Effect of Neprilysin Inhibition on Various Natriuretic Peptide Assays.
Aminobutyrates
/ administration & dosage
Angiotensin Receptor Antagonists
/ administration & dosage
Biphenyl Compounds
Drug Combinations
Drug Monitoring
/ methods
Female
Heart Failure
/ blood
Humans
Male
Middle Aged
Natriuretic Peptide, Brain
/ analysis
Neprilysin
/ antagonists & inhibitors
Pharmacological Phenomena
Stroke Volume
Tetrazoles
/ administration & dosage
Valsartan
biomarkers
heart failure
natriuretic peptides
neprilysin
Journal
Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365
Informations de publication
Date de publication:
26 03 2019
26 03 2019
Historique:
received:
05
07
2018
revised:
27
11
2018
accepted:
05
12
2018
entrez:
23
3
2019
pubmed:
23
3
2019
medline:
28
2
2020
Statut:
ppublish
Résumé
With sacubitril/valsartan treatment, B-type natriuretic peptide (BNP) concentrations increase; it remains unclear whether change in BNP concentrations is similar across all assays for its measurement. Effects of sacubitril/valsartan on atrial natriuretic peptide (ANP) concentrations in patients are unknown. Lastly, the impact of neprilysin inhibition on mid-regional pro-ANP (MR-proANP), N-terminal pro-BNP (NT-proBNP), proBNP This study sought to examine the effects of sacubitril/valsartan on results from different natriuretic peptide assays. Twenty-three consecutive stable patients with heart failure and reduced ejection fraction were initiated and titrated on sacubitril/valsartan. Change in ANP, MR-proANP, BNP (using 5 assays), NT-proBNP (3 assays), proBNP Average time to 3 follow-up visits was 22, 46, and 84 days. ANP rapidly and substantially increased with initiation and titration of sacubitril/valsartan, more than doubling by the first follow-up visit (+105.8%). Magnitude of ANP increase was greatest in those with concentrations above the median at baseline (+188%) compared with those with lower baseline concentrations (+44%); ANP increases were sustained. Treatment with sacubitril/valsartan led to inconsistent changes in BNP, which varied across methods assessed. Concentrations of MR-proANP, NT-proBNP, and proBNP Initiation and titration of sacubitril/valsartan led to variable changes in concentrations of multiple natriuretic peptides. These results provide important insights into the effects of sacubitril/valsartan treatment on individual patient results, and further suggest the benefit of neprilysin inhibition may be partially mediated by increased ANP concentrations.
Sections du résumé
BACKGROUND
With sacubitril/valsartan treatment, B-type natriuretic peptide (BNP) concentrations increase; it remains unclear whether change in BNP concentrations is similar across all assays for its measurement. Effects of sacubitril/valsartan on atrial natriuretic peptide (ANP) concentrations in patients are unknown. Lastly, the impact of neprilysin inhibition on mid-regional pro-ANP (MR-proANP), N-terminal pro-BNP (NT-proBNP), proBNP
OBJECTIVES
This study sought to examine the effects of sacubitril/valsartan on results from different natriuretic peptide assays.
METHODS
Twenty-three consecutive stable patients with heart failure and reduced ejection fraction were initiated and titrated on sacubitril/valsartan. Change in ANP, MR-proANP, BNP (using 5 assays), NT-proBNP (3 assays), proBNP
RESULTS
Average time to 3 follow-up visits was 22, 46, and 84 days. ANP rapidly and substantially increased with initiation and titration of sacubitril/valsartan, more than doubling by the first follow-up visit (+105.8%). Magnitude of ANP increase was greatest in those with concentrations above the median at baseline (+188%) compared with those with lower baseline concentrations (+44%); ANP increases were sustained. Treatment with sacubitril/valsartan led to inconsistent changes in BNP, which varied across methods assessed. Concentrations of MR-proANP, NT-proBNP, and proBNP
CONCLUSIONS
Initiation and titration of sacubitril/valsartan led to variable changes in concentrations of multiple natriuretic peptides. These results provide important insights into the effects of sacubitril/valsartan treatment on individual patient results, and further suggest the benefit of neprilysin inhibition may be partially mediated by increased ANP concentrations.
Identifiants
pubmed: 30898202
pii: S0735-1097(19)30288-8
doi: 10.1016/j.jacc.2018.12.063
pii:
doi:
Substances chimiques
Aminobutyrates
0
Angiotensin Receptor Antagonists
0
Biphenyl Compounds
0
Drug Combinations
0
Tetrazoles
0
Natriuretic Peptide, Brain
114471-18-0
Valsartan
80M03YXJ7I
Neprilysin
EC 3.4.24.11
sacubitril and valsartan sodium hydrate drug combination
WB8FT61183
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1273-1284Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.