Your browser doesn't support javascript.
loading
Angiotensin receptor blocker-neprilysin inhibitor for heart failure with reduced ejection fraction.
Nasrallah, Dima; Abdelhamid, Alaa; Tluli, Omar; Al-Haneedi, Yaman; Dakik, Habib; Eid, Ali H.
Afiliación
  • Nasrallah D; College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
  • Abdelhamid A; College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
  • Tluli O; College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
  • Al-Haneedi Y; College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar.
  • Dakik H; Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
  • Eid AH; Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar. Electronic address: ali.eid@qu.edu.qa.
Pharmacol Res ; 204: 107210, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38740146
ABSTRACT
Heart failure with reduced ejection fraction (HFrEF) is a clinical syndrome characterized by volume overload, impaired exercise capacity, and recurrent hospital admissions. A major contributor to the pathophysiology and clinical presentation of heart failure is the activation of the renin-angiotensin-aldosterone system (RAAS). Normally, RAAS is responsible for the homeostatic regulation of blood pressure, extracellular fluid volume, and serum sodium concentration. In HFrEF, RAAS gets chronically activated in response to decreased cardiac output, further aggravating the congestion and cardiotoxic effects. Hence, inhibition of RAAS is a major approach in the pharmacologic treatment of those patients. The most recently introduced RAAS antagonizing medication class is angiotensin receptor blocker/ neprilysin inhibitor (ARNI). In this paper, we discuss ARNIs' superiority over traditional RAAS antagonizing agents in reducing heart failure hospitalization and mortality. We also tease out the evidence that shows ARNIs' renoprotective functions in heart failure patients including those with chronic or end stage kidney disease. We also discuss the evidence showing the added benefit resulting from combining ARNIs with a sodium-glucose cotransporter-2 (SGLT-2) inhibitor. Moreover, how ARNIs decrease the risk of arrhythmias and reverse cardiac remodeling, ultimately lowering the risk of cardiovascular death, is also discussed. We then present the positive outcome of ARNIs' use in patients with diabetes mellitus and those recovering from acute decompensated heart failure. ARNIs' side effects are also appreciated and discussed. Taken together, the provided insight and critical appraisal of the evidence justifies and supports the implementation of ARNIs in the guidelines for the treatment of HFrEF.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Volumen Sistólico / Neprilisina / Antagonistas de Receptores de Angiotensina / Insuficiencia Cardíaca Límite: Animals / Humans Idioma: En Revista: Pharmacol Res Asunto de la revista: FARMACOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Volumen Sistólico / Neprilisina / Antagonistas de Receptores de Angiotensina / Insuficiencia Cardíaca Límite: Animals / Humans Idioma: En Revista: Pharmacol Res Asunto de la revista: FARMACOLOGIA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos