{"doi":"10.1016/j.jchf.2020.09.013","title":"Atrial Natriuretic Peptide and Treatment With Sacubitril/Valsartan in Heart Failure With Reduced Ejection Fraction","abstract":"OBJECTIVES: This study sought to assess associations between longitudinal change in atrial natriuretic peptide (ANP) and reverse cardiac remodeling following initiation of sacubitril/valsartan in patients with heart failure with reduced ejection fraction (HFrEF). BACKGROUND: Neprilysin inhibition results in an increase of several vasoactive peptides that may mediate the beneficial effects of sacubitril/valsartan, including ANP. METHODS: In a prospective study of initiation and titration of sacubitril/valsartan in patients with HFrEF, blood was collected at scheduled time points into tubes containing protease inhibitors. This pre-specified exploratory analysis included patients in whom ANP was measured at baseline and serially through 12 months of treatment. RESULTS: Among 144 participants (mean age: 64.5 years; left ventricular ejection fraction: 30.8%), following initiation of sacubitril/valsartan, there was an early and significant increase in ANP, with the majority of rise from 99 pg/ml at baseline to 156 pg/ml at day 14 (p < 0.001). There was a further trend toward a second increase from day 30 to day 45 (p = 0.07). At maximal rise, ANP had doubled. In longitudinal analyses, early rise in ANP was followed by a subsequent increase in urinary cycle guanosine monophosphate. Larger early increase in ANP was associated with larger later improvements in left ventricular ejection fraction and left atrial volume index (p < 0.001 for both). CONCLUSIONS: Concentrations of ANP doubled after initiation of sacubitril/valsartan in patients with HFrEF. Larger early increases in ANP were associated with a greater magnitude of subsequent reverse cardiac remodeling. (Effects of Sacubitril/Valsartan Therapy on Biomarkers, Myocardial Remodeling and Outcomes [PROVE-HF]; NCT02887183).","journal":"JACC Heart Failure","year":2020,"id":55993,"datarank":2.4384941181591273,"base_score":4.499809670330265,"endowment":4.499809670330265,"self_citation_contribution":0.6749714505495399,"citation_network_contribution":1.7635226676095874,"self_endowment_contribution":0.6749714505495399,"citer_contribution":1.7635226676095874,"corpus_percentile":null,"corpus_rank":null,"citation_count":89,"citer_count":66,"citers_with_citation_signal":46,"citers_with_endowment":46,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9561,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT02887183"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":273235,"name":"Margaret F. Prescott","orcid":null,"position":1,"is_corresponding":false},{"id":290754,"name":"Alexander Camacho","orcid":"0000-0002-8832-5744","position":2,"is_corresponding":false},{"id":293266,"name":"Seethalakshmi Iyer","orcid":null,"position":3,"is_corresponding":false},{"id":290755,"name":"Alan S. Maisel","orcid":"0000-0001-7467-0195","position":4,"is_corresponding":false},{"id":262064,"name":"G. Michael Felker","orcid":"0000-0002-5931-1239","position":5,"is_corresponding":false},{"id":49613,"name":"Javed Butler","orcid":"0000-0001-7683-4720","position":6,"is_corresponding":false},{"id":290756,"name":"Ileana L. Piña","orcid":"0000-0002-4986-7129","position":7,"is_corresponding":false},{"id":290757,"name":"Nasrien E. Ibrahim","orcid":"0000-0003-3376-5336","position":8,"is_corresponding":false},{"id":293267,"name":"Cheryl Abbas","orcid":null,"position":9,"is_corresponding":false},{"id":290758,"name":"John C. Burnett","orcid":"0000-0002-3414-1659","position":10,"is_corresponding":false},{"id":27970,"name":"Scott D. Solomon","orcid":"0000-0003-3698-9597","position":11,"is_corresponding":false},{"id":97061,"name":"James L. Januzzi","orcid":"0000-0002-8338-1798","position":12,"is_corresponding":false},{"id":232172,"name":"Sean Murphy","orcid":"0000-0002-5928-5974","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-18T21:05:49.581291Z","pmid":"33189632","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}