Reverse Cardiac Remodeling and ARNI Therapy
Cardiac remodeling is defined as a group of molecular, cellular, and interstitial changes that manifest clinically as changes in size, mass, geometry, and function of the heart after injury. The process results in a poor prognosis because of its association with ventricular dysfunction and malignant arrhythmias. Reverse remodeling has become a primary objective in HF treatment which is achieved with the help of guideline-directed medical and device therapies (GDMT). Combined angiotensin receptor/neprilysin inhibitor (ARNI) therapy has become a widely accepted component of GDMT. In this regard, Andrew Abboud and colleagues have published a review paper in the Current Heart Failure Reports under the title “Reverse Cardiac Remodeling and ARNI Therapy”. The summary of this review is given below:
Objective:
To review the effect of GDMT, specially ARNI therapy on cardiac remodeling.
Method:
The review was conducted from the currently available evidence and scientific and medical knowledge.
Findings:
Studies of ARNI therapy in HFrEF indicated a clear benefit in mortality and health status along with an impressive signal for early reverse cardiac remodeling with the use of sacubitril/valsartan. The treatment with sacubitril/valsartan has become a necessary component from GDMT for HF therapy.
Authors acknowledge future studies to understand the role of ARNI therapy in HFpEF.
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