Neprilysin and Natriuretic Peptide Regulation in Heart Failure

Antoni Bayes-Genis, Nuria Morant-Talamante, Josep Lupón

Research output: Contribution to journalReview articleResearchpeer-review

17 Citations (Scopus)


© 2016, Springer Science+Business Media New York. Neprilysin is acknowledged as a key player in neurohormonal regulation, a cornerstone of modern drug therapy in chronic heart failure. In the cardiovascular system, neprilysin cleaves numerous vasoactive peptides, some with mainly vasodilating effects (natriuretic peptides, adrenomedullin, bradykinin) and other with mainly vasoconstrictor effects (angiotensin I and II, endothelin-1). For decades, neprilysin has been an important biotarget. Academia and industry have combined active efforts to search for neprilysin inhibitors (NEPIs) that might be useful in clinical practice. NEPI monotherapy was initially tested with little success due to efficacy issues. Next, combination of NEPI and ACE-inhibiting activity agents were abandoned due to safety concerns. Recently, the combination of NEPI and ARB, also known as ARNI, has shown better than expected results in heart failure with reduced ejection fraction, and multitude of ongoing studies are set to prove its value across the heart failure spectrum.
Original languageEnglish
Pages (from-to)151-157
JournalCurrent Heart Failure Reports
Issue number4
Publication statusPublished - 1 Aug 2016


  • ARNI
  • Heart failure
  • Natriuretic peptides
  • Neprilysin


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