Related Experiment Video

Updated: Jul 30, 2025

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
07:24

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR

Published on: April 8, 2013

24.3K

Sacubitril/Valsartan Does Not Change the Use and Dose of Loop Diuretics in Patients With Heart Failure With Reduced

Kazuhiko Kido1, Christopher Bianco2, Marco Caccamo2

  • 1Department of Clinical Pharmacy, West Virginia University School of Pharmacy, Morgantown, WV, USA.

Journal of Pharmacy Practice
|May 16, 2023
PubMed

Insights

Initiating sacubitril/valsartan for heart failure did not significantly alter loop diuretic use or dosage over six months. This suggests pre-emptive reduction of loop diuretics may not be necessary when starting this medication.

Area of Science:

  • Cardiology
  • Pharmacology
  • Heart Failure Management

Background:

  • Lack of standardized guidelines for managing loop diuretics post-sacubitril/valsartan initiation.
  • Need to understand the impact of sacubitril/valsartan on diuretic therapy in heart failure patients.

Purpose of the Study:

  • To analyze longitudinal trends in loop diuretic use and dosage within six months of sacubitril/valsartan initiation.
  • To assess if sacubitril/valsartan influences the need for loop diuretics in heart failure with reduced ejection fraction.

Main Methods:

  • Retrospective cohort study of 427 adult heart failure patients with reduced ejection fraction (ejection fraction ≤40%).
  • Analysis of loop diuretic use and furosemide equivalent doses at baseline, 2 weeks, 1, 3, and 6 months post-sacubitril/valsartan initiation.

Main Results:

  • No significant longitudinal changes observed in loop diuretic prevalence or furosemide equivalent dose over the 6-month follow-up.
  • Sacubitril/valsartan use was not significantly associated with reductions in loop diuretic use or dose.

Conclusions:

  • Sacubitril/valsartan initiation did not significantly alter loop diuretic use or dosage within a 6-month period.
  • Pre-emptive reduction of loop diuretic doses may not be required upon initiating sacubitril/valsartan.

Keywords:
diureticheart failureloop diureticsacubitrilvalsartan

More Related Videos

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol07:59

Bedside Ultrasound for Guiding Fluid Removal in Patients with Pulmonary Edema: The Reverse-FALLS Protocol

Published on: July 28, 2018

11.2K
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

10.5K

Related Concept Videos

Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
433
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
473
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
16
Antihypertensive Drugs: Angiotensin II Receptor Blockers01:30

Antihypertensive Drugs: Angiotensin II Receptor Blockers

In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
793
Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

Antihypertensive Drugs: Potassium-Sparing Diuretics

Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
661
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
402