Review Articles

Neprilysin Inhibition and the Treatment of Heart Failure

Recent Steps in the Right Direction

Bartell, Nicholas MD^*; Frishman, William H. MD^†

From the ^*Departments of Medicine, University of Rochester/Strong Memorial Hospital, Rochester, NY; and ^†New York Medical College/Westchester Medical Center, Valhalla, NY.

Disclosure: The authors have no conflicts of interest to report.

Correspondence: William H. Frishman, MD, Department of Medicine, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595. E-mail: [email protected].

Cardiology in Review 25(6):p 315-320, November/December 2017. | DOI: 10.1097/CRD.0000000000000169

Abstract

Numerous investigators have attempted to target the natriuretic peptide system in the treatment of heart failure since it was first described over 30 years ago. The history of neprilysin inhibition as a treatment for heart failure has been characterized by numerous setbacks. Recently, the PARADIGM-HF trial has shown favorable results, which may bring neprilysin inhibition into the mainstream of clinical practice. This article will review the history of the natriuretic peptide system and the investigations into it as a target for heart failure treatment, culminating in the positive results of the PARADIGM-HF trial, as well as planned and potential future directions for research.