title: Therapeutic options of Angiotensin Receptor Neprilysin inhibitors (ARNis) in chronic heart failure with reduced ejection fraction: Beyond RAAS and sympathetic nervous system inhibition.
abstract: In heart failure, in addition to the renin-angiotensin-aldosterone system and sympathetic nervous system, the natriuretic peptide (NP) system plays a fundamental role among compensating mechanisms. The NPs undergo rapid enzymatic degradation that limits their vasorelaxant, natriuretic, and diuretic actions. Degradation of NPs is partially due to the action of neprilysin, which is a membrane-bound endopeptidase found in many tissues. This article summarizes recent findings on a new natriuretic peptide-enhancing drug and their implication for future pharmacological treatment of patients suffering from heart failure with reduced ejection fraction.
authors.affiliation: Cardiology Department, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Pisana, Roma, Italy. Electronic address: maurizio.volterrani@sanraffaele.it.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Volterrani
authors.affiliation: Cardiology Department, Istituto di Ricovero e Cura a Carattere Scientifico San Raffaele Pisana, Roma, Italy; Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Roma, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Iellamo
authors.affiliation: Cardiology, Heart Failure and Heart Transplant Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Senni
authors.affiliation: Heart Failure Unit, Cardiology Department, Guglielmo da Saliceto Hospital, Piacenza, Italy.
authors.forename: Massimo F
authors.initials: MF
authors.lastname: Piepoli
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D002908:Chronic Disease; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D015260:Neprilysin / Q000037:antagonists & inhibitors* / Q000502:physiology; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology; D013318:Stroke Volume / Q000187:drug effects* / Q000502:physiology; D013564:Sympathetic Nervous System / Q000187:drug effects* / Q000502:physiology
chemical_list: D057911:Angiotensin Receptor Antagonists; D015260:Neprilysin
keywords: Cardiac outcomes; Chronic heart failure; Natriuretic peptide inhibitors; Natriuretic peptide system; Renin–angiotensin–aldosterone system