ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiovascular Pharmacology and Drug Discovery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1550624
This article is part of the Research TopicNew Frontiers in Heart Failure Therapy: Mechanisms, Efficacy, and ChallengesView all 8 articles
Effects of Angiotensin Receptor-Neprilysin Inhibition on myocardial energy metabolism and prognosis in patients with acute myocardial infarction complicated with heart failure
Provisionally accepted
- 1Department of Geriatrics, No.903 Hospital of PLA Joint Logistics Support Force, Hangzhou, China
- 2Dalian medical university, Dalian, China
- 3Dalian, Dalian, China
- 4Affiliated Zhongshan Hospital of Dalian University, Dalian, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objective: To evaluate the effect of angiotensin receptor-neprilysin inhibitor(ARNI) on myocardial energy metabolism and prognosis in patients with acute myocardial infarction (AMI) complicated with Heart failure (HF). Methods: Retrospective analysis the data of 244 of in-patients admitted to this center, who were diagnosed with AMI complicated with HF, and 210 patients among them completed a 1year follow-up. According to the use of angiotensin converting enzyme inhibitors(ACEI)/angiotensin receptor blockers(ARB)/ARNI, the 210 patients were divided into ARNI group 107 cases (51.0%), and Non-ARNI(ACEI/ARB) group 103 cases (49.0%). The main outcome measures were the changes in myocardial energy expenditure (MEE) and prognostic indicators at 1-year of follow-up. Results: ARNI significantly reduced MEE after 1-year when compared with the ACEI/ARB [(129.61±40.81)kcal/min vs. (154.49±47.58)kcal/min, P<0.01].The level of MEE in group HFrEF was significantly higher than that in group HFmrEF(P<0.05). The rates of hospitalization for heart failure (23.0% vs. 43.4%,P=0.001), the rates recurrent myocardial infarction (9.8% vs. 22.1%,P=0.009) and renal function deterioration rates (5.7% vs. 13.1%,P=0.049) in ARNI group was significantly lower Non-ARNI group. In ROC analysis, MEE (kcal/min) cut-off value of 178 had 85% sensitivity and 64% specificity for prediction of cardiac death (AUC=0.74,P=0.007). During 1-year follow up, MEE over 178 kcal/min was associated with increased risk of all-cause death as compared to patients with MEE less 178 kcal/min. Conclusion: ARNI significantly reduced MEE compared ACEI/ARB. MEE is significantly associated with severity of left ventricular systolic function dysfunction and long-term prognosis that MEE was a powerful predictor of cardiac death and MEE over 178 kcal/min are linked with increased risk of 1-year all-cause mortality in patients with AMI complicated with HF.
Keywords: Acute myocardial infraction, Heart Failure, ARNI, MEE, Energy Metabolism
Received: 23 Dec 2024; Accepted: 08 Jul 2025.
Copyright: © 2025 Cheng, Nie, Chen, Yang, Liang and Yu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Qin Yu, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.