Short term effect of sacubitril/valsartan on comprehensive geriatric assessment in chronic heart failure: a real life analysis

被引：5

作者：

Armentaro, Giuseppe ^{[1
]}

Condoleo, Valentino ^{[1
]}

Pelaia, Corrado ^{[1
]}

Cassano, Velia ^{[1
]}

Miceli, Sofia ^{[1
]}

Maio, Raffaele ^{[1
]}

Salzano, Andrea ^{[2
]}

Pelle, Maria Chiara ^{[1
]}

Perticone, Maria ^{[1
]}

Succurro, Elena ^{[1
]}

Arturi, Franco ^{[1
]}

Andreozzi, Francesco ^{[1
]}

Sesti, Giorgio ^{[3
]}

Sciacqua, Angela ^{[1
]}

机构：

[1] Magna Graecia Univ Catanzaro, Dept Med & Surg Sci, Campus Univ Germaneto, I-88100 Catanzaro, Italy

[2] IRCSS, SYNLAB SDN, Diagnost & Nucl Inst, Naples, Italy

[3] Univ Rome Sapienza, Dept Clin & Mol Med, Rome, Italy

来源：

INTERNAL AND EMERGENCY MEDICINE | 2023年 / 18卷 / 01期

关键词：

Sacubitril/Valsartan; Heart failure with reduced ejection fraction; Cognitive impairment; Comprehensive geriatric assessment; Cardiac index; Global longitudinal strain; COGNITIVE IMPAIRMENT; DEPRESSIVE SYMPTOMS; ELDERLY-PATIENTS; MORTALITY; VALIDATION; ILLNESS; ANXIETY; SCALE;

D O I：

10.1007/s11739-022-03130-6

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Sacubitril/Valsartan (Sac-Val) has improved clinical prognosis in patients affected by heart failure (HF) with reduced ejection fraction (HFrEF). Comorbidities have a crucial impact on clinical presentation and prognosis in HF patients. Cognitive impairment (CoI) and Depression are a very common comorbidity in patients with HF and is widely recognized as a specific determinant of chronic disability, and HF patients with poor physical functional performance in Short physical performance battery (SPPB) showed a worse prognosis. The aim of the present study was to evaluate the potential effects of Sac-Val on functional, humoral, and cognitive aspects, evaluated by performing comprehensive geriatric assessment (CGA), in a cohort of elderly HFrEF. We studied 61 patients (51 men and 10 women, mean age 76.4 & PLUSMN; 5.1 years) suffering from HFrEF. After 6 months follow-up, we observed a significant improvement in humoral and functional parameters of CGA, renal function, NTpro-BNP levels and echocardiographic parameters. In the whole population, multivariate analysis shows that changes of Cardiac Index, NT-proBNP and Respiratory rate contributed for 26.0%, 9.7% and 4.8% to GDS variability, respectively, and the whole model accounted for a 41.1% of GDS variation; moreover changes of Global longitudinal strain, estimated glomerular filtration rate, Cardiac Index and BMI contributed for 23.9%, 11.7%, 5.4% and 4.0% to SPPB variability, respectively, and the whole model accounted for a 45% of SPPB variation. This represents the first real-world study carried out in an elderly population suffering from chronic HFrEF with numerous comorbidities, in which treatment with Sac-Val for 6 months induced important improvements in clinical, humoral, hemodynamic, and functional outcomes, without adverse effects on cognitive performance.

引用

页码：113 / 125

页数：13