Pathogenetic justification of sacubitril / valsartan use in respiratory-cardial comorbidity
DOI:
https://doi.org/10.14739/2310-1237.2022.3.266425Keywords:
comorbidity, chronic obstructive pulmonary disease, heart failure, sacubitrile / valsartan, natriuretic peptide, G-dependent protein kinaseAbstract
Among the comorbid conditions that significantly worsen quality of life and life expectancy are the chronic obstructive pulmonary disease and heart failure. Difficulties of drug therapy are the mutually exclusive approaches in the treatment of chronic obstructive pulmonary disease and concomitant cardiovascular pathology.
Aim of this study was to provide scientific evidence of the possible use of the combined drug LCZ696 (angiotensin receptor neprilysin inhibitor, ARNI), which contains neprilysin inhibitor sacubitril (AHU377) and angiotensin II blocker valsartan, in patients with congestive heart failure.
The article presents a review of the literature. It was demonstrated that the cause of mortality in patients with chronic obstructive pulmonary disease could be both changes in the respiratory system and complications in the cardiovascular system. It has been shown that progressive chronic obstructive pulmonary disease leads to the formation of pulmonary hypertension, right ventricular hypertrophy, decrease in its systolic function, subsequent dilatation of the right ventricle, and development of right ventricular heart failure, which is one of the most serious and difficult tests in the treatment process. The further development of such a combined pathology is left ventricular heart failure.
The role of the system of natriuretic peptides, namely brain natriuretic peptide, brain natriuretic propeptide, C-type natriuretic peptide, and N-terminal precursor of C-type natriuretic peptide, as markers of chronic obstructive pulmonary disease and heart failure has been discussed. Natriuretic peptide is currently a recognized marker of heart failure, the high value of which is achieved for determining the prognosis and stratification of the risk of heart failure. Natriuretic peptide acts as a vasodilator, provides antiproliferative activity through the G-dependent protein kinase pathway and promotes bronchodilation, causing the release of acetylcholine from bronchial epithelial cells.
Conclusions. All these properties suggest that natriuretic peptides may be a potential treatment in patients with cardiac complications and chronic obstructive pulmonary disease. The best way to prolong life of natriuretic peptide is to inhibit degradation of the natriuretic peptide with the neprilysin inhibitor sacubitril.
References
Forum of International Respiratory Societies. (2021). The global impact of respiratory disease (3rd ed.). European Respiratory Society. https:firsnet.org/images/publications/FIRS_Master_09202021.pdf
Voinarovska, G., & Asanov, E. (2020). Ishemichna khvoroba sertsia ta khronichne obstruktyvne zakhvoriuvannia lehen: aktualna problema komorbidnosti u vnutrishnii medytsyni [Ischemic heart disease and chronic obstructive pulmonary disease: the topical problem of comorbidity in internal medicine]. ScienceRise: Medical Science, (3), 20-24. https://doi.org/10.15587/2519-4798.2020.203968
