Which medications in the drug class Angiotensin Receptor-Neprilysin Inhibitors (ARNi) are used in the treatment of Dilated Cardiomyopathy?

Updated: Mar 02, 2021
  • Author: Vinh Q Nguyen, MD, FACC; Chief Editor: Gyanendra K Sharma, MD, FACC, FASE  more...
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Angiotensin Receptor-Neprilysin Inhibitors (ARNi)

Neprilysin is responsible for degradation of atrial and brain natriuretic peptide. Inhibition of neprilysin results in increased natriuresis, increased urine cGMP, and decreased plasma MR-proANP and NT-proBNP. Angiotensin II receptor type I inhibition reduces blood pressure and blocks the vasoconstrictor and aldosterone-secreting effects of angiotensin II.

Sacubitril/valsartan (Entresto)

Sacubitril/valsartan may be considered in place of ACE inhibitors for patients who remain symptomatic on optimal heart failure therapy. It is indicated to reduce the risk of cardiovascular death and hospitalization in chronic heart failure (CHF). Benefits are most clearly evident in adults with LVEF below normal.  

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