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Atrial Natriuretic Peptide Mediates Reverse Cardiac Remodeling During Treatment with Sacubitril/Valsartan in Patients with Heart Failure with Reduced Ejection Fraction
- Source :
- Journal of Cardiac Failure. 26:S15
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Introduction Sacubitril/valsartan (S/V) promotes reverse cardiac remodeling in patients with HFrEF. Neprilysin inhibition results in increase of several vasoactive peptides that may mediate effects of S/V, however its effects on atrial natriuretic peptide (ANP) are largely unknown. Effects of ANP are mediated by cyclic guanosine monophosphate (cGMP). Hypothesis Longitudinal change in ANP concentration following initiation of S/V is associated with reverse cardiac remodeling. Methods Within a prospective open-label study of initiation and titration of S/V in patients with HFrEF, this pre-specified sub-study included patients in whom ANP was measured from samples collected in protease inhibitors to minimize its degradation. Concentrations of ANP and cGMP were measured at baseline and serially through 12 months of treatment. Echocardiographic assessment of LVEF and left atrial volume index (LAVi) was performed at baseline, 6 and 12 months. Results Among 144 participants (mean age 64.5 years; LVEF 30.8%), median ANP concentration at baseline was 102 pg/mL. Following initiation of S/V, ANP increased steeply and consistently during the first 2 months, with a significant increase in log-transformed ANP concentration at Day 14 (from 4.60 pg/mL to 5.05 pg/mL; Δ = 0.453; P Conclusions Concentrations of ANP increase substantially after initiation of S/V in patients with HFrEF. Larger early increases in ANP after S/V initiation were associated with greater magnitude of reverse cardiac remodeling (PROVE-HF; NCT02887183).
- Subjects :
- medicine.medical_specialty
Ejection fraction
business.industry
medicine.disease
Sacubitril
chemistry.chemical_compound
Valsartan
Atrial natriuretic peptide
chemistry
Heart failure
Internal medicine
cardiovascular system
medicine
Cardiology
Cardiology and Cardiovascular Medicine
business
Cyclic guanosine monophosphate
Neprilysin
hormones, hormone substitutes, and hormone antagonists
Sacubitril, Valsartan
circulatory and respiratory physiology
medicine.drug
Subjects
Details
- ISSN :
- 10719164
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiac Failure
- Accession number :
- edsair.doi...........087bc6d0363c3ddcf609b17a10e5fe6e