Potabashnii, V. A., Kniazieva, O. V., & Markova, O. Y. (2021). Problemy diahnostyky ta likuvannia khronichnoi ishemichnoi khvoroby sertsia v poiednanni z khronichnym obstruktyvnym zakhvoriuvanniam lehen za danymy retrospektyvnoho analizu [Problems of diagnosis and treatment of chronic ischaemic heart disease combined with chronic obstructive pulmonary disease according to retrospective analysis]. Medicni perspektivi, 26(2), 72-79. https://doi.org/10.26641/2307-0404.2021.2.234517
Gorter, T. M., van Veldhuisen, D. J., Bauersachs, J., Borlaug, B. A., Celutkiene, J., Coats, A. J. S., Crespo-Leiro, M. G., Guazzi, M., Harjola, V. P., Heymans, S., Hill, L., Lainscak, M., Lam, C. S. P., Lund, L. H., Lyon, A. R., Mebazaa, A., Mueller, C., Paulus, W. J., Pieske, B., Piepoli, M. F., … de Boer, R. A. (2018). Right heart dysfunction and failure in heart failure with preserved ejection fraction: mechanisms and management. Position statement on behalf of the Heart Failure Association of the European Society of Cardiology. European journal of heart failure, 20(1), 16-37. https://doi.org/10.1002/ejhf.1029
Konstam, M. A., Kiernan, M. S., Bernstein, D., Bozkurt, B., Jacob, M., Kapur, N. K., Kociol, R. D., Lewis, E. F., Mehra, M. R., Pagani, F. D., Raval, A. N., Ward, C., & American Heart Association Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; and Council on Cardiovascular Surgery and Anesthesia (2018). Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association. Circulation, 137(20), e578-e622. https://doi.org/10.1161/CIR.0000000000000560
Liczek, M., Panek, I., Damiański, P., Jęczeń, O., Jaźwiec, J., Kuna, P., & Panek, M. (2018). Neprilysin inhibitors as a new approach in the treatment of right heart failure in the course of chronic obstructive pulmonary disease. Response to the letter of Siniorakis et al. Advances in respiratory medicine, 86(5), 257-259. https://doi.org/10.5603/ARM.2018.0042
Humbert, M., Kovacs, G., Hoeper, M. M., Badagliacca, R., Berger, R. M. F., Brida, M., Carlsen, J., Coats, A. J. S., Escribano-Subias, P., Ferrari, P., Ferreira, D. S., Ghofrani, H. A., Giannakoulas, G., Kiely, D. G., Mayer, E., Meszaros, G., Nagavci, B., Olsson, K. M., Pepke-Zaba, J., Quint, J. K., … ESC/ERS Scientific Document Group (2022). 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. European heart journal, 43(38), 3618-3731. https://doi.org/10.1093/eurheartj/ehac237
Long, L., Mordi, I. R., Bridges, C., Sagar, V. A., Davies, E. J., Coats, A. J., Dalal, H., Rees, K., Singh, S. J., & Taylor, R. S. (2019). Exercise-based cardiac rehabilitation for adults with heart failure. The Cochrane database of systematic reviews, 1(1), CD003331. https://doi.org/10.1002/14651858.CD003331.pub5
Ovcharenko, L. K., Tsіganenko, I. V. & Zaіats Yu. B. (2022). Khronichna sertseva nedostatnist: prychyna chy naslidok? [Chronic heart failure: cause or result?]. Aktualni problemy suchasnoi medytsyny, 22(1), 196-202 [in Ukrainian]. https://doi.org/10.31718/2077-1096.22.1.196
McDonagh, T. A., Metra, M., Adamo, M., Gardner, R. S., Baumbach, A., Böhm, M., Burri, H., Butler, J., Čelutkienė, J., Chioncel, O., Cleland, J. G. F., Coats, A. J. S., Crespo-Leiro, M. G., Farmakis, D., Gilard, M., Heymans, S., Hoes, A. W., Jaarsma, T., Jankowska, E. A., Lainscak, M., … ESC Scientific Document Group (2021). 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. European heart journal, 42(36), 3599-3726. https://doi.org/10.1093/eurheartj/ehab368
