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摘要: 心力衰竭是各种心血管疾病的严重和终末阶段,具有很高的发病率和病死率。沙库巴曲缬沙坦钠是第1种血管紧张素受体脑啡肽酶抑制剂(ARNI),在治疗慢性心力衰竭方面比血管紧张素转换酶抑制剂(ACEI)及血管紧张素受体拮抗剂(ARB)有更大优势。目前多项心力衰竭诊疗指南已将ARNI作为治疗心力衰竭的一线用药。近些年多项实验室及临床研究表明ARNI在高血压、心律失常、心肌梗死、糖尿病和糖尿病肾病等其他疾病治疗中具有巨大潜力。本文就ARNI在心血管及相关疾病治疗中的有效性及安全性的研究进展进行综述。
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关键词:
- 血管紧张素受体脑啡肽酶抑制剂 /
- 心力衰竭 /
- 心血管疾病
Abstract: Heart failure is a serious and terminal stage of various cardiovascular diseases, with high morbidity and mortality. Sacubitril/valsartan is the first angiotensin receptor neprilysin inhibitor(ARNI). The efficacy and safety of ARNI in treating chronic heart failure are significantly better than angiotensin-converting enzyme inhibitors(ACEI) and angiotensin receptor blockers(ARB). At present, ARNI has been used as a first-line drug in the treatment of heart failure in several guidelines for the diagnosis and treatment of heart failure. Several laboratory and clinical studies revealed the great potential of ARNI in treating hypertension, arrhythmia, myocardial infarction, diabetes, diabetic nephropathy, and other cardiovascular diseases. In this paper, we review the latest research progress of the efficacy and safety of ARNI in cardiovascular and other related diseases. -
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[1] Savarese G,Lund LH.Global public health burden of heart failure[J].Card Fail Rev,2017,3(1):7-11.
[2] Hubers SA,Brown NJ.Combined angiotensin receptor antagonismand neprilysin inhibition[J].Circulation,2016,133(11):1115-1124.
[3] McMurray JJ,Packer M,Desai AS,et al.Angiotensin-neprilysin inhibition versus enalapril in heart failure[J].N Engl J Med,2014,371(11):993-1004.
[4] 杨萍,丁澍,刘培晶,等.血管紧张素受体脑啡肽酶抑制剂治疗伴射血分数降低的心力衰竭的安全性及有效性观察[J].临床心血管病杂志,2020,30(3):257-261.
[5] Yancy CW,Jessup M,Bozkurt B,et al.2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure:A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America[J].Circulation,2017,136(6):e137-e161.
[6] 中华医学会心血管病学分会心力衰竭学组,中国医师协会心力衰竭专业委员会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2018[J].中华心力衰竭和心肌病杂志,2018,2(4):196-225.
[7] Volpe M,Battistoni A,Rubattu S.Natriuretic peptides in heart failure:Current achievements and future perspectives[J].Int J Cardiol,2018,281:186-189.
[8] Velazquez EJ,Morrow DA,DeVore AD,et al.Angiotensin-neprilysin inhibition in acute decompensated heart failure[J].N Engl J Med,2019,380(6):539-548.
[9] Wachter R,Senni M,Belohlavek J,et al.Initiation of sacubitril/valsartan in haemodynamicallystabilised heart failure patients in hospital or early after discharge:primary results of the randomised TRANSITION study[J]..Eur J Heart Fail,2019,21(8):998-1007.
[10] Solomon SD,Zile M,Pieske B,et al.The angiotensin receptor neprilysin inhibitor LCZ696 in heart failure with preserved ejection fraction:a phase 2 double-blind randomised controlled trial[J].Lancet,2012,380(9851):1387-1395.
[11] Solomon SD,McMurray JJV,Anand IS,et al.Angiotensin-neprilysin inhibition in heart failure with preserved ejection fraction[J].N Engl J Med,2019,381(17):1609-1620.
[12] McMurray J,Jackson AM,Lam C,et al.Effects of sacubitril-valsartan versus valsartan in women compared with men with heart failure and preserved ejection fraction:insights from PARAGON-HF[J].Circulation,2020,141(5):338-351.
[13] Beale AL,Meyer P,Marwick TH,et al.Sex differences in cardiovascular pathophysiology:why women are overrepresented in heart failure with preserved ejection fraction[J].Circulation,2018,138(2):198-205.
[14] Tibrewala A,Yancy CW.Heart failure with preserved ejection fraction in women[J].Heart Fail Clin,2019,15(1):9-18.
[15] Glisic M,Rojas LZ,Asllanaj E,et al.Sex steroids,sex hormone-binding globulin and levels of N-terminal pro-brain natriuretic peptide in postmenopausal women[J].Int J Cardiol,2018,261:189-195.
[16] Reddy Y,Iyer SR,Scott CG,et al.Soluble neprilysin in the general population:clinical determinants and its relationship to cardiovascular disease[J].J Am Heart Assoc,2019,8(15):e012943.
