心臟衰竭是許多心臟疾病的最終表現，目前雖然已有許多藥物來進行治療與控制， 然死亡率仍位居高位。新一代藥品valsartan-sacubitril (LCZ696, Entresto) 為血管收縮素受體併腦啡肽脢抑制劑 (Angiotensin II-Receptor Neprilysin Inhibitor,ARNI)， 具有抑制腎素— 血管收縮素— 醛固酮系統 (Angiotensin II-Receptor Neprilysin Inhibitor, RAAS) 及增強利鈉尿胜肽系統 (natriuretic peptide system, NPS)的雙效作用，可增加血液中利鈉尿胜肽的濃度並拮抗血管收縮素的作用，來改善心衰竭的症狀；臨床試驗PARADIGM-HF 中相較於enalapril，能有效降低死亡率及因心衰竭症狀導致住院的發病率，除低血壓的發生情形較高外，其他副作用皆與enalapril相差不多或有更低的發生率。期待臨床上使用此類藥物後，能使心衰竭病患獲得更好的治療效果。
 

Heart failure is the ultimate expression of many heart diseases, although currently there are many drugs can treat and control heart failure symptoms, but mortality remains high. Valsartan-sacubitril (LCZ696, Entresto) is first-in-class dual angiotensin receptor and neprilysin inhibitors, it can simultaneously inhibit the renin-angiotensin-aldosterone system (RAAS) and natriuretic peptide system (NPS), result in increasing the blood concentration of natriuretic peptides and antagonism of angiotensin II, then improve heart failure symptoms. PARADIGM-HF comparing the long-term efficacy and safety of LCZ696 with enalapril in the patients with chronic heart failure with reduced ejection fraction. The results display significant reduction of mortality and hospitalization for heart failure with acceptable safety profile, except higher rate of symptomatic hypotension, more safe or similar rate than enalapril. We are looking forward to the clinical use of such drug, make heart failure patients get better treatment.