The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

ARNI Therapy in Heart Failure

The place of sacubitril/valsartan combination in HFrEF treatment.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is ARNI Therapy in Heart Failure?

Sacubitril/valsartan (ARNI) is a next-generation heart failure drug that combines angiotensin II receptor blockade with neprilysin inhibition. Neprilysin inhibition prevents the breakdown of natriuretic peptides, providing vasodilation, natriuresis and antifibrotic effects.

The PARADIGM-HF trial showed that ARNI therapy reduced cardiovascular death and heart failure hospitalizations by 20% compared to enalapril. It is indicated in symptomatic heart failure with EF <=40%.

Symptoms

Exertional dyspnea and orthopnea
Peripheral edema
Easy fatigue
Paroxysmal nocturnal dyspnea
Heart failure with EF <=40%

Risk Factors

Symptomatic HFrEF despite ACEi/ARB therapy
NYHA functional class II-IV
Tolerable systolic blood pressure (>100 mmHg)
Need for 36-hour washout between ACEi and ARNI

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Evaluation for transition from ACEi/ARB to ARNI in HFrEF treatment
  • If symptom control remains inadequate on optimal-dose ARNI
  • If hypotension or worsening kidney function develops

Treatment Methods

01
Sacubitril/valsartan starting dose: 24/26 mg or 49/51 mg twice daily
02
Target dose: 97/103 mg twice daily (when tolerated)
03
36-hour washout when switching from ACEi
04
Monitoring of blood pressure, potassium and creatinine
05
Combined with other neurohormonal therapies (beta-blocker, MRA, SGLT2i)
06
Four-pillar therapy (ARNI + beta-blocker + MRA + SGLT2i)

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kardiyoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Hypertension (High Blood Pressure)

Kardiyoloji

Hypertension is a condition in which blood pressure readings remain above 140/90 mmHg; early treatment helps prevent serious complications.

Coronary Artery Disease

Kardiyoloji

Narrowing of the coronary arteries due to atherosclerosis can cause chest pain (angina) and heart attack.

Heart Failure

Kardiyoloji

Heart failure is a chronic cardiac condition characterized by shortness of breath, leg swelling, and fatigue.

Heart Attack (Myocardial Infarction)

Kardiyoloji

A heart attack is a medical emergency; because heart muscle is lost by the minute, immediate intervention saves lives.

Atrial Fibrillation

Kardiyoloji

Atrial fibrillation is a common arrhythmia characterized by an irregular heartbeat and increased risk of stroke.

Heart Palpitations

Kardiyoloji

Palpitations are usually due to benign causes, but underlying cardiac rhythm disorders must be ruled out.

Heart Valve Diseases

Kardiyoloji

Valve stenosis or regurgitation increases the workload of the heart and, over time, can lead to heart failure.

Aortic Aneurysm

Kardiyoloji

Aortic aneurysms are often silent; early diagnosis allows treatment before rupture (a life-threatening tear).

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.