[17] Ruilope LM,Dukat A,Bohm M,et al.Blood-pressure reduction with LCZ696,a novel dual-acting inhibitor of the angiotensin II receptor and neprilysin:a randomised,double-blind,placebo-controlled,active comparator study[J].Lancet,2010,375(9722):1255-1266.
[18] Cheung DG,Aizenberg D,Gorbunov V,et al.Efficacy and safety of sacubitril/valsartan in patients with essential hypertension uncontrolled by olmesartan:A randomized,double-blind,8-week study[J].J Clin Hypertens(Greenwich),2018,20(1):150-158.
[19] Kusaka H,Sueta D,Koibuchi N,et al.LCZ696,Angiotensin II receptor-neprilysin inhibitor,ameliorates high-salt-induced hypertension and cardiovascular injury more than valsartan alone[J].Am J Hypertens,2015,28(12):1409-1417.
[20] Wang TD,Tan RS,Lee HY,et al.Effects of sacubitril/valsartan(LCZ696) on natriuresis,diuresis,blood pressures,and NT-proBNP in salt-sensitive hypertension[J].Hypertension,2017,69(1):32-41.
[21] Ando K,Kawarazaki H,Miura K,et al.[Scientific statement]Report of the Salt Reduction Committee of the Japanese Society of Hypertension(1) Role of salt in hypertension and cardiovascular diseases[J].Hypertens Res,2013,36(12):1009-1019.
[22] Martens P,Nuyens D,Rivero-Ayerza M,et al.Sacubitril/valsartan reduces ventricular arrhythmias in parallel with left ventricular reverse remodeling in heart failure with reduced ejection fraction[J].Clin Res Cardiol,2019,108(10):1074-1082.
[23] Russo V,Bottino R,Rago A,et al.The Effect of sacubitril/valsartan on device detected arrhythmias and electrical parameters among dilated cardiomyopathy patients with reduced ejection fraction and implantable cardioverter defibrillator[J].J Clin Med,2020,9(4):1111.
[24] Martens P,Nuyens D,Rivero-Ayerza M,et al.Sacubitril/valsartan reduces ventricular arrhythmias in parallel with left ventricular reverse remodeling in heart failure with reduced ejection fraction[J].Clin Res Cardiol,2019,108(10):1074-1082.
[25] Torrado J,Cain C,Mauro AG,et al.Sacubitril/valsartan averts adverse post-infarction ventricular remodeling and preserves systolic function in rabbits[J].J Am Coll Cardiol,2018,72(19):2342-2356.
[26] Ishii M,Kaikita K,Sato K,et al.Cardioprotective effects of LCZ696(sacubitril/valsartan)after experimental acute myocardial infarction[J].JACC Basic Transl Sci,2017,2(6):655-668.
[27] Seferovic JP,Claggett B,Seidelmann SB,et al.Effect of sacubitril/valsartan versus enalapril on glycaemic control in patients with heart failure and diabetes:a post-hoc analysis from the PARADIGM-HF trial[J].Lancet Diabetes Endocrinol,2017,5(5):333-340.
[28] Jordan J,Stinkens R,Jax T,et al.Improved insulin sensitivity with angiotensin receptor neprilysin inhibition in individuals with obesity and hypertension[J].Clin Pharmacol Ther,2017,101(2):254-263.
[29] Davidson EP,Coppey LJ,Shevalye H,et al.Vascular and neural complications in type 2diabetic rats:improvement by sacubitril/valsartan greater than valsartan alone[J].Diabetes,2018,67(8):1616-1626.
[30] Roksnoer LC,van Veghel R,Clahsen-van Groningen MC,et al.Blood pressure-independent renoprotection in diabetic rats treated with AT1receptor-neprilysin inhibition compared with AT1receptor blockade alone[J].Clin Sci(Lond),2016,130(14):1209-1220.
[31] Packer M,Claggett B,Lefkowitz MP,et al.Effect of neprilysin inhibition on renal function in patients with type 2diabetes and chronic heart failure who are receiving target doses of inhibitors of the renin-angiotensin system:a secondary analysis of the PARADIGM-HF trial[J].Lancet Diabetes Endocrinol,2018,6(7):547-554.
[32] Hallow KM,Gebremichael Y,Helmlinger G,et al.Primary proximal tubule hyperreabsorption and impaired tubular transport counterregulation determine glomerular hyperfiltration in diabetes:a modeling analysis.Am J Physiol Renal Physiol[J].2017,312(5):819-835.
[33] Campbell DJ.Long-term neprilysin inhibition-implications for ARNIs[J].Nat Rev Cardiol,2017,14(3):171-186.
[34] Vodovar N,Paquet C,Mebazaa A,et al.Neprilysin,cardiovascular,and Alzheimer's diseases:the therapeutic split?[J].Eur Heart J,2015,36(15):902-905.
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