Cheng, Y. J., Chen, Z. G., Yao, F. J., Liu, L. J., Zhang, M., & Wu, S. H. (2022). Airflow obstruction, impaired lung function and risk of sudden cardiac death: a prospective cohort study. Thorax, 77(7), 652-662. http://dx.doi.org/10.1136/thoraxjnl-2021-218296
Rosenkranz, S., Howard, L. S., Gomberg-Maitland, M., & Hoeper, M. M. (2020). Systemic Consequences of Pulmonary Hypertension and Right-Sided Heart Failure. Circulation, 141(8), 678-693. https://doi.org/10.1161/CIRCULATIONAHA.116.022362
Labaki, W. W., Xia, M., Murray, S., Curtis, J. L., Barr, R. G., Bhatt, S. P., Bleecker, E. R., Hansel, N. N., Cooper, C. B., Dransfield, M. T., Wells, J. M., Hoffman, E. A., Kanner, R. E., Paine, R., 3rd, Ortega, V. E., Peters, S. P., Krishnan, J. A., Bowler, R. P., Couper, D. J., Woodruff, P. G., … Han, M. K. (2018). NT-proBNP in stable COPD and future exacerbation risk: Analysis of the SPIROMICS cohort. Respiratory medicine, 140, 87-93. https://doi.org/10.1016/j.rmed.2018.06.005
Ibrahim, N. E., & Januzzi, J. L., Jr (2018). Established and Emerging Roles of Biomarkers in Heart Failure. Circulation research, 123(5), 614-629. https://doi.org/10.1161/CIRCRESAHA.118.312706
Ponikowski, P., Voors, A. A., Anker, S. D., Bueno, H., Cleland, J. G. F., Coats, A. J. S., Falk, V., González-Juanatey, J. R., Harjola, V. P., Jankowska, E. A., Jessup, M., Linde, C., Nihoyannopoulos, P., Parissis, J. T., Pieske, B., Riley, J. P., Rosano, G. M. C., Ruilope, L. M., Ruschitzka, F., Rutten, F. H., … ESC Scientific Document Group (2016). 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. European heart journal, 37(27), 2129-2200. https://doi.org/10.1093/eurheartj/ehw128
Bodrug, N. & Luca, E. (2022). Natriuretic peptides in elderly patients with chronic obstructive pulmonary disease. The Egyptian Journal of Bronchology, 16(1), 1-7. https://doi.org/10.1186/s43168-022-00132-y
Lugnier, C., Meyer, A., Charloux, A., Andrès, E., Gény, B., & Talha, S. (2019). The endocrine function of the heart: physiology and involvements of natriuretic peptides and cyclic nucleotide phosphodiesterases in heart failure. Journal of clinical medicine, 8(10), 1746. https://doi.org/10.3390/jcm8101746
Pellicori, P., Cleland, J. G., & Clark, A. L. (2022). Chronic obstructive pulmonary disease and heart failure: a breathless conspiracy. Cardiology Clinics, 40(2), 171-182. https://doi.org/10.1016/j.ccl.2021.12.005
Prickett, T. C., & Espiner, E. A. (2020). Circulating products of C-type natriuretic peptide and links with organ function in health and disease. Peptides, 132, 170363. https://doi.org/10.1016/j.peptides.2020.170363
Akpinar, E., Ateş, C., Akpinar, S., & Hoşgün, D. (2020). Impairment in heart functions and prognostic role of N-terminal pro-brain natriuretic peptide in patients with chronic obstructive pulmonary disease exacerbation. Eurasian Journal of Pulmonology, 22(1), 48. https://doi.org/10.4103/ejop.ejop_30_19
Travers, J. G., Tharp, C. A., Rubino, M., & McKinsey, T. A. (2022). Therapeutic targets for cardiac fibrosis: From old school to next-gen. Journal of Clinical Investigation, 132(5), e148554. https://doi.org/10.1172/JCI148554
Michels da Silva, D., Langer, H., & Graf, T. (2019). Inflammatory and molecular pathways in heart failure - ischemia, HFpEF and transthyretin cardiac amyloidosis. International journal of molecular sciences, 20(9), 2322. https://doi.org/10.1097/fjc.0000000000000007
