51. Effect of Sacubitril/Valsartan on Exercise-Induced Lipid Metabolism in Patients With Obesity and Hypertension
- Author
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Uwe Tegtbur, Rudi Stinkens, Thomas Langenickel, Gijs H. Goossens, Jens Jordan, Tim Heise, Marcus May, Stefan Engeli, Bas Havekes, Sven Haufe, Ellen E. Blaak, Thomas Jax, Diego Albrecht, Parasar Pal, Promovendi NTM, Humane Biologie, RS: NUTRIM - R2 - Liver and digestive health, RS: NUTRIM - R1 - Obesity, diabetes and cardiovascular health, Interne Geneeskunde, and MUMC+: MA Endocrinologie (9)
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Male ,Adipose Tissue/metabolism ,obesity ,Tetrazoles ,Blood Pressure ,030204 cardiovascular system & hematology ,Sacubitril ,Lipid Metabolism/drug effects ,0302 clinical medicine ,lipid metabolism ,Exercise/physiology ,Aminobutyrates/administration & dosage ,030212 general & internal medicine ,Tetrazoles/administration & dosage ,INTERSTITIAL ANGIOTENSIN-II ,Calcium Channel Blockers/administration & dosage ,INSULIN-RESISTANCE ,Aminobutyrates ,GLUCOSE-METABOLISM ,Middle Aged ,Calcium Channel Blockers ,HUMAN ADIPOCYTES ,Drug Combinations ,Editorial ,ADIPOSE-TISSUE ,Treatment Outcome ,Adipose Tissue ,Valsartan ,BRAIN NATRIURETIC PEPTIDE ,Obesity, Abdominal ,Hypertension/diagnosis ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,HEART-FAILURE ,Female ,Drug Monitoring ,Drug Monitoring/methods ,medicine.drug ,medicine.medical_specialty ,TRIAL VAL-HEFT ,hypertension ,valsartan ,Blood Pressure/drug effects ,neprilysin ,Abdominal/diagnosis ,Angiotensin Receptor Antagonists ,03 medical and health sciences ,NEPRILYSIN INHIBITION ,Insulin resistance ,Lipid oxidation ,Double-Blind Method ,Internal medicine ,Internal Medicine ,medicine ,Lipolysis ,Humans ,Clinical Trials ,Amlodipine ,Natriuretic Peptides ,sacubitril ,Exercise ,Obesity, Abdominal/diagnosis ,NORMAL-WEIGHT ,exercise-induced lipolysis ,natriuretic peptide ,business.industry ,Amlodipine/administration & dosage ,Biphenyl Compounds ,Natriuretic Peptides/metabolism ,Original Articles ,medicine.disease ,natriuretic peptide, neprilysin ,Kardiovaskuläre Luft- und Raumfahrtmedizin ,Blood pressure ,Endocrinology ,Angiotensin Receptor Antagonists/administration & dosage ,sacubitril/valsartan ,business ,Neprilysin/antagonists & inhibitors ,Sacubitril, Valsartan - Abstract
Supplemental Digital Content is available in the text., Sacubitril/valsartan (LCZ696), a novel angiotensin receptor-neprilysin inhibitor, was recently approved for the treatment of heart failure with reduced ejection fraction. Neprilysin degrades several peptides that modulate lipid metabolism, including natriuretic peptides. In this study, we investigated the effects of 8 weeks’ treatment with sacubitril/valsartan on whole-body and adipose tissue lipolysis and lipid oxidation during defined physical exercise compared with the metabolically neutral comparator amlodipine. This was a multicenter, randomized, double-blind, active-controlled, parallel-group study enrolling subjects with abdominal obesity and moderate hypertension (mean sitting systolic blood pressure ≥130–180 mm Hg). Lipolysis during rest and exercise was assessed by microdialysis and [1,1,2,3,3-2H]-glycerol tracer kinetics. Energy expenditure and substrate oxidation were measured simultaneously using indirect calorimetry. Plasma nonesterified fatty acids, glycerol, insulin, glucose, adrenaline and noradrenaline concentrations, blood pressure, and heart rate were also determined. Exercise elevated plasma glycerol, free fatty acids, and interstitial glycerol concentrations and increased the rate of glycerol appearance. However, exercise-induced stimulation of lipolysis was not augmented on sacubitril/valsartan treatment compared with amlodipine treatment. Furthermore, sacubitril/valsartan did not alter energy expenditure and substrate oxidation during exercise compared with amlodipine treatment. In conclusion, sacubitril/valsartan treatment for 8 weeks did not elicit clinically relevant changes in exercise-induced lipolysis or substrate oxidation in obese patients with hypertension, implying that its beneficial cardiovascular effects cannot be explained by changes in lipid metabolism during exercise. Clinical Trial Registration— URL: https://www.clinicaltrials.gov. Unique identifier: NCT01631864.
- Published
- 2018
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