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沙库巴曲缬沙坦在治疗射血分数保留的心衰中的有效性和安全性
Efficacy and Safety of Sacubitril-Valsartan in the Treatment of Heart Failure with Preserved Ejection Fraction

DOI: 10.12677/ACM.2020.107204, PP. 1353-1359

Keywords: 射血分数保留的心衰，血管紧张素受体–脑啡肽酶抑制剂，沙库巴曲缬沙坦
Heart Failure with Preserved Ejection Fraction, Angiotensin Receptor-Neprilysin Inhibitor, Sacubitril-Valsartan

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Abstract:

心力衰竭是绝大多数心血管疾病的终末阶段，病死率极高，射血分数保留的心衰(Heart Failure with preserved ejection fraction, HFpEF)已经成为心力衰竭的主要表现形式。在呼吸困难的患者中，HFpEF的诊断具有很大的挑战性，而且目前针对HFpEF的治疗缺少足够的循证医学证据。沙库巴曲缬沙坦是首个血管紧张素受体–脑啡肽酶双重抑制剂，是一种具有全新作用机制的治疗心衰的药物，已被指南推荐用于射血分数降低的心衰(HFrEF)患者。目前，该药物对HFpEF患者没有明确的适应症。然而，其复杂的作用机制以及先前的实验和临床数据似乎表明其在HFpEF中的潜在治疗作用。现将沙库巴曲缬沙坦在治疗射血分数保留的心衰中的有效性和安全性作一综述。
Heart failure is the terminal stage of most cardiovascular diseases, with a very high mortality rate. Heart failure with preserved ejection fraction (HFpEF) has become the main manifestation of heart failure. In patients with dyspnea, the diagnosis of HFpEF is very challenging, and the current treatment targeting HFpEF lacks sufficient evidence-based medicine. Sacubitri-valsartan is the first dual inhibition of angiotensin receptor and neprilysin with a new mechanism of action for heart failure. It has been recommended by the guidelines for heart failure patients with reduced ejection fraction. At present, the drug has no clear indications for HFpEF patients. However, its complex mechanism of action and previous experimental and clinical data seem to indicate its potential therapeutic role in HFpEF. In this review, we summarize the efficacy and safety of sacubitril-valsartan in the treatment of HFpEF.

