Which medication is an example of an ARNI used in heart failure management?

Which medication is an example of an ARNI used in heart failure management?

• A. Sacubitril/valsartan (an ARNI)
• B. Lisinopril (an ACE inhibitor)
• C. Amlodipine (a calcium channel blocker)
• D. Hydralazine (a vasodilator)

Answer: (A)

An ARNI combines neprilysin inhibition with angiotensin receptor blockade to treat heart failure. Sacubitril/valsartan does this by blocking the angiotensin II receptor (valsartan) and preventing the breakdown of natriuretic peptides (sacubitril). The buildup of natriuretic peptides promotes vasodilation, natriuresis, and anti-remodeling effects, while the receptor blockade reduces vasoconstriction and sodium retention. This dual action translates into meaningful clinical benefits, notably in heart failure with reduced ejection fraction, where it lowers cardiovascular death and heart failure hospitalizations compared with an ACE inhibitor. Other medications listed are not ARNI. An ACE inhibitor reduces angiotensin II formation but does not inhibit neprilysin to boost natriuretic peptides. A calcium channel blocker mainly causes vasodilation by blocking calcium influx in vascular smooth muscle, not affecting neprilysin. A vasodilator like hydralazine lowers blood pressure through a different mechanism and does not combine neprilysin inhibition with angiotensin receptor blockade. Therefore, the ARNI in heart failure management is sacubitril/valsartan.

An ARNI combines neprilysin inhibition with angiotensin receptor blockade to treat heart failure. Sacubitril/valsartan does this by blocking the angiotensin II receptor (valsartan) and preventing the breakdown of natriuretic peptides (sacubitril). The buildup of natriuretic peptides promotes vasodilation, natriuresis, and anti-remodeling effects, while the receptor blockade reduces vasoconstriction and sodium retention. This dual action translates into meaningful clinical benefits, notably in heart failure with reduced ejection fraction, where it lowers cardiovascular death and heart failure hospitalizations compared with an ACE inhibitor.

Other medications listed are not ARNI. An ACE inhibitor reduces angiotensin II formation but does not inhibit neprilysin to boost natriuretic peptides. A calcium channel blocker mainly causes vasodilation by blocking calcium influx in vascular smooth muscle, not affecting neprilysin. A vasodilator like hydralazine lowers blood pressure through a different mechanism and does not combine neprilysin inhibition with angiotensin receptor blockade. Therefore, the ARNI in heart failure management is sacubitril/valsartan.