Heart failure (HF)

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Heart failure (HF) is a common pathology that affects over 6 million adults. The lifetime risk of HF is 1:9 for males and 1:6 for females, and increases greatly in individuals who have experienced prior myocardial infarction (MI). Thus, treatment and prevention of HF are a major priority for most health care professionals, yet poor prevention and care are the most cited reasons for adverse clinical outcomes.

In 2014, the FDA approved the drug Entresto for the management and treatment of HF, finding that it significantly reduced the risk of death from HF-related conditions by 16-20% and was particularly effective at reducing the risk of death for HF patients with reduced left ventricular ejection fraction (LVEF). Entresto is actually a combination of two drugs: sacubitril, which inhibits the enzyme neprilysin, and valsartan, which is an angiotensin II receptor antagonist.

How do these drugs work together to reduce the risk of further heart failure and preserve function? In your response, briefly describe the two signaling pathways that are affected by the drug, how they are affected, and what the body’s overall response to the drug intervention is. How does this benefit patients with HF?

Sample Solution

Sacubitril/valsartan has been shown to reduce hospitalizations for heart failure and improve survival. Sacubitril belongs to a group of drugs called neprilysin inhibitors and valsartan belongs to a class of drugs called angiotensin receptor blockers (ARBs). They work by relaxing blood vessels so that blood can flow more easily, which makes it easier for your heart to pump blood to your body. They work in different ways. Valsartan blocks the action of a hormone from the kidney called angiotensin II, which can be harmful in patients with heart failure, by blocking the receptors to which angiotensin II normally attaches. This effect stops the hormone`s harmful effects on the heart, and it allows blood vessels to dilate or widen. Sacubitril blocks the breakdown of natriuretic peptides produced in the body.

 

 

Destiny is Love’s Nemesis in “The Definition of Love” by Andrew Marvell

The meaning of adoration by Andrew Marvel is an image of incongruity. Marvell grasps love-related feelings and causes it to suffocate with a quiet, quiet, quiet tones. Wonder composed a slight energy, asserting that destiny itself would contradict genuine affection. Wonder initially depicted Fate as the purpose behind his harsh love history in the second from last quarter. (Lines 9 to 12) With this as a main priority, it is characteristic that disdain of Marvel’s predetermination will stream into the following two quarters.

Andrew Marvell’s sonnet “To His Coy Mistress” is proposed to catch the genuine affection of adoration. This is around the world. Romance is significant today as it was during the 1600s. Character in this sonnet, most likely Andrew Marvel himself needs to have intercourse with a lady by sexual orientation. It is presumably a conduct of affection, that lady is by all accounts safe. He attempted to convince her to pass on today or snatch the present life. This sonnet is a story isolated into three sections. The initial segment is verification of that time. “On the off chance that we are adequately worldwide, time, this lady won’t perpetrate a wrongdoing” (lines 1-2). Andrew Marville accentuates time. Time is the most significant as the relationship isn’t so significant. This job will attempt to convince his darling to give her affection, most likely her virgin to him. He disclosed to her that it is time now, and it might be grieved in the event that she was pausing. She should snatch this day. In the present culture it is more apparent than in the 1600’s.

The meaning of adoration by Andrew Marvel is an image of incongruity. Marvell grasps love-related feelings and causes it to suffocate with a quiet, quiet, quiet tones. Wonder composed a slight energy, asserting that destiny itself would restrict genuine romance. – You can characterize love. At some point, I was dealing with my multi year old whore, one of the most sumptuous darlings. At the point when she was sitting close to my sweetheart’s sibling Matthew and eating potato chips, she said she said “I like him without question.” She gulped potato chips, however I unquestionably need it more. More articulation of adoration dribbles from her lips. At long last, an issue has emerged. “Reg, would you be able to purchase more chips?”

 

 

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