Heart Failure and Transplant Program, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS 39216, USA.
Medicina (Kaunas). 2024 Jul 9;60(7):1112. doi: 10.3390/medicina60071112.
This review article examines the mechanism of action of Angiotensin Receptor-Neprilysin Inhibitors (ARNIs) and Sodium-Glucose Co-Transporter 2 Inhibitors (SGLT2is) in managing chronic right ventricular (RV) dysfunction. Despite advancements in heart failure (HF) treatment, RV dysfunction remains a significant contributor to morbidity and mortality. This article explores the The article explores the impact of ARNIs and SGLT2is on RV function based on clinical and preclinical evidence, and the potential benefits of combined therapy. It highlights the need for further research to optimize patient outcomes and suggests that RV function should be considered in future clinical trials as part of risk stratification for HF therapies. This review underscores the importance of the early initiation of ARNIs and SGLT2is as per guideline-directed medical therapy for eligible HFrEF and HFpEF patients to improve co-existing RV dysfunction.
这篇综述文章探讨了血管紧张素受体-脑啡肽酶抑制剂(ARNI)和钠-葡萄糖共转运蛋白 2 抑制剂(SGLT2i)在治疗慢性右心室(RV)功能障碍中的作用机制。尽管心力衰竭(HF)治疗取得了进展,但 RV 功能障碍仍然是发病率和死亡率的重要原因。本文基于临床和临床前证据探讨了 ARNI 和 SGLT2i 对 RV 功能的影响,以及联合治疗的潜在益处。它强调了需要进一步研究以优化患者的治疗效果,并建议在未来的 HF 治疗临床试验中,应将 RV 功能作为风险分层的一部分进行考虑。本综述强调了早期启动 ARNI 和 SGLT2i 的重要性,因为这些药物是指南指导的医学治疗,适用于有资格的 HFrEF 和 HFpEF 患者,以改善并存的 RV 功能障碍。