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Changing the treatment of heart failure with reduced ejection fraction： clinical use of sacubitril-valsartan combination

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Journal of Geriatric Cardiology 2016年第11期13卷 914-923页

作者： edgardo kaplinsky Cardiology Unit Medicine Department Hospital Municipal de Badalona. Via Augusta Av. 9-13 (08911) Badalona Spain

尽管有重要治疗学的进展，有长期的心失败(HF ) 的病人在病态和死亡的高风险留下。Sacubitril valsartan (以前作为 LCZ696 知道) 一个新口头的代理人与减少的喷射在成年人为征兆的长期的心失败的治疗被同意部分。自从它合并 neprilysin... 详细信息

尽管有重要治疗学的进展，有长期的心失败(HF ) 的病人在病态和死亡的高风险留下。Sacubitril valsartan (以前作为 LCZ696 知道) 一个新口头的代理人与减少的喷射在成年人为征兆的长期的心失败的治疗被同意部分。自从它合并 neprilysin 禁止者， sacubitril 和血管收缩素 II，它在班血管收缩素受体 neprilysin 禁止者(ARNI ) 被描述为第一受体对手， valsartan。Neprilysin 是包括 natriuretic 毁坏几 vasoactive 肽的 endopeptidase 肽(NP ) ， bradykinin， endothelin 和血管收缩素 II (Ang-II ) 。因此，它的抑制的自然后果是两个， NP 和 Ang-II 的 plasmatic 层次的增加(随相反的生物行动) 。那么，这些的联合抑制两个系统(Sacubitril / valsartan ) 可以在 HF 提高 NP 效果的好处(natriuresis，多尿，等等) 当 Ang-II 受体被禁止时(减少的血管缩小和醛固酮版本) 。在大临床的试用(与 8442 个病人一起的 PARADIGM-HF ) ，这个新代理人被发现显著地减少心血管，所有由于 HF 象住院一样引起死亡(与 enalapril 相比) 。这张手稿为 sacubitril valsartan， dosing 和小心考察临床的证据，在有减少的喷射的 HF 的治疗的未来方向和它的考虑地方部分。

关键词：心力衰竭临床应用治疗分数脑啡肽酶抑制剂血管紧张素受体受体拮抗剂生物学行为

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After having changed the treatment of heart failure with reduced ejection fraction: what are the latest evidences with sacubitril valsartan?

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Journal of Geriatric Cardiology 2019年第2期16卷 151-155页

作者： edgardo kaplinsky Cardiology Unit Department of Medicine Hospital Municipal de Badalona

1 Introduction Sacubitril/valsartan(SV)is a first in class dual action molecule of the neprilysin(NEP)inhibitor prodrug sacubitril(AHU377)and the angiotensin II receptor(Ang-II)type 1 antagonist valsartanJ11 It is the first angiotensin receptor-neprilysin inhibitor(ARNI)whose pharmacodynamic effects are consistent with a simultaneous stimulation of the natriuretic peptides system(via NEP inhibition)and the blockade of the renin-angiotensin-aldosterone system(valsartan effect)that finally results in systemic vasodilation,increased diuresis and natriuresis,reduction of plasmatic volume and diminution of peripheral vascular resistance.

关键词： Heart failure SacubitribValsartan

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PARADIGM-HF trial： will LCZ696 change the current treatment of systolic heart failure？

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Journal of Geriatric Cardiology 2015年第5期12卷 470-473页

作者： edgardo kaplinsky Cardiology Unit Medicine Department Hospital Municipal de Badalona Spain

Heart failure (HF) is a global health problem with an estimated prevalence of over 5.8 million in the USA and over 23 million worldwide. It represents the most common cause of hospitalization in elderly patients (≥ 65 years) and its incidence has a growing trend mainly due to the aging of the population. Neurohumoral activation plays a major role in the pathophysiology. So in consequence, the cornerstone of its medical treatment is based on the inhibition of the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system. According to this, all patients with HF and reduced ejection fraction should be treated with an angiotensin converting enzyme inhibitor (ACEI) or an angiotensin receptor blocker (ARB) plus a beta blocker (BB) and if needed, a mineralocorticoid receptor antagonist (MRA).

关键词：心力衰竭收缩性治疗试验

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Syrup versus Drops of Iron III Hydroxide Polymaltose in the Treatment of Iron Deficiency Anemia of Infancy

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Open Journal of Pediatrics 2015年第1期5卷 34-38页

作者： Ayala Yahav Chaim kaplinsky Miguel M. Glatstein Yaakov Shachter Aryeh Simmonds Yakov Shiff Dennis Scolnik Nechama Sharon Department of Pediatrics Laniado Hospital Netanya Israel Department of Pediatric Hemato-Oncology Sheba Hospital Tel Hashomer Israel Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology Dana-Dwek Children Hospital Tel Aviv Sourasky Medical Center Affiliated to the Sackler Faculty of Medicine Tel Aviv Israel Divisions of Pediatric Emergency Medicine and Clinical Pharmacology and Toxicology Department of Pediatrics The Hospital for Sick Children University of Toronto Toronto Canada Pediatric Hemato-Oncology Laniado Hospital Netanya Israel

Background: Iron deficiency anemia in infants is the most common micronutrient deficiency worldwide. The main cause is low iron intake in the presence of accelerated physiologic growth rate. Objective: The current study aimed at prospectively comparing the efficacy of iron III hydroxide polymaltose syrup (IPS) versus iron III hydroxide polymaltose drops (IPD) in treating iron deficiency among infants attending the hematology outpatient clinic. Our hypothesis was that IPS would be less effective possibly related to the difficulty of giving the medication. Methods: Participants diagnosed with iron deficiency anemia between 11-24 months were randomly assigned to receive either IPS or IPD for 3 months. The main outcome parameter was hemoglobin blood level, while the secondary outcome parameters were: 1) iron;2) ferritin;3) transferrin (i.e.?total iron binding capacity);4) mean corpuscular volume;and 5) red blood cell distribution width. Results: Out of the 104 recruited infants, 55 (52%) completed the study: 29 in the IPS group and26 inthe IPD group. There was no significant difference in the main outcome parameter at either 1 or 3 months of treatment: mean hemoglobin was 10.5 versus 10.7 g/dL within a 1 month treatment, P = 0.4;mean hemoglobin was 11.0 versus 11.1 g/dL within a 3 months of treatment, P = 0.59. Likewise, no significant differences were found with respect to the occurrence of side effects. Conclusion: Oral IPD and IPS are equally effective in treating iron deficiency anemia in infants aged 11 - 24 months.

关键词： Iron Deficiency Anemia (IDA) Treatment Iron III Hydroxide Polymaltose Formulation

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