血管紧张素受体脑啡肽酶抑制剂治疗射血分数保留的心力衰竭的最新证据

心力衰竭作为心脏疾病的终末阶段，具有较高的患病率和死亡率。射血分数保留的心力衰竭（HFpEF）发病率约占所有心力衰竭的50%，但其临床诊断率低，合并症多，住院率逐年上升，已成为临床关注的重点。血管紧张素受体脑啡肽酶抑制剂（ARNI）在降低射血分数降低的心力衰竭（HFrEF）患者的住院率和死亡率方面效果显著，已被作为指南的Ⅰ类推荐药物广泛应用于临床，但其在HFpEF中的作用尚不明确。本文就ARNI在HFpEF中的作用机制及临床最新证据进行综述，阐述了ARNI在HFpEF患者中改善心、肾功能和逆转心室重构方面的优势，以期为HFpEF提供新的治疗思路。

Recent Evidence on Angiotensin Receptor-neprilsin Inhibitor in Heart Failure with Preserved Ejection Fraction

Heart failure is the end stage of most cardiac diseases with high morbidity and mortality. Heart failure with preserved ejection fraction（HFpEF），as a clinical focus，accounts for about 50% of all cases of heart failure，and is associated with increased incidence of hospitalization due to low rate of diagnosis and multiple comorbidities. Angiotensin receptor-neprilsin inhibitor（ARNI） has been proved to significantly decrease the rates of death and readmission，and is widely used as the recommended drugs of class Ⅰ in heart failure with reduced ejection fraction（HFrEF）. However，the mechanism of action of ARNI in HFpEF is still unclear. Thus we summarized the latest clinical evidence on its mechanism of action in HFpEF. This article reviews the mechanism of the effect of ARNI in HFpEF and the latest clinical evidence for it，expounds the advantages of ARNI in improving heart and kidney function and reversing ventricular remodeling in patients with HFpEF，in order to provide new treatment ideas for HFpEF.