血管紧张素受体奈普利素抑制剂用于HFrEF:这是第一个导致利尿需求大幅减少的疾病修饰治疗药物类别吗?

International Journal of Heart Failure Pub Date : 2021-02-25 eCollection Date: 2021-04-01 DOI:10.36628/ijhf.2020.0043
Brian Kerr, Rebabonye B Pharithi, Matthew Barrett, Carmel Halley, Joe Gallagher, Mark Ledwidge, Kenneth McDonald
{"title":"血管紧张素受体奈普利素抑制剂用于HFrEF:这是第一个导致利尿需求大幅减少的疾病修饰治疗药物类别吗?","authors":"Brian Kerr,&nbsp;Rebabonye B Pharithi,&nbsp;Matthew Barrett,&nbsp;Carmel Halley,&nbsp;Joe Gallagher,&nbsp;Mark Ledwidge,&nbsp;Kenneth McDonald","doi":"10.36628/ijhf.2020.0043","DOIUrl":null,"url":null,"abstract":"<p><p>Despite significant advances in disease modifying therapy in heart failure (HF), diuretics have remained the cornerstone of volume management in all HF phenotypes. Diuretics, alongside their definite acute haemodynamic and symptomatic benefits, also possess many possible deleterious side effects. Moreover, questions remain regarding the prognostic impact of chronic diuretic use. To date, few data exist pertaining to diuretic reduction as a result of individual traditional guideline directed medical therapy in HF with reduced ejection fraction (HFrEF). However, diuretic reduction has been demonstrated with sacubitril/valsartan (angiotensin receptor-neprilysin inhibitor [ARNi]) from the PARADIGM study, as well as, post-marketing reports from our own group and others. Whether the ARNi compound represents the dawn of a new era, where effective therapies will have a more noticeable reduction on diuretic need, remains to be seen. The emergence of sodium glucose transport 2 inhibitors and guanylate cyclase stimulators may further exemplify this issue and potentially extend this benefit to HF patients outside of the HFrEF phenotype. In conclusion, emerging new therapies in HFrEF could reduce the reliance on diuretics in the management of this phenotype of HF. These developments further highlight the clinical importance to continually assess an individual's diuretic requirements through careful volume assessment.</p>","PeriodicalId":14058,"journal":{"name":"International Journal of Heart Failure","volume":"3 2","pages":"106-116"},"PeriodicalIF":0.0000,"publicationDate":"2021-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/a7/ijhf-3-106.PMC9536695.pdf","citationCount":"2","resultStr":"{\"title\":\"Angiotensin Receptor Neprilysin Inhibitors in HFrEF: Is This the First Disease Modifying Therapy Drug Class Leading to a Substantial Reduction in Diuretic Need?\",\"authors\":\"Brian Kerr,&nbsp;Rebabonye B Pharithi,&nbsp;Matthew Barrett,&nbsp;Carmel Halley,&nbsp;Joe Gallagher,&nbsp;Mark Ledwidge,&nbsp;Kenneth McDonald\",\"doi\":\"10.36628/ijhf.2020.0043\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Despite significant advances in disease modifying therapy in heart failure (HF), diuretics have remained the cornerstone of volume management in all HF phenotypes. Diuretics, alongside their definite acute haemodynamic and symptomatic benefits, also possess many possible deleterious side effects. Moreover, questions remain regarding the prognostic impact of chronic diuretic use. To date, few data exist pertaining to diuretic reduction as a result of individual traditional guideline directed medical therapy in HF with reduced ejection fraction (HFrEF). However, diuretic reduction has been demonstrated with sacubitril/valsartan (angiotensin receptor-neprilysin inhibitor [ARNi]) from the PARADIGM study, as well as, post-marketing reports from our own group and others. Whether the ARNi compound represents the dawn of a new era, where effective therapies will have a more noticeable reduction on diuretic need, remains to be seen. The emergence of sodium glucose transport 2 inhibitors and guanylate cyclase stimulators may further exemplify this issue and potentially extend this benefit to HF patients outside of the HFrEF phenotype. In conclusion, emerging new therapies in HFrEF could reduce the reliance on diuretics in the management of this phenotype of HF. These developments further highlight the clinical importance to continually assess an individual's diuretic requirements through careful volume assessment.</p>\",\"PeriodicalId\":14058,\"journal\":{\"name\":\"International Journal of Heart Failure\",\"volume\":\"3 2\",\"pages\":\"106-116\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2021-02-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/a7/ijhf-3-106.PMC9536695.pdf\",\"citationCount\":\"2\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Heart Failure\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.36628/ijhf.2020.0043\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/4/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Heart Failure","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36628/ijhf.2020.0043","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/4/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 2

