Menendez Juan Tamargo
Department of Pharmacology, School of Medicine, University Complutense, Madrid, Spain.
Card Fail Rev. 2016 May;2(1):40-46. doi: 10.15420/cfr.2016:1:1.
Heart failure (HF) represents a growing financial burden on healthcare systems and despite therapeutic advances, mortality remains high. Current treatments focus on blocking neurohormonal pathways, such as the renin-angiotensin aldosterone system (RAAS). Recent research has focused on the natriuretic peptide system, which confers beneficial effects in HF, whereas activation of the RAAS and of the sympathetic nervous system has detrimental effects. LCZ696 (sacubutril/valsartan), a first-in-class angiotensin II AT[1] receptor neprilysin inhibitor, has a unique mode of action that targets both pathways. Clinical studies to date indicate that LCZ696 is effective and safe in mild to moderate arterial hypertension and in HF patients with preserved ejection fraction, and has been shown to be superior to enalapril in patients with moderate to severe HF due to reduced left ventricular ejection fraction.
心力衰竭（HF）给医疗系统带来了日益沉重的经济负担，尽管治疗取得了进展，但死亡率仍然很高。目前的治疗重点是阻断神经激素途径，如肾素-血管紧张素-醛固酮系统（RAAS）。最近的研究集中在利钠肽系统，该系统在HF中具有有益作用，而RAAS和交感神经系统的激活则具有有害作用。LCZ696（沙库巴曲/缬沙坦）是首个血管紧张素II AT[1]受体脑啡肽酶抑制剂，具有针对这两种途径的独特作用模式。迄今为止的临床研究表明，LCZ696在轻度至中度动脉高血压以及射血分数保留的HF患者中有效且安全，并且在因左心室射血分数降低导致的中度至重度HF患者中已被证明优于依那普利。
