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Neprilysin and Natriuretic Peptide Regulation in Heart Failure

  • Pathophysiology: Neuroendocrine, Vascular, and Metabolic Factors (S Katz, Section Editor)
  • Published:
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Abstract

Neprilysin is acknowledged as a key player in neurohormonal regulation, a cornerstone of modern drug therapy in chronic heart failure. In the cardiovascular system, neprilysin cleaves numerous vasoactive peptides, some with mainly vasodilating effects (natriuretic peptides, adrenomedullin, bradykinin) and other with mainly vasoconstrictor effects (angiotensin I and II, endothelin-1). For decades, neprilysin has been an important biotarget. Academia and industry have combined active efforts to search for neprilysin inhibitors (NEPIs) that might be useful in clinical practice. NEPI monotherapy was initially tested with little success due to efficacy issues. Next, combination of NEPI and ACE-inhibiting activity agents were abandoned due to safety concerns. Recently, the combination of NEPI and ARB, also known as ARNI, has shown better than expected results in heart failure with reduced ejection fraction, and multitude of ongoing studies are set to prove its value across the heart failure spectrum.

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Authors and Affiliations

  1. Heart Failure Clinic, Cardiology Service, Department of Medicine, UAB, Hospital Universitari Germans Trias i Pujol, Carretera del Canyet, 08916, Badalona, Barcelona, Spain

    Antoni Bayes-Genis & Josep Lupón

  2. Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain

    Antoni Bayes-Genis & Josep Lupón

  3. Novartis Pharmaceuticals, Barcelona, Spain

    Nuria Morant-Talamante

Authors
  1. Antoni Bayes-Genis
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  2. Nuria Morant-Talamante
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  3. Josep Lupón
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Correspondence to Antoni Bayes-Genis.

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Conflict of Interest

J. Lupón and A. Bayes-Genis have applied for an international patent for the use of soluble neprilysin as a prognostic marker in patients with HF. Dr Bayes-Genis has lectured and participated in advisory boards for Novartis.

Nuria Morant-Talamante has been hired by Novartis Pharmaceutical (Barcelona, Spain).

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Pathophysiology: Neuroendocrine, Vascular, and Metabolic Factors

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Bayes-Genis, A., Morant-Talamante, N. & Lupón, J. Neprilysin and Natriuretic Peptide Regulation in Heart Failure. Curr Heart Fail Rep 13, 151–157 (2016). https://doi.org/10.1007/s11897-016-0292-x

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  • DOI: https://doi.org/10.1007/s11897-016-0292-x

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