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Recurrent hypotension induced by sacubitril/valsartan in cardiomyopathy secondary to Duchenne muscular dystrophy: A case report

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World Journal of Clinical Cases 2019年第23期7卷 4098-4105页

作者： Jia-Min Li Han Chen Department of Cardiology Zhejiang Provincial Key Laboratory of Cardiovascular Disease Diagnosis and Treatment The Second Affiliated Hospital Zhejiang University School of Medicine

BACKGROUND Duchenne muscular dystrophy(DMD),which is caused by a mutation/deletion in the dystrophin gene on the X-chromosome,is the most common type of neuromuscular disorder in *** muscle weakness progressively develops in DMD patients and usually leads to respiratory failure in the early adolescent *** muscle is frequently affected in DMD patients,which leads to a high burden of cardiomyopathy and heart *** the era of improved respiratory care,cardiac deaths are becoming the major cause of mortality in DMD *** SUMMARY We report the case of a 15-year-old boy who presented to the hospital due to recurrent orthopnea for 6 mo and palpitations for 4 *** was diagnosed with progressive muscular dystrophy at the age of 3 years and was confined to a wheelchair at 12 *** was prescribed diuretics and digoxin at the outpatient clinic;however,his symptoms did not ***/valsartan was added 1 mo prior to presentation,but he experienced recurrent episodes of *** electrocardiogram showed atrial tachycardia with a heart rate of 201 bpm,and he was then *** was found following the administration of sacubitril/valsartan tablets;he could not tolerate even a small dose,always developing *** symptoms were relieved after discontinuing sacubitril/valsartan,and his heart rate was controlled by a small dose of metoprolol tartrate and *** tachycardia spontaneously converted in this patient,and his symptoms attenuated in the following 6 mo,without palpitation *** Blood pressure should be closely monitored in DMD patients with advanced heart failure when taking sacubitril/valsartan.

关键词： sacubitril/valsartan Duchenne muscular dystrophy Heart failure Hypotension Case report

Use of sacubitril/valsartan in heart failure with reduced ejection fraction

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South China Journal of Cardiology 2019年第4期20卷 252-257页

作者：吴利强冯慧婷冯慧娟 Guangdong Hospital of Traditional Chinese Medicine The Sixth Affiliated Hospital of Sun Yat-sen University

Background Angiotensin receptor and neprilysin inhibition(ARNI) has been shown to reduce cardiovascular mortality. However, there is a paucity of real-world data in the effects of ARNI in heart failure patients with reduced ejection fraction(HFr EF). Methods We included 225 consecutive HFr EF patients receiving combined sacubitril/valsartan administration and standard HF treatment(Group A) and 550 consecutive HFr EF patients receiving only the standard HF treatment(Group B) from January 2016 to January 2018. Primary outcome was death from cardiovascular causes or first unplanned hospitalization for HF. Results Thirty-three deaths or first unplanned hospitalization for HF occurred in Group A(14.7%) and 102 in Group B(22.7%) with 0.56 hazard ratio(HR), and 95% confidence interval(CI, 0.491-0.867;P=0.001) during a follow-up of 12 month. Moreover, escalation of sacubitril/valsartan(89 cases, 39.6%) was associated with the best clinical outcomes(Psacubitril/valsartan has beneficial effect on HFr EF patients and the effect enhances when higher dose is given.[S Chin J Cardiol 2019;20(4):252-257]

关键词： sacubitril/valsartan heart failure hypotension

The Effect of sacubitril/valsartan in a Dialysis Patient with Severe Heart Failure*

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Case Reports in Clinical Medicine 2021年第7期10卷 197-202页

作者： Pingping Kong Yanna Dou Xiaoyang Wang Jing Xiao Zhanzheng Zhao The Nephrology Centre Department of the First Affiliated Hospital of Zhengzhou Zhengzhou China Nephrology Institute of Zhengzhou University Zhengzhou China

Heart failure (HF) is a major comorbidity in patients with end-stage renal disease (ESRD). The pathogenesis of HF in patients on renal replacement therapy represents the confluence of several traditional and nontraditional vascular risk factors, unique to the milieu of chronic kidney disease and the dialysis modality [1]. The purpose of this report is to describe the efficacy and safety of sacubitril/valsartan for an ESRD patient on hemodialysis therapy conmbined with heart failure with reduced ejection fraction (HFrEF). A 35-year-old woman was undergoing hemodialysis due to ESRD and suffering from heart failure with reduced ejection fraction. Because of worsening heart failure and hypertension, she was prescribed with sacubitril/valsartan at a dose of 50 mg twice a day, spironolactone at a dose of 20 mg three times a day and metoprolol at a dose of 23.75 mg once daily. There was a symptomatic improvement with the heart failure and reduction in NT-proBNP level, accompanied by a decrease of blood pressure after using sacubitric/valsartan. In conclusion, it is safe and effective to take sacubitril/valsartan in this hemodialysis patient with severe heart failure.

关键词： End Stage Renal Disease sacubitril/valsartan Hemodialysis Heart Failure Reduced Ejection Fraction

Research progress of sacubitril/valsartan in heart failure patients with preserved ejection fraction

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Journal of Chinese Pharmaceutical Sciences 2022年第6期31卷 471-477页

作者： Jingjing Cao Shujuan Zhao Chenglong Zhao Peizhi Ma Department of Pharmacy Henan Provincial People's HospitalPeople's Hospital of Zhengzhou UniversityZhengzhou 450003China

With the launch of sacubitril/valsartan(ARNI),there are new options for the treatment of heart failure(HF).However,ARNI is currently only used in HF patients with reduced ejection fraction(HFrEF).No evidence shows that no modern treatment can reduce mortality in HF patients with preserved ejection fraction(HFpEF).Therefore,it is urgently necessary clarify whether ARNI can be used in the treatment of *** the present study,we summarized the research progress of ARNI in the treatment of HFpEF.

