Is Entresto good for the brain?

作     者：Nirav Patel Jason Gluck 

作者机构：Department of CardiologyUniversity of ConnecticutHarford HospitalHartfordCT 06102United States 

出 版 物：《World Journal of Cardiology》 (世界心脏病学杂志（英文版）（电子版）)

年 卷 期：2017年第9卷第7期

页      面：594-599页

学科分类：1007[医学-药学(可授医学、理学学位)] 10[医学] 

主　　题：Heart failure Sacubitril-valsartan Entresto LCZ696 Neprilysin inhibitor Alzheimer’s disease 

摘      要：The main stay pharmacotherapy for heart failure(HF) is targeted towards rennin-angiotensin-aldosterone(RAAS) and neprilysin pathways(NP). Both therapeutic strategies decreases morbidity and mortality but also carry considerable adverse effects. This review of the literature highlights the new generation of HF drug, sacubitril-valsartan(SV), trade name Entresto(researched as LCZ696, Novartis) which simultaneously blocks RAAS and NP. This dual action of angiotensin receptors blocker and neprilysin inhibitor(NPi) has improved HF prognosis and it is an evolution in the management of HF. Although the initial follow-up of patients treated with SV has yielded promising results, there are concerns regarding potential side effects especially an increase in the risk of Alzheimer s disease(AD) and young onset of AD. NPi interferes with the breakdown and clearing of beta-amyloid peptides, the plaques seen in AD, raising concern for AD in SV patients. On the other hand, hypertension and cardiovascular diseases are established risk factors for AD which can be decreased by SV therapy. It is therefore essential that SV treated patients are followed up over an extended period of time to detect any adverse cognitive changes.