摘要

尽管心力衰竭(HF)的疾病修饰治疗取得了重大进展,利尿剂仍然是所有HF表型容量管理的基石。利尿剂,除了他们明确的急性血流动力学和症状的好处,也有许多可能有害的副作用。此外,关于长期使用利尿剂对预后影响的问题仍然存在。迄今为止,很少有数据表明,在心力衰竭伴射血分数降低(HFrEF)的个体化传统指导药物治疗中,利尿剂减少。然而,从PARADIGM研究以及我们自己的小组和其他小组的上市后报告来看,苏比里尔/缬沙坦(血管紧张素受体-奈普利素抑制剂[ARNi])已被证明具有利尿作用。ARNi化合物是否代表了一个新时代的曙光,在这个新时代,有效的治疗方法将更显著地减少利尿剂的需求,还有待观察。葡萄糖转运2钠抑制剂和鸟苷酸环化酶刺激剂的出现可能进一步证明了这一问题,并可能将这种益处扩展到HFrEF表型以外的HF患者。总之,HFrEF的新疗法可以减少对利尿剂的依赖。这些发展进一步强调了通过仔细的容量评估来持续评估个人利尿剂需求的临床重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Angiotensin Receptor Neprilysin Inhibitors in HFrEF: Is This the First Disease Modifying Therapy Drug Class Leading to a Substantial Reduction in Diuretic Need?

Despite significant advances in disease modifying therapy in heart failure (HF), diuretics have remained the cornerstone of volume management in all HF phenotypes. Diuretics, alongside their definite acute haemodynamic and symptomatic benefits, also possess many possible deleterious side effects. Moreover, questions remain regarding the prognostic impact of chronic diuretic use. To date, few data exist pertaining to diuretic reduction as a result of individual traditional guideline directed medical therapy in HF with reduced ejection fraction (HFrEF). However, diuretic reduction has been demonstrated with sacubitril/valsartan (angiotensin receptor-neprilysin inhibitor [ARNi]) from the PARADIGM study, as well as, post-marketing reports from our own group and others. Whether the ARNi compound represents the dawn of a new era, where effective therapies will have a more noticeable reduction on diuretic need, remains to be seen. The emergence of sodium glucose transport 2 inhibitors and guanylate cyclase stimulators may further exemplify this issue and potentially extend this benefit to HF patients outside of the HFrEF phenotype. In conclusion, emerging new therapies in HFrEF could reduce the reliance on diuretics in the management of this phenotype of HF. These developments further highlight the clinical importance to continually assess an individual's diuretic requirements through careful volume assessment.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
Understanding the Epidemiologic Profile and Predictors of Readmission of Heart Failure: Unveiling Opportunities for Improved Care. In-hospital Outcomes of Aspiration Pneumonia Hospitalizations With Acute Heart Failure: A Nationwide Analysis Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Management of the Underlying Etiologies and Comorbidities of Heart Failure. Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Advanced and Acute Heart Failure. Association of Blood Pressure and Prognosis of Heart Failure With Systolic Dysfunction: A Myth That Should Be Solved.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1