关键词： Preserved ejection fraction Reduced ejection fraction sacubitril/valsartan

Study of influence of sacubitril/valsartan on plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 levels in patients with heart failure

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Journal of Hainan Medical University 2018年第6期24卷 9-12页

作者： Yan-Fen Li Chun-Hong Chen Zhan-Qi Wang Fang Wang Ya Li Department of Medicine Baoding Hengtian HospitalHebei Baoding 071000 China Department of Cardiology Affiliated Hospital of Hebei UniversityBaoding 071000 China

Objective:To study the influence of sacubitril/valsartan on plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 levels in patients with heart failure. Methods: To choose 42 cases of chronic heart failure in our hospital form August 2017 to December 2017 as the study group, and 42 cases of chronic heart failure form January 2017 to June 2017 as the control group. The patients in the control group were treated with 80 mg valsartan on the basis of general treatment, 1 times a day, and the patients in the study group were added with 50mg sacubitril/valsartan on the basis of general treatment, 2 times a day. To compare the plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 levels before and after treatment in the two ***:Before treatment, there was no statistical difference between the levels of plasma NE, AngⅡ, ALD and serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9 in the two groups;(1) After treatment, the levels of plasma NE, AngⅡ, ALD in the control group compared with those before treatment in the seme group, there were significant differences, and there were significant differences between the two groups;(2) After treatment, the levels of serum sCD40L, sICAM-1, sFas, sFasL in the control group compared with those before treatment in the same group, there were significant differences, and there were significant differences between the two groups;(3) After treatment, the levels of serum cTnI, MMP-9 in the control group compared with those before treatment in the seme group, there were significant differences, and there were significant differences between the two ***: The application of sacubitril/valsartan to patients with heart failure on the basis of general treatment, not only could significantly improve the levels of plasma NE, AngⅡ, ALD, and also could significantly improve the levels of serum sCD40L, sICAM-1, sFas, sFasL and cTnI, MMP-9, the curative effect was more significant, it w

关键词： Heart failure sacubitril/valsartan Plasma factor Serum factor

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 sacubitril/valsartan

ARNI and SGLT2i: a promising association to be used with caution

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Journal of Geriatric Cardiology 2020年第11期17卷 728-732页

作者： Andrea Herbst Francesco Orso Marta Migliorini Simona Virciglio Silvia Tognelli Viola Camartini Alessandra Pratesi Francesco Fattirolli NiccolòMarchionni Andrea Ungar Samuele Baldasseroni Heart Failure Clinic Division of Geriatric Medicine and Intensive Care UnitAzienda Ospedaliero-Universitaria CareggiFlorenceItaly Department of Experimental and Clinical Medicine University of FlorenceItaly Department of Cardiothoracovascular Medicine Azienda Ospedaliero-Universitaria CareggiItaly

During the last years, several pharmacological treatments have significantly improved outcome of patients with heart failure with reduced ejection fraction(HFr EF) particularly by inhibiting the renin–angiotensin–aldosterone system(RAAS) and by blocking the sympathetic system.[1,2] More recently, it was demonstrated that a further positive neurohormonal modulation of RAAS and of the natriuretic peptides pathway with sacubitril/valsartan(Sa/Va).

关键词： Chronic heart failure sacubitril/valsartan SGLT2i

Angiotensin receptor blocker neprilysin inhibitors

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World Journal of Cardiology 2021年第8期13卷 325-339页

作者： Daisuke Usuda Toshihiro Higashikawa Yuta Hotchi Kenki Usami Shintaro Shimozawa Shungo Tokunaga Ippei Osugi Risa Katou Sakurako Ito Toshihiko Yoshizawa Suguru Asako Kentaro Mishima Akihiko Kondo Keiko Mizuno Hiroki Takami Takayuki Komatsu Jiro Oba Tomohisa Nomura Manabu Sugita Emergency and Critical Care Medicine Juntendo University Nerima HospitalNerima-ku 177-8521TokyoJapan Geriatric Medicine Kanazawa Medical University Himi Municipal HospitalHimi-shi 935-8531ToyamaJapan

Heart failure(HF)is a clinical syndrome that results from a structural or functional cardiac disorder that reduces the ability of the ventricle of the heart to fill with,or eject,*** is a multifaceted clinical condition that affects up to 2%of the population in the developed world,and is linked to significant morbidity and mortality;it is therefore considered a major concern for public *** the mechanism of HF,three neurohumoral factors-the reninangiotensin-aldosterone system,the sympathetic nervous system,and natriuretic peptides—are related to the pathology of chronic HF(CHF),and the targets of *** receptor blocker and neprilysin inhibitor(angiotensinreceptor neprilysin inhibitor),namely sacubitril/valsartan(SAC/VAL),has been introduced as a treatment for ***/VAL is an efficacious,safe,and costeffective therapy that improves quality of life and longevity in patients with HF with reduced ejection fraction(HFrEF),and reduces hospital *** inhospital initiation strategy offers a potential new avenue to improve the clinical uptake of SAC/*** the last five years,SAC/VAL has been established as a cornerstone component of comprehensive disease-modifying medical therapy in the management of chronic *** the other hand,further work,with carefully designed and controlled preclinical studies,is necessary for understanding the molecular mechanisms,effects,and confirmation of issues such as long-term safety in both human and animal models.

关键词： Angiotensin receptor blocker and neprilysin inhibitor Chronic heart failure Renin-angiotensin-aldosterone-system Sympathetic nervous system Natriuretic peptide sacubitril/valsartan