Use of sacubitril-valsartan in blood pressure control with left ventricular assist devices

Dobarro, David; Díez‐López, Carles; Couto‐Mallón, David; Castrodeza, Javier; Gómez‐Bueno, Manuel; Tobar, Javier; McKenzie, S.; Goncalves, A; Melendo-Viu, María; Ortíz, Carlos; González‐Costello, José

doi:10.1016/j.healun.2020.08.017

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…Similarly, Dobarro et al . [36] demonstrated effective BP reduction, LVEDD reduction and improvement in NYHA functional class with ARNI use in 22 patients after LVAD implantation [36]. In our experience, ARNI use is a well tolerated and effective therapy for BP control especially among CF-LVAD patients in whom optimal BP is not achieved despite the use of two to three antihypertensive.…”

Section: Pharmacological Therapy For Blood Pressure Control In Left V...mentioning

confidence: 76%

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Management of hypertension in patients supported with continuous flow left ventricular assist devices

Krishnarao

Krim

2023

Current Opinion in Cardiology

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Purpose of reviewHypertension remains one of the most common clinical problems leading to devastating postleft ventricular assist device (LVAD) implant complications. This study reviews the pathophysiology of hypertension in the setting of continuous flow LVAD support and provides an update on currently available antihypertensive therapies for LVAD patients.Recent findingsThe true prevalence of hypertension in the LVAD population remains unknown. Effective blood pressure (BP) control and standardization of BP measurement are key to prevent suboptimal left ventricular unloading, pump malfunction and worsening aortic regurgitation. Angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), beta blockers and mineralocorticoid receptor antagonists (MRA) are the preferred antihypertensive agents because of their additional potential benefits, including optimization of haemodynamics, prevention of stroke, gastrointestinal bleed and in some patients myocardial recovery. Angiotensin receptor-neprilysin inhibition (ARNI) may be a well tolerated and effective therapy for BP control especially among CF-LVAD patients with resistant hypertension. Similarly, sodium glucose co-transporter 2 inhibitors (SGLT2i) should be considered in the absence of contraindications.SummaryHypertension is very common post-LVAD implant. Heart failure guideline directed medical therapies, including ACEI, ARB, beta blockers and MRA, are the preferred antihypertensive agents to improve post-LVAD outcomes.

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Section: Pharmacological Therapy For Blood Pressure Control In Left V...mentioning

confidence: 76%

“…More contemporary studies have evaluated the use of ARNI in the setting of CF-LVAD [34,35 ▪ ,36]. Schnettler et al .…”

Section: Pharmacological Therapy For Blood Pressure Control In Left V...mentioning

confidence: 99%

Management of hypertension in patients supported with continuous flow left ventricular assist devices

Krishnarao

Krim

2023

Current Opinion in Cardiology

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“…MRAs (spironolactone) should be used for their potassium-sparing and antifibrotic effects [142]. Hydralazine and perhaps ARNI [151][152][153] are other options of BP-lowering drugs that can be considered in CF-LVAD recipients with hypertension. Evidence indicates that BP control can be achieved in patients with CF-LVADs, with the majority of patients requiring only 1 or 2 antihypertensives [154].…”

Section: Blood Pressure Regulationmentioning

confidence: 99%

Contemporary Drug Treatment of Advanced Heart Failure with Reduced Ejection Fraction

Vishram-Nielsen

Tomasoni

Gustafsson

et al. 2022

Drugs

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The introduction of multiple new pharmacological agents over the past three decades in the field of heart failure with reduced ejection fraction (HFrEF) has led to reduced rates of mortality and hospitalizations, and consequently the prevalence of HFrEF has increased, and up to 10% of patients progress to more advanced stages, characterized by high rates of mortality, hospitalizations, and poor quality of life. Advanced HFrEF patients often show persistent or progressive signs of severe HF symptoms corresponding to New York Heart Association class III or IV despite being on optimal medical, surgical, and device therapies. However, a subpopulation of patients with advanced HF, those with the most advanced stages of disease, were often insufficiently represented in the major trials demonstrating efficacy and tolerability of the drugs used in HFrEF due to exclusion criteria such as low BP and kidney dysfunction. Consequently, the results of many landmark trials cannot necessarily be transferred to patients with the most advanced stages of HFrEF. Thus, the efficacy and tolerability of guidelinedirected medical therapies in patients with the most advanced stages of HFrEF often remain unsettled, and this knowledge is of crucial importance in the planning and timing of consideration for referral for advanced therapies. This review discusses the evidence regarding the use of contemporary drugs in the advanced HFrEF population, covering components such as guideline HFrEF drugs, diuretics, inotropes, and the use of HFrEF drugs in LVAD recipients, and provides suggestions on how to manage guideline-directed therapy in this patient group.

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Sacubitril/valsartan

2021

Reactions Weekly

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Use of sacubitril-valsartan in blood pressure control with left ventricular assist devices

Cited by 7 publications

References 5 publications

Management of hypertension in patients supported with continuous flow left ventricular assist devices

Management of hypertension in patients supported with continuous flow left ventricular assist devices

Contemporary Drug Treatment of Advanced Heart Failure with Reduced Ejection Fraction

Sacubitril/valsartan

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