Heart failure (HF)
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.
