Sympathoinhibitory effect of sacubitril-valsartan in heart failure with reduced ejection fraction: A pilot study.
Auton Neurosci
; 235: 102834, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-34186274
ABSTRACT
Chronic sympathetic nervous system (SNS) overactivity, characteristic of heart failure (HF) with reduced ejection fraction (HFrEF), is associated with poor prognosis and contributes to increased mortality risk. Sacubitril-valsartan is a recently approved, first-in-class, angiotensin receptor neprilysin inhibitor (ARNI) drug that markedly reduces the risks of death from cardiovascular causes and hospitalization for HF in patients with HFrEF, but the physiological mechanisms underlying these benefits are not fully understood. This single-arm, open-label, prospective study sought to test the hypothesis that short-term treatment with sacubitril-valsartan reduces SNS activity, measured directly via muscle sympathetic nerve activity (MSNA), in patients with HFrEF. MSNA, heart rate (HR), and arterial blood pressure (BP) were assessed in stable Class II and III patients with HFrEF (n = 9, 69 ± 8 yrs.; 28.6 ± 3.6 kg/m2) on contemporary, guideline-directed medical treatment who were subsequently started on sacubitril-valsartan. These measurements were repeated after two months of treatment with sacubitril-valsartan. Sacubitril-valsartan reduced MSNA burst frequency (baseline 43 ± 10 bursts/min; 2-month 36 ± 10 bursts/min, p = 0.05) and burst incidence (baseline 68 ± 16 bursts/100 heartbeats; 2-month 55 ± 16 bursts/100 heartbeats, p = 0.02), while HR and BP were unchanged following the treatment (p > 0.05). These preliminary findings provide new evidence regarding the ability of sacubitril-valsartan to rapidly reduce SNS activity in patients with HFrEF, suggesting the presence of a novel sympathoinhibitory effect of this new drug class.
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MEDLINE
Assunto principal:
Insuficiência Cardíaca
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article