{"title":"血管紧张素受体-奈普利素抑制剂在接受冠状动脉旁路移植术的心力衰竭伴射血分数降低患者围手术期的应用","authors":"Manoj Durairaj, Kaushal Pandey, Rajneesh Malhotra, Ritwik Raj Bhuyan, Vijyant Devenraj, Arunkumar Ulaganathan, Abhay Singh Walia, Mohd Azam Haseen, Debasish Sahu, Madhav Kumar, Sangram Keshari Behera, Atul Kumar Gupta, Sanjay Kumar, Chandan Ray Mohapatra, Sanjay Jain, Ambrish Khatod, Tushar Kumar, Neeraj Kumar Sharma, Amrutraj Nerlikar, Soumya Ranjan Mahapatra, Lingraj Nath","doi":"10.1007/s12055-024-01890-8","DOIUrl":null,"url":null,"abstract":"<p><p>Heart failure with reduced ejection fraction (HFrEF) is frequently observed in patients undergoing coronary artery bypass grafting (CABG), and it significantly increases the risk of postoperative death while exerting a crucial influence on the recovery process following the surgical intervention. HFrEF is one of the prevalent risk factors for early readmission in patients who underwent CABG. Angiotensin receptor-neprilysin inhibitor (ARNI) has been recognized as a critical medical therapy in the management of HFrEF; however, its efficacy and safety have yet to be corroborated in the context of CABG. Therefore, this opinion document developed by a group of cardiothoracic and vascular surgeons in India focuses on the utilization of ARNI for patients with HFrEF, including those undergoing or having undergone CABG. These opinions based on clinical experience include perioperative use of ARNI; postoperative initiation of ARNI; strategies for addressing challenges such as hyperkalemia, hypotension, and renal dysfunction; and initiation of other foundational medical therapies in HFrEF management in the context of CABG.</p>","PeriodicalId":13285,"journal":{"name":"Indian Journal of Thoracic and Cardiovascular Surgery","volume":"41 3","pages":"308-313"},"PeriodicalIF":0.6000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832846/pdf/","citationCount":"0","resultStr":"{\"title\":\"Perioperative utilization of angiotensin receptor-neprilysin inhibitor in patients with heart failure with reduced ejection fraction undergoing coronary artery bypass grafting-a narrative review.\",\"authors\":\"Manoj Durairaj, Kaushal Pandey, Rajneesh Malhotra, Ritwik Raj Bhuyan, Vijyant Devenraj, Arunkumar Ulaganathan, Abhay Singh Walia, Mohd Azam Haseen, Debasish Sahu, Madhav Kumar, Sangram Keshari Behera, Atul Kumar Gupta, Sanjay Kumar, Chandan Ray Mohapatra, Sanjay Jain, Ambrish Khatod, Tushar Kumar, Neeraj Kumar Sharma, Amrutraj Nerlikar, Soumya Ranjan Mahapatra, Lingraj Nath\",\"doi\":\"10.1007/s12055-024-01890-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Heart failure with reduced ejection fraction (HFrEF) is frequently observed in patients undergoing coronary artery bypass grafting (CABG), and it significantly increases the risk of postoperative death while exerting a crucial influence on the recovery process following the surgical intervention. HFrEF is one of the prevalent risk factors for early readmission in patients who underwent CABG. Angiotensin receptor-neprilysin inhibitor (ARNI) has been recognized as a critical medical therapy in the management of HFrEF; however, its efficacy and safety have yet to be corroborated in the context of CABG. Therefore, this opinion document developed by a group of cardiothoracic and vascular surgeons in India focuses on the utilization of ARNI for patients with HFrEF, including those undergoing or having undergone CABG. These opinions based on clinical experience include perioperative use of ARNI; postoperative initiation of ARNI; strategies for addressing challenges such as hyperkalemia, hypotension, and renal dysfunction; and initiation of other foundational medical therapies in HFrEF management in the context of CABG.</p>\",\"PeriodicalId\":13285,\"journal\":{\"name\":\"Indian Journal of Thoracic and Cardiovascular Surgery\",\"volume\":\"41 3\",\"pages\":\"308-313\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832846/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Thoracic and Cardiovascular Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12055-024-01890-8\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/30 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Thoracic and Cardiovascular Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12055-024-01890-8","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/30 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Perioperative utilization of angiotensin receptor-neprilysin inhibitor in patients with heart failure with reduced ejection fraction undergoing coronary artery bypass grafting-a narrative review.
Heart failure with reduced ejection fraction (HFrEF) is frequently observed in patients undergoing coronary artery bypass grafting (CABG), and it significantly increases the risk of postoperative death while exerting a crucial influence on the recovery process following the surgical intervention. HFrEF is one of the prevalent risk factors for early readmission in patients who underwent CABG. Angiotensin receptor-neprilysin inhibitor (ARNI) has been recognized as a critical medical therapy in the management of HFrEF; however, its efficacy and safety have yet to be corroborated in the context of CABG. Therefore, this opinion document developed by a group of cardiothoracic and vascular surgeons in India focuses on the utilization of ARNI for patients with HFrEF, including those undergoing or having undergone CABG. These opinions based on clinical experience include perioperative use of ARNI; postoperative initiation of ARNI; strategies for addressing challenges such as hyperkalemia, hypotension, and renal dysfunction; and initiation of other foundational medical therapies in HFrEF management in the context of CABG.
期刊介绍：
The primary aim of the Indian Journal of Thoracic and Cardiovascular Surgery is education. The journal aims to dissipate current clinical practices and developments in the area of cardiovascular and thoracic surgery. This includes information on cardiovascular epidemiology, aetiopathogenesis, clinical manifestation etc. The journal accepts manuscripts from cardiovascular anaesthesia, cardiothoracic and vascular nursing and technology development and new/innovative products.The journal is the official publication of the Indian Association of Cardiovascular and Thoracic Surgeons which has a membership of over 1000 at present.DescriptionThe journal is the official organ of the Indian Association of Cardiovascular-Thoracic Surgeons. It was started in 1982 by Dr. Solomon Victor and ws being published twice a year up to 1996. From 2000 the editorial office moved to Delhi. From 2001 the journal was extended to quarterly and subsequently four issues annually have been printed out at time and regularly without fail. The journal receives manuscripts from members and non-members and cardiovascular surgeons. The manuscripts are peer reviewed by at least two or sometimes three or four reviewers who are on the panel. The manuscript process is now completely online. Funding the journal comes partially from the organization and from revenue generated by subscription and advertisement.
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