Angiotensin receptor blocker neprilysin inhibitors  

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 

机构地区：[1]Emergency and Critical Care Medicine,Juntendo University Nerima Hospital,Nerima-ku 177-8521,Tokyo,Japan [2]Geriatric Medicine,Kanazawa Medical University Himi Municipal Hospital,Himi-shi 935-8531,Toyama,Japan

出　　处：《World Journal of Cardiology》2021年第8期325-339,共15页世界心脏病学杂志（英文版）（电子版）

摘　　要：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,blood.It 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 health.Regarding 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 treatment.Angiotensin receptor blocker and neprilysin inhibitor(angiotensinreceptor neprilysin inhibitor),namely sacubitril/valsartan(SAC/VAL),has been introduced as a treatment for CHF.SAC/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 admissions.An inhospital initiation strategy offers a potential new avenue to improve the clinical uptake of SAC/VAL.In the last five years,SAC/VAL has been established as a cornerstone component of comprehensive disease-modifying medical therapy in the management of chronic HFrEF.On 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 

分 类 号：R541.6[医药卫生—心血管疾病]