Angiotensin receptor-neprilysin inhibitor attenuates cardiac hypertrophy and improves diastolic dysfunction in a mouse model of heart failure with preserved ejection fraction

Clin Exp Pharmacol Physiol. 2022 Aug;49(8):848-857. doi: 10.1111/1440-1681.13672. Epub 2022 Jun 14.

Abstract

LCZ696, an angiotensin receptor-neprilysin inhibitor, has shown promising clinical efficacy in patients with heart failure (HF) with reduced ejection fraction. However, its potential effects on heart failure with preserved ejection fraction (HFpEF) are still not fully understood. We evaluated the effect of LCZ696 on HFpEF in transverse aortic constriction mice and compared it with the effect of the angiotensin receptor blocker, valsartan. We found that LCZ696 improved cardiac diastolic function by reducing ventricular hypertrophy and fibrosis in mice with overload-induced diastolic dysfunction. In addition, there was superior inhibition of LCZ696 than stand-alone valsartan. As a potential underlying mechanism, we demonstrated that LCZ696 behaves as a potent suppressor of calcium-mediated calcineurin-nuclear factor of activated T cells (NFAT) signalling transduction pathways. Hence, we demonstrated the protective effects of LCZ696 in overload-induced HFpEF and provided a pharmaceutical therapeutic strategy for related diseases.

Keywords: HFpEF; LCZ696; NFAT; calcium; hypertrophy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aminobutyrates* / pharmacology
  • Aminobutyrates* / therapeutic use
  • Angiotensin Receptor Antagonists* / pharmacology
  • Animals
  • Biphenyl Compounds* / pharmacology
  • Biphenyl Compounds* / therapeutic use
  • Cardiomegaly* / drug therapy
  • Diastole / drug effects
  • Disease Models, Animal
  • Drug Combinations
  • Heart Failure* / drug therapy
  • Heart Failure* / physiopathology
  • Mice
  • Neprilysin* / antagonists & inhibitors
  • Receptors, Angiotensin / therapeutic use
  • Stroke Volume* / drug effects
  • Stroke Volume* / physiology
  • Tetrazoles / pharmacology
  • Tetrazoles / therapeutic use
  • Valsartan* / pharmacology
  • Valsartan* / therapeutic use
  • Ventricular Dysfunction / drug therapy
  • Ventricular Dysfunction / physiopathology

Substances

  • Aminobutyrates
  • Angiotensin Receptor Antagonists
  • Biphenyl Compounds
  • Drug Combinations
  • Receptors, Angiotensin
  • Tetrazoles
  • Valsartan
  • Neprilysin
  • sacubitril and valsartan sodium hydrate drug combination