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Effect of sacubitril/valsartan on natriuretic peptide in patients with compensated heart failure

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Abstract

The time-dependent changes in the natriuretic peptide families during sacubitril/valsartan (S/V) treatment remain obscure in the Asian heart failure (HF) cohort. Eighty-one outpatients with compensated HF were analyzed. The patients were divided into two groups based on the administration of S/V (n = 42) or angiotensin converting enzyme inhibitor (ACE-I; n = 39). Changes to the natriuretic peptide families and the daily dose of loop diuretics were evaluated 3 and 6 months after the intervention. The atrial natriuretic peptide (ANP) level was significantly increased (102 [63–160] pg/mL to 283 [171–614] pg/mL [3 months]; 409 [210–726] pg/mL [6 months]) in the S/V group but not in the ACE-I group. The dose of furosemide was significantly decreased during the six-month follow-up period in the S/V group (40 [20–40] mg to 20 [10–20] mg) but not in the ACE-I group. A multivariate logistic regression model showed that the presence of persistent atrial fibrillation (AF) and HF with a preserved left ventricular ejection fraction (HFpEF) was independently associated with a high delta-ANP ratio (≥ 4.5 ANP value on the start date/ANP value at 6 months; the mean value was used as the cutoff value) (odds ratio [OR]: 4.649, 95% CI 1.032–20.952 and OR: 7.558, 95% CI 1.427–40.042). The plasma level of ANP was increased, and the loop diuretic dose was decreased by the addition of neprilysin inhibitor therapy in patients with compensated HF. In patients with HFpEF and complicated persistent AF, neprilysin inhibitor therapy was associated with an increase in ANP.

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Acknowledgements

We thank the staff of Hasegawa Hospital (K. Takayoshi), Toho Kamagaya Hospital (Y. Suzuki), Kanamachi Daiichi Hospital (S. Sawada) and Nippon Medical School Chiba Hokusoh Hospital for collecting the medical data. We would like to thank Japan Medical Communication (JMC) (https://www.japan-mc.co.jp/) for editing and proofreading this manuscript.

Funding

This research received no grants from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan

    Akihiro Shirakabe, Masato Matsushita, Tomofumi Sawatani & Kuniya Asai

  2. Department of Cardiovascular Medicine, Nippon Medical School Hospital, Tokyo, Japan

    Satsuki Noma

  3. Department of Internal Medicine, Toho Kamagaya Hospital, Chiba, Japan

    Tsutomu Takayasu & Hideki Kanai

  4. Department of Internal Medicine, Hasegawa Hospital, Chiba, Japan

    Miwako Asano

  5. Department of Internal Medicine, Kanamachi Daiichi Hospital, Tokyo, Japan

    Akiko Nomura

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  1. Akihiro Shirakabe
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Correspondence to Akihiro Shirakabe.

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Shirakabe, A., Matsushita, M., Sawatani, T. et al. Effect of sacubitril/valsartan on natriuretic peptide in patients with compensated heart failure. Heart Vessels 38, 773–784 (2023). https://doi.org/10.1007/s00380-022-02230-9

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  • DOI: https://doi.org/10.1007/s00380-022-02230-9

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