Improvement in quality of life with sacubitril/ /valsartan in cardiac resynchronization non-responders: The RESINA (RESynchronization plus an Inhibitor of Neprilysin/Angiotensin) registry

• Published in: Cardiology journal Vol. 28; no. 3; pp. 402 - 410
• Main Authors: Rubio Campal, José Manuel, Del Castillo, Hugo, Arroyo Rivera, Belén, de Juan Bitriá, Carmen, Taibo Urquia, Mikel, Sánchez Borque, Pepa, Miracle Blanco, Ángel, Bravo Calero, Loreto, Martí Sánchez, David, Tuñón Fernández, José
• Format: Journal Article
• Language: English
• Published: Poland Wydawnictwo Via Medica 25-05-2021; Via Medica
• Subjects: Aged; Aged, 80 and over; Aminobutyrates - therapeutic use; Angiotensin Receptor Antagonists - therapeutic use; Angiotensins; Biphenyl Compounds; Cardiac Resynchronization Therapy; Cardiomyopathy; Clinical Cardiology; Drug Combinations; Female; Heart Failure - diagnosis; Heart Failure - drug therapy; Hospitalization; Humans; Male; Neprilysin; Quality of Life; Questionnaires; Registries; Stroke Volume; Tetrazoles - therapeutic use; Treatment Outcome; Valsartan; Ventricular Function, Left; quality of life; resynchronization; sacubitril/valsartan
• ISSN: 1897-5593; 1898-018X
• DOI: 10.5603/CJ.a2021.0009

Clinical management of cardiac resynchronization therapy (CRT) non-responders is difficult, and their prognosis is poor. The aim of the present study was to evaluate whether treatment with sacubitril/valsartan can improve quality of life (QoL) parameters in these patients.
Thirty five non-responders to CRT were included (75 ± 7 years, 28% females, mean left ventricular ejection fraction 28 ± 8%, 54% non-ischemic cardiomyopathy) with maximally optimized drug therapy and New York Heart Association class II-III. They were all on angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and were switched to sacubitril/valsartan. One week before and 6 months after initiation of the therapy they completed both the Minnesota Living with Heart Failure (MLWHF) and the 12-item Kansas City Cardiomyopathy Questionnaires (KCCQ-12). The primary outcome was the effect of sacubitril/valsartan on the physical, clinical, social and emotional QoL parameters and number of hospitalizations.
The mean total scores of both questionnaires improved from baseline to the follow-up visit at 6-months (KCCQ-12 40 ± 10 to 47 ± 10; p < 0.001; MLWHF 40 ± 15 to 29 ± 15; p < 0.001). The best results were seen in the KCCQ-12 total symptom domains (77% improvement), the MLWHF physical domain (81% improvement), and the MLWHF emotional domain (71% improvement). Two patients died during follow-up. The mean number of hospitalizations reduced significantly (1 ± 0.6 vs. 0.5 ± 0.8; p = 0.003) CONCLUSIONS: In CRT non-responders, sacubitril/valsartan significantly improved overall QoL, physical limitations and emotional domains and reduced the number of hospitalizations.