HFSA: Neprilysin Post-MI Fails to Reverse LV Remodeling

Sample size and study duration may be a factor in null outcome

Neprilysin inhibitors have vasodilatory, anti-hypertrophy, anti-fibrotic, and sympatholytic effects, all of which suggest that they could slow or prevent the left ventricular remodeling that may occur following myocardial infarction — remodeling that leads to heart failure.

That was the hypothesis that British Heart Fund researchers tested in a randomized trial comparing sacubitril/valsartan to valsartan alone in patients at high risk for heart failure following MI.

But Kieran Docherty, MD, of the British Heart Fund Research Centre at the University of Glasgow and Queen Elizabeth University Hospital in Glasgow, and colleagues found that “patients with asymptomatic left ventricular systolic dysfunction (and low NT-proBNP levels) following MI did not achieve a significant reverse remodeling effect with sacubitril/valsartan compared to valsartan.”

Docherty said he and his colleagues enrolled patients who were at least 3 months post-MI, had an LVEF of 40%

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