Sacubitril/valsartan and short-term changes in the 6-minute walk test: A pilot study

Background: Impaired exercise capacity is the most disabling symptom in patients with heart failure with reduced ejection fraction (HFrEF). Despite sacubitril/valsartan showing reduced long-term morbidity and mortality over enalapril in HFrEF, its effects on short-term functional capacity remain uncertain. We sought to evaluate the effects of sacubilril/valsartan on a 30-day six-minute walk test in eligible patients with HFrEF. Methods and results: From November 1, 2016 to February 1, 2017, a total of 58 stable symptomatic patients with HFrEF were eligible for sacubitril/valsartan and underwent 6-MWT before and 30 days after initiation of sacubitril/valsartan therapy. A mixed-effects model for repeated-measures was used to analyze the changes. Mean age was 70 +/- 11 years. 72.4% males, 46.6% with ischemic heart disease, and 51.7% on NYHA functional class Ill were included. The mean (SD) values of baseline LVEF and 6MWT were 30 +/- 7%, and 300 +/- 89 m, respectively. The median (IQR) of NT-proBNP at baseline was 2701 pg/ml (1087-4200). Compared with baseline, the 6-MWT distance increased significantly at 30 days by 13.9% (+Delta - 41.8 m (33.4-50.2); p < 0.001). Conclusions: In this pilot study, sacubitril/valsartan was associated with an improvement in exercise tolerance in symptomatic patients with HFrEF. (C) 2017 Elsevier B.V. All rights reserved.