Colliva, A., Braga, L., Giacca, M., & Zacchigna, S. (2020). Endothelial cell-cardiomyocyte crosstalk in heart development and disease. The Journal of physiology, 598(14), 2923-2939. https://doi.org/10.1113/JP276758
Burke, R. M., Lighthouse, J. K., Mickelsen, D. M., & Small, E. M. (2019). Sacubitril/valsartan decreases cardiac fibrosis in left ventricle pressure overload by restoring PKG signaling in cardiac fibroblasts. Circulation: Heart Failure, 12(4), e005565. http://doi.org/10.1161/CIRCHEARTFAILURE.118.005565
Wilck, N., Markó, L., Balogh, A., Kräker, K., Herse, F., Bartolomaeus, H., Szijártó, I. A., Gollasch, M., Reichhart, N., Strauss, O., Heuser, A., Brockschnieder, D., Kretschmer, A., Lesche, R., Sohler, F., Stasch, J. P., Sandner, P., Luft, F. C., Müller, D. N., Dechend, R., … Haase, N. (2018). Nitric oxide-sensitive guanylyl cyclase stimulation improves experimental heart failure with preserved ejection fraction. JCI insight, 3(4), e96006. https://doi.org/10.1172/jci.insight.96006
Goetze, J. P., Bruneau, B. G., Ramos, H. R., Ogawa, T., de Bold, M. K., & de Bold, A. J. (2020). Cardiac natriuretic peptides. Nature Reviews Cardiology, 17(11), 698-717. https://doi.org/10.1038/s41569-020-0381-0
Cao, Z., Jia, Y., & Zhu, B. (2019). BNP and NT-proBNP as diagnostic biomarkers for cardiac dysfunction in both clinical and forensic medicine. International journal of molecular sciences, 20(8), 1820. https://doi.org/10.3390/ijms20081820
Heinzel, F. R., Hegemann, N., Hohendanner, F., Primessnig, U., Grune, J., Blaschke, F., de Boer, R. A., Pieske, B., Schiattarella, G. G., & Kuebler, W. M. (2020). Left ventricular dysfunction in heart failure with preserved ejection fraction-molecular mechanisms and impact on right ventricular function. Cardiovascular diagnosis and therapy, 10(5), 1541-1560. https://doi.org/10.21037/cdt-20-477
Oh, A., Okazaki, R., Sam, F., & Valero-Muñoz, M. (2019). Heart failure with preserved ejection fraction and adipose tissue: a story of two tales. Frontiers in Cardiovascular Medicine, 6, 110. https://doi.org/10.3389/fcvm.2019.00110
Domondon, M., Nikiforova, A. B., DeLeon-Pennell, K. Y., & Ilatovskaya, D. V. (2019). Regulation of mitochondria function by natriuretic peptides. American Journal of Physiology-Renal Physiology, 317(5), F1164-F1168. https://doi.org/10.1152/ajprenal.00384.2019
Nielsen, P. M., Grimm, D., Wehland, M., Simonsen, U., & Krüger, M. (2018). The combination of Valsartan and Sacubitril in the treatment of hypertension and heart failure - an update. Basic & clinical pharmacology & toxicology, 122(1), 9-18. https://doi.org/10.1111/bcpt.12912
Ashcheulova, T. V., Kompaniiets, K. M., & Herasymchuk, N. M. (2019). Supramolecular complex sacubitril/valsartan - the first representative of a new class of drugs for the treatment of chronic heart failure. Pathologia, 16(3), 408-416. https://doi.org/10.14739/2310-1237.2019.3.188964
Dargad, R. R., Prajapati, M. R., Dargad, R. R., & Parekh, J. D. (2018). Sacubitril/valsartan: A novel angiotensin receptor-neprilysin inhibitor. Indian heart journal, 70 Suppl 1(Suppl 1), S102-S110. https://doi.org/10.1016/j.ihj.2018.01.002