References

[1]  van Riet, E.E., Hoes, A.W., Limburg, A., et al. (2014) Prevalence of Unrecognized Heart Failure in Older Persons with Shortness of Breath on Exertion. European Journal of Heart Failure, 16, 772-777.
https://doi.org/10.1002/ejhf.110
[2]  甄宇治, 段立楠, 刘超, 等. 比索洛尔治疗左室射血分数保留心力衰竭患者的疗效观察[J]. 中国循证心血管医学杂志, 2016, 8(4): 442-444, 447.
[3]  黄南清, 郑学鸥. 铁缺乏与左室射血分数保留性心力衰竭的关系[J]. 中国循证心血管医学杂志, 2016, 8(6): 746-748.
[4]  赵国元, 赵志强, 毛静远, 等. 射血分数正常心力衰竭的临床研究现状[J]. 中西医结合心脑血管病杂志, 2015, 13(16): 1809-1817.
[5]  Chandra, A., Vaduganathan, M., Lewis, E.F., et al. (2019) Health-Related Quality of Life in Heart Failure with Preserved Ejection Fraction: The PARAGON-HF Trial. JACC: Heart Failure, 7, 862-874.
[6]  Mc Murray, J.J., Packer, M., Desai, A.S., et al. (2014) Angiotensin-Neprilysin Inhibition versus Enalapril in Heart Failure. The New England Journal of Medicine, 371, 993-1004.
https://doi.org/10.1056/NEJMoa1409077
[7]  Reddy, Y.N.V., Carter, R.E., Obokata, M., Redfield, M.M. and Borlaug, B.A. (2018) A Simple, Evidence-Based Approach to Help Guide Diagnosis of Heart Failure with Preserved Ejection Fraction. Circulation, 138, 861-870.
https://doi.org/10.1161/CIRCULATIONAHA.118.034646
[8]  中华医学会心血管病学分会心力衰竭学组, 中国医师协会心力衰竭专业委员会中华心血管病杂志编辑委员会. 中国心力衰竭诊断和治疗指南2018[J]. 中华心血管病杂志, 2018, 46(10): 760-789.
[9]  Hubers, S.A. and Brown, N.J. (2016) Combined Angiotensin Receptor Antagonism and Neprilysin Inhibition. Circulation, 133, 1115-1124.
https://doi.org/10.1161/CIRCULATIONAHA.115.018622
[10]  Liu, Y., Studzinski, C., Beckett, T., et al. (2010) Circulating Neprilysin Clears Brain Amyloid. Molecular and Cellular Neuroscience, 45, 101-107.
https://doi.org/10.1016/j.mcn.2010.05.014
[11]  Ambrosy, A.P., Mentz, R.J., et al. (2018) The Role of Angiotensin Receptor-Neprilysin Inhibitors in Cardiovascular Disease—Existing Evidence, Knowledge Gaps, and Future Directions. European Journal of Heart Failure, 20, 963-972.
https://doi.org/10.1002/ejhf.1159
[12]  黄樱, 硕孙颖. 心力衰竭与脑啡肽酶的研究进展[J]. 中华老年多器官疾病杂志, 2018, 17(1): 73-76.
[13]  Cleland, J.G. and Swedberg, K. (1998) Lack of Efficacy of Neutral Endopeptidase Inhibitor Ecadotril in Heart Failure. The International Ecadotril Multicentre Dose-Ranging Study Investigators. The Lancet, 351, 1657-1658.
https://doi.org/10.1016/S0140-6736(05)77712-6
[14]  Lyle, M.A., et al. (2020) Circulating Neprilysin in Patients with Heart Failure and Preserved Ejection Fraction. JACC: Heart Failure.
https://doi.org/10.1016/j.jchf.2019.07.005
[15]  Hamdani, N., Bishu, K.G., von Frieling-Salewsky, M., Redfield, M.M. and Linke, W.A. (2013) Deranged Myofilament Phosphorylation and Function in Experimental Heart Failure with Preserved Ejection Fraction. Cardiovascular Research, 97, 464-471.
https://doi.org/10.1093/cvr/cvs353
[16]  Hamdani, N., Franssen, C., Louren？o, A., Falc？o-Pires, I., Fontoura, D., Leite, S., Plettig, L., López, B., Ottenheijm, C.A., Becher, P.M., González, A., Tsch？pe, C., Díez, J., Linke, W.A., Leite-Moreira, A.F. and Paulus, W.J. (2013) Myocardial Titin Hypophosphorylation Importantly Contributes to Heart Failure with Preserved Ejection Fraction in a Rat Metabolic Risk Model. Circulation: Heart Failure, 6, 1239-1249.
https://doi.org/10.1161/CIRCHEARTFAILURE.113.000539
[17]  van Heerebeek, L., Hamdani, N., Falc？o-Pires, I., Leite-Moreira, A.F., Begieneman, M.P., Bronzwaer, J.G., van der Velden, J., Stienen, G.J., Laarman, G.J., Somsen, A., Verheugt, F.W., Niessen, H.W. and Paulus, W.J. (2012) Low Myocardial Protein Kinase G Activity in Heart Failure with Preserved Ejection Fraction. Circulation, 126, 830-839.
https://doi.org/10.1161/CIRCULATIONAHA.111.076075
[18]  Tokudome, T., Horio, T., Kishimoto, I., Soeki, T., Mori, K., Kawano, Y., Kohno, M., Garbers, D.L., Nakao, K. and Kangawa, K. (2005) Calcineurin-Nuclear Factor of Activated T Cells Pathway-Dependent Cardiac Remodeling in Mice Deficient in Guanylyl Cyclase A, a Receptor for Atrial and Brain Natriuretic Peptides. Circulation, 111, 3095- 3104.
https://doi.org/10.1161/CIRCULATIONAHA.104.510594
[19]  Franssen, C., Chen, S., Unger, A., Korkmaz, H.I., De Keulenaer, G.W., Tsch？pe, C., Leite-Moreira, A.F., Musters, R., Niessen, H.W., Linke, W.A., Paulus, W.J. and Hamdani, N. (2016) Myocardial Microvascular Inflammatory Endothelial Activation in Heart Failure with Preserved Ejection Fraction. JACC: Heart Failure, 4, 312-324.
https://doi.org/10.1016/j.jchf.2015.10.007
[20]  Trivedi, R.K., Polhemus, D.J., Li, Z., Yoo, D., Koiwaya, H., Scarborough, A., et al. (2018) Combined Angiotensin Receptor-Neprilysin Inhibitors Improve Cardiac and Vascular Function via Increased NO Bioavailability in Heart Failure. Journal of the American Heart Association, 7, e008268.
https://doi.org/10.1161/JAHA.117.008268
[21]  Hinson, J.P., Kapas, S. and Smith, D.M. (2000) Adrenomedullin, a Multifunctional Regulatory Peptide. Endocrine Reviews, 21, 138-167.
https://doi.org/10.1210/edrv.21.2.0396
[22]  胡正清. 降钙素基因相关肽与心力衰竭[J]. 中国危重病急救医学, 1997, 9(6): 378-380.
[23]  Cruden, N.L., Witherow, F.N., Webb, D.J., Fox, K.A. and Newby, D.E. (2004) Bradykinin Contributes to the Systemic Hemodynamic Effects of Chronic Angiotensin-Converting Enzyme Inhibition in Patients with Heart Failure. Arteriosclerosis, Thrombosis, and Vascular Biology, 24, 1043-1048.
https://doi.org/10.1161/01.ATV.0000129331.21092.1d
[24]  Solomon, S.D., Zile, M., Pieske, B., et al. (2012) The Angiotensin Receptor Neprilysin Inhibitor LCZ696 in Heart Failure with Preserved Ejection Fraction: A Phase 2 Double-Blind Randomised Controlled Trial. The Lancet, 380, 1387-1395.
https://doi.org/10.1016/S0140-6736(12)61227-6
[25]  Green, C.P., Porter, C.B., Bresnahan, D.R. and Spertus, J.A. (2000) Development and Evaluation of the Kansas City Cardiomyopathy Questionnaire: A New Health Status Measure for Heart Failure. Journal of the American College of Cardiology, 35, 1245-1255.
https://doi.org/10.1016/S0735-1097(00)00531-3
[26]  Solomon, S.D., McMurray, J.J.V., Anand, I.S., et al. (2019) Angiotensin-Neprilysin Inhibition in Heart Failure with Preserved Ejection Fraction. The New England Journal of Medicine, 381, 1609-1620.

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