blockers

The correlation between baseline FC estimated by NYHA and estimated with peak VO2 was poor (Fig 1 A). In both groups there was a tendency to improve FC by both NYHA and by CPET. (Fig 1 B, D). According to our series, pts with the greatest improvement in FC by CEPT had worse baseline peakVO2 consumption (912 vs 1170 ml / min, p = 0.03), lower weight (74 ± 8 vs 95 ± 18 kg, p = 0, 02) and were older (74 ± 5 years vs 61 ± 10 years, p = 0.19)

CONCLUSIONS There is a poor correlation between FC assessed by NYHA and measured by CEPT in pts with ventricular dysfunction. Pts have worse FC by CEPT than by NYHA. Treatment with ARNI tends to improve the FC estimated by both methods after 3 months. It is especially in older pts, without overweight conditions and with worse basal situation that improve better in our series. This data points to a functional objective improvement with ARNI.

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