Cardiopulmonary exercise test-based assessment of the effects of sacubitril/valsartan on the blood pressure response to exercise in patients with acute myocardial infarction during hospitalization.

OBJECTIVE: To investigate the effects of sacubitril/valsartan (S/V) on cardiopulmonary function and blood pressure response to exercise during hospitalization in patients with acute myocardial infarction (AMI) based on the cardiopulmonary exercise test (CPET). METHODS: A total of 265 AMI patients were treated with either perindopril or S/V within 24 hours of admission. CPET was completed for all patients before discharge. There were 182 cases in the perindopril group and 83 cases in the S/V group. RESULTS: The proportion of exercise oscillatory ventilation (EOV) was higher in the S/V group than in the perindopril group (10.8% vs 1.6%, X2 = 11.148, P = .001). The resting heart rate (HR), resting diastolic blood pressure (DBP), and warm-up DBP were lower in the S/V group than in the perindopril group (P < .05). The resting systolic blood pressure (SBP) was 9.0 mmHg lower (115.7 ± 17.5 vs 106.7 ± 15.0, P < .001), the SBP during warm-up was 9.5 mmHg lower (124.8 ± 23.7 vs 115.3 ± 22.5,P = .002), the SBP at the anaerobic threshold (AT) was 10.5 mmHg lower (135.3 ± 24.8 vs 127.1 ± 25.1,P = .021),the SBP at max watts was 11.5 mmHg lower (148.9 ± 26.4 vs 137.4 ± 26.4,P = .001), and the SBP during one-minute recovery was 12.3 mmHg lower (146.5 ± 27.1 vs 134.2 ± 24.4, P = .001)in the S/V group than in the perindopril group. The S/V group had a higher oxygen ventilation equivalent and carbon dioxide ventilation equivalent (VE/VCO2) at AT and a lower oxygen uptake-work rate relationship during max watts (P < .05). The differences in the oxygen pulse, stroke volume, peak oxygen uptake (VO2 peak), and VE/VCO2 slope were not statistically significant between the two groups. CONCLUSION: Treatment with S/V was able to reduce the exercise blood pressure in patients with AMI during hospitalization, but did not significantly improve the VO2 peak, VE/VCO2 slope, or exercise tolerance.

[Role of socio-economy and management in sustainable transmission control of schistosomiasis in Taoyuan County, Hunan Province, China].

OBJECTIVE: To clarify the role of socio-economy and management in the sustainable schistosomiasis-control in Taoyuan County, an endemic area in hilly region, Hunan Province, China. METHODS: From 1996 to 2011, the data of socio-economy, the management of schistosomiasis control organizations, environment, and the changes in schistosomiasis prevalence were collected in Taoyuan County where schistosomiasis transmission had been controlled since 2008. A sampling survey of schistosomiasis prevalence of human and bovine was performed in 2011 to verify the current status of schistosomiasis transmission. All the data were analyzed statistically to evaluate the role of socio-economy and management in the sustainable schistosomiasis control. RESULTS: During the period from 1998 to 2012, the socio-economy including the residents' productive mode and daily life in Taoyuan County improved dramatically, but the recurrence risk of schistosomiasis endemic still existed due to the retuning of out-going workers and the migrating population. Moreover, the introduction of exotic species of plants and animals may increase the risk. The low running cost of schistosomiasis control organization as well as the efficient and adequate resource allocation in the county was in line with the national requirement to strengthen the rural grass-roots public health system. CONCLUSION: The harmonious development of socio-economy and the scientific and efficient health system in Taoyuan County are the key factors for the sustainable transmission control of schistosomiasis.