Potential of valsartan+sacubitril therapy in hypertensive heart disease
The course of hypertension is often complicated by left ventricular hypertrophy (or hypertensive heart disease, HHD). The main “corridor” of natural HHD is development of heart failure with preserved ejection fraction (HFpEF). With HFpEF, the bioavailability of natriuretic peptides (NP) is significa...
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| Language: | Russian |
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«FIRMA «SILICEA» LLC
2021-08-01
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| Series: | Российский кардиологический журнал |
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| Online Access: | https://russjcardiol.elpub.ru/jour/article/view/4568 |
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| author | A. G. Ovchinnikov A. D. Gvozdeva A. V. Potekhina M. V. Vitsenya F. T. Ageev |
| author_facet | A. G. Ovchinnikov A. D. Gvozdeva A. V. Potekhina M. V. Vitsenya F. T. Ageev |
| author_sort | A. G. Ovchinnikov |
| collection | DOAJ |
| description | The course of hypertension is often complicated by left ventricular hypertrophy (or hypertensive heart disease, HHD). The main “corridor” of natural HHD is development of heart failure with preserved ejection fraction (HFpEF). With HFpEF, the bioavailability of natriuretic peptides (NP) is significantly reduced, as a result of which the activity of cGMP-PKG signaling pathway, which plays a key role in maintaining normal diastolic function, weakens. It is possible to increase the activity of this pathway using the neprilysin inhibitor sacubitril. In case of HFpEF, the greatest efficacy from valsartan+sacubitril therapy should be expected in patients with severe concentric LVH, who have the most pronounced natriuretic peptide deficiency. Valsartan+sacubitril therapy has a clear hypotensive effect, causes a reversal of left ventricular hypertrophy and fibrosis. Since no effective treatment has yet been found for HFpEF, the main way for HHD treatment should be to prevent the diastolic dysfunction progression, which justifies valsartan+sacubitril therapy starting from the early/ asymptomatic stages. |
| first_indexed | 2024-04-09T20:44:59Z |
| format | Article |
| id | doaj.art-cff14da5d96c4a3e9b46d1a9c2786f43 |
| institution | Directory Open Access Journal |
| issn | 1560-4071 2618-7620 |
| language | Russian |
| last_indexed | 2024-04-09T20:44:59Z |
| publishDate | 2021-08-01 |
| publisher | «FIRMA «SILICEA» LLC |
| record_format | Article |
| series | Российский кардиологический журнал |
| spelling | doaj.art-cff14da5d96c4a3e9b46d1a9c2786f432023-03-29T21:23:38Zrus«FIRMA «SILICEA» LLCРоссийский кардиологический журнал1560-40712618-76202021-08-0126710.15829/1560-4071-2021-45683313Potential of valsartan+sacubitril therapy in hypertensive heart diseaseA. G. Ovchinnikov0A. D. Gvozdeva1A. V. Potekhina2M. V. Vitsenya3F. T. Ageev4A.L. Myasnikov Institute of Clinical Cardiology, National Medical Research Center of Cardiology; Moscow State University of Medicine and DentistryA.L. Myasnikov Institute of Clinical Cardiology, National Medical Research Center of CardiologyA.L. Myasnikov Institute of Clinical Cardiology, National Medical Research Center of CardiologyA.L. Myasnikov Institute of Clinical Cardiology, National Medical Research Center of CardiologyA.L. Myasnikov Institute of Clinical Cardiology, National Medical Research Center of CardiologyThe course of hypertension is often complicated by left ventricular hypertrophy (or hypertensive heart disease, HHD). The main “corridor” of natural HHD is development of heart failure with preserved ejection fraction (HFpEF). With HFpEF, the bioavailability of natriuretic peptides (NP) is significantly reduced, as a result of which the activity of cGMP-PKG signaling pathway, which plays a key role in maintaining normal diastolic function, weakens. It is possible to increase the activity of this pathway using the neprilysin inhibitor sacubitril. In case of HFpEF, the greatest efficacy from valsartan+sacubitril therapy should be expected in patients with severe concentric LVH, who have the most pronounced natriuretic peptide deficiency. Valsartan+sacubitril therapy has a clear hypotensive effect, causes a reversal of left ventricular hypertrophy and fibrosis. Since no effective treatment has yet been found for HFpEF, the main way for HHD treatment should be to prevent the diastolic dysfunction progression, which justifies valsartan+sacubitril therapy starting from the early/ asymptomatic stages.https://russjcardiol.elpub.ru/jour/article/view/4568natriuretic peptideneprilysinsacubitrilleft ventricular hypertrophyhypertensive heart diseaseheart failure with preserved ejection fraction |
| spellingShingle | A. G. Ovchinnikov A. D. Gvozdeva A. V. Potekhina M. V. Vitsenya F. T. Ageev Potential of valsartan+sacubitril therapy in hypertensive heart disease Российский кардиологический журнал natriuretic peptide neprilysin sacubitril left ventricular hypertrophy hypertensive heart disease heart failure with preserved ejection fraction |
| title | Potential of valsartan+sacubitril therapy in hypertensive heart disease |
| title_full | Potential of valsartan+sacubitril therapy in hypertensive heart disease |
| title_fullStr | Potential of valsartan+sacubitril therapy in hypertensive heart disease |
| title_full_unstemmed | Potential of valsartan+sacubitril therapy in hypertensive heart disease |
| title_short | Potential of valsartan+sacubitril therapy in hypertensive heart disease |
| title_sort | potential of valsartan sacubitril therapy in hypertensive heart disease |
| topic | natriuretic peptide neprilysin sacubitril left ventricular hypertrophy hypertensive heart disease heart failure with preserved ejection fraction |
| url | https://russjcardiol.elpub.ru/jour/article/view/4568 |
| work_keys_str_mv | AT agovchinnikov potentialofvalsartansacubitriltherapyinhypertensiveheartdisease AT adgvozdeva potentialofvalsartansacubitriltherapyinhypertensiveheartdisease AT avpotekhina potentialofvalsartansacubitriltherapyinhypertensiveheartdisease AT mvvitsenya potentialofvalsartansacubitriltherapyinhypertensiveheartdisease AT ftageev potentialofvalsartansacubitriltherapyinhypertensiveheartdisease |