Atrial Natriuretic Peptide and Treatment With Sacubitril/Valsartan in Heart Failure With Reduced Ejection Fraction

This study sought to assess associations between longitudinal change in atrial natriuretic peptide (ANP) and reverse cardiac remodeling following initiation of sacubitril/valsartan in patients with heart failure with reduced ejection fraction (HFrEF). Neprilysin inhibition results in an increase of...

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Bibliographic Details
Published in:JACC. Heart failure 2021-02, Vol.9 (2), p.127-136
Main Authors: Murphy, Sean P., Prescott, Margaret F., Camacho, Alexander, Iyer, Seethalakshmi R., Maisel, Alan S., Felker, G. Michael, Butler, Javed, Piña, Ileana L., Ibrahim, Nasrien E., Abbas, Cheryl, Burnett, John C., Solomon, Scott D., Januzzi, James L.
Format: Article
Language:English
Subjects:
ANP
cardiac remodeling
HFrEF
sacubitril/valsartan
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Summary:This study sought to assess associations between longitudinal change in atrial natriuretic peptide (ANP) and reverse cardiac remodeling following initiation of sacubitril/valsartan in patients with heart failure with reduced ejection fraction (HFrEF). Neprilysin inhibition results in an increase of several vasoactive peptides that may mediate the beneficial effects of sacubitril/valsartan, including ANP. In a prospective study of initiation and titration of sacubitril/valsartan in patients with HFrEF, blood was collected at scheduled time points into tubes containing protease inhibitors. This pre-specified exploratory analysis included patients in whom ANP was measured at baseline and serially through 12 months of treatment. Among 144 participants (mean age: 64.5 years; left ventricular ejection fraction: 30.8%), following initiation of sacubitril/valsartan, there was an early and significant increase in ANP, with the majority of rise from 99 pg/ml at baseline to 156 pg/ml at day 14 (p 
ISSN:2213-1779
2213-1787
DOI:10.1016/j.jchf.2020.09.013