Voronkov, L. H., Berezin, O. Ye., Zharinova, V. Yu., Zhebel, V. M., Koval, O. A., Rudyk, Yu. S., Parkhomenko, O. M., & Tseluiko, V. I. (2019). Biolohichni markery ta yikh zastosuvannia pry sertsevii nedostatnosti. Konsensus Vseukrainskoi asotsiatsii kardiolohiv Ukrainy, Vseukrainskoi asotsiatsii fakhivtsiv iz sertsevoi nedostatnosti ta Ukrainskoi asotsiatsii fakhivtsiv z nevidkladnoi kardiolohii [Biological markers and their use in heart failure. Consensus of the All-Ukrainian Association of Cardiologists of Ukraine, the All-Ukrainian Association of Heart Failure Specialists and the Ukrainian Association of Emergency Cardiology Specialists]. Ukrainskyi kardiolohichnyi zhurnal, 26(2), 11-22. [in Ukrainian]. http://doi.org/10.31928/1608-635X-2019.2.1122
Dalzell, J. R., Seed, A., Berry, C., Whelan, C. J., Petrie, M. C., Padmanabhan, N., Clarke, A., Biggerstaff, F., Hillier, C., & McMurray, J. J. (2014). Effects of neutral endopeptidase (neprilysin) inhibition on the response to other vasoactive peptides in small human resistance arteries: studies with thiorphan and omapatrilat. Cardiovascular therapeutics, 32(1), 13-18. https://doi.org/10.1111/1755-5922.12053
Karoor, V., Oka, M., Walchak, S. J., Hersh, L. B., Miller, Y. E., & Dempsey, E. C. (2013). Neprilysin regulates pulmonary artery smooth muscle cell phenotype through a platelet-derived growth factor receptor-dependent mechanism. Hypertension, 61(4), 921-930. https://doi.org/10.1161/HYPERTENSIONAHA.111.199588
Cunningham, J. W., Claggett, B. L., O'Meara, E., Prescott, M. F., Pfeffer, M. A., Shah, S. J., Redfield, M. M., Zannad, F., Chiang, L. M., Rizkala, A. R., Shi, V. C., Lefkowitz, M. P., Rouleau, J., McMurray, J. J. V., Solomon, S. D., & Zile, M. R. (2020). Effect of Sacubitril/Valsartan on Biomarkers of Extracellular Matrix Regulation in Patients With HFpEF. Journal of the American College of Cardiology, 76(5), 503-514. https://doi.org/10.1016/j.jacc.2020.05.072
Zhang, H., Liu, G., Zhou, W., Zhang, W., Wang, K., & Zhang, J. (2019). Neprilysin inhibitor-angiotensin II receptor blocker combination therapy (sacubitril/valsartan) suppresses atherosclerotic plaque formation and inhibits inflammation in apolipoprotein E-deficient Mice. Scientific reports, 9(1), 1-7. https://doi.org/10.1038/s41598-019-42994-1
Pulmonary Artery Pressure Reduction With ENTresto (Sacubitril/Valsartan) (PARENT) (2020). ClinicalTrials.gov Identifier: NCT02788656 https://clinicaltrials.gov/ct2/show/record/NCT02788656
Iborra-Egea, O., Gálvez-Montón, C., Roura, S., Perea-Gil, I., Prat-Vidal, C., Soler-Botija, C., & Bayes-Genis, A. (2017). Mechanisms of action of sacubitril/valsartan on cardiac remodeling: a systems biology approach. NPJ systems biology and applications, 3(1), 1-9. https://doi.org/10.1038/s41540-017-0013-4
Desai, A. S. (2021, July 20). Sacubitril/valsartan lowers pulmonary artery pressures at 30 days in HFrEF. Healio. https://www.healio.com/news/cardiology/20210720/sacubitrilvalsartan-lowers-pulmonary-artery-pressures-at-30-days-in-hfref
Desai, A. S. (2020). Effects of ARNI treatment on arterial hemodynamics, cardiac remodelling and pulmonary artery pressure in HFrEF. Physicians' Academy for Cardiovascular Education. https://pace-cme.org/2020/01/14/effects-of-arni-treatment-on-arterial-hemodynamics-cardiac-remodelling-and-pulmonary-artery-pressure-in-hfref/
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).
