AIM To investigate the efficacy and safety of Sacubitril/valsartan combined with exercise therapy on improvement of cardiac functions in patients with chronic heart failure complicated with hypotension and reduced ejection fraction.
METHODS Sixty chronic heart failure patients with controlled symptoms, blood pressure ranging from 90/50mmHg to 100/60mmHg and LVEF<40% were selected and they were divided into exercise therapy group (Sacubitril/valsartan + exercise) and control group (Sacubitril/valsartan alone). On the basis of their previous treatment, Sacubitril/valsartan was gradually prescribed to the maximum tolerated dose for the patients in the two groups according to their blood pressure, and exercise therapy was added in exercise group.
RESULTS Compared with the control group after 3 months of treatment, the amount of exercise in this group increased more than that in the control group after 3 months of treatment (P<0.01); Compared with that before treatment, there was no significant difference in systolic blood pressure in the control group. The value of systolic blood pressure in the exercise therapy group increased after 3 months of treatment and more after 6 months of treatment (all P<0.01); Compared with that before treatment, the diastolic blood pressure in the control group increased after 6 months of treatment (P<0.05), and the diastolic blood pressure in the exercise therapy group increased after 6 months of treatment (P<0.01). Compared with this group after 3 months of treatment, the value of 6-MWT in the control group and exercise therapy group increased after 6 months of treatment, all P<0.01. Compared with the control group at the same time point, the values of 6-MWT and systolic blood pressure in the exercise therapy group increased after 3 months of treatment, and increased more after 6 months of treatment (all P<0.01); Compared with that before treatment, LVEF in the control group and exercise therapy group increased after 3 months of treatment, increased more after 6 months of treatment, LVESD, LVESV and LVEDV decreased after 3 months of treatment, and decreased more after 6 months of treatment (all P<0.01). Compared with this group after 3 months of treatment, LVEF in the control group and exercise therapy group increased after 6 months of treatment, and LVESD, LVESD, LVESV and LVEDV decreased after 6 months of treatment (all P<0.01). Compared with the control group in the same time period, LVEF in the exercise therapy group increased after 3 months of treatment, increased more after 6 months of treatment, decreased LVESD, LVESD, LVESV and LVEDV after 3 months of treatment, and decreased more after 6 months of treatment (all P<0.01). The rehospitalization rate in the exercise therapy group was lower than that in the control group (P<0.05).
CONCLUSION In patients with heart failure complicated with hypotension and reduced ejection fraction, Sacubitril/valsartan plus exercise therapy is safe and markedly improves patients’ cardiac functions.
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