Focused Treatment of Heart Failure with Reduced Ejection Fraction Using Sacubitril/Valsartan.

American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions
Rex C Liu

Abstract

The clinical syndrome of heart failure (HF) can be described as the reduced capacity of the heart to deliver blood throughout the body. To compensate for inadequate tissue perfusion, the renin-angiotensin aldosterone system (RAAS) and the sympathetic nervous system (SNS) become activated, resulting in increased blood pressure, heart rate, and blood volume. Consequent activation of the natriuretic peptide system (NPS) typically balances these effects; however, the NPS is unable to sustain compensation for excessive neurohormonal activation over time. Until recently, mortality benefits have been provided to patients with HF only by therapies that target the RAAS and SNS, including angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), mineralocorticoid receptor antagonists, and beta-blockers. Sacubitril/valsartan, the first-in-class angiotensin receptor/neprilysin inhibitor (ARNI), targets both the NPS and RAAS to further improve clinical outcomes. This review discusses the focused management of patients with HF with reduced ejection fraction (HFrEF) and suggests changes to current management paradigms. From this assessment, the evidence supports favoring sacubitril/valsartan over ACEIs or ARBs, a...Continue Reading

References

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Citations

Nov 27, 2020·Biomolecules·Valeria ContiAmelia Filippelli
Jun 30, 2021·Autonomic Neuroscience : Basic & Clinical·Kanokwan BunsawatD Walter Wray
Sep 8, 2021·Current Cardiology Reviews·Mahmoud AbdelnabiFady Gerges

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Clinical Trials Mentioned

NCT01035255
NCT02957409
NCT01920711
NCT02887183
NCT00344513
NCT02554890
NCT02661217

Software Mentioned

PARAGON
HF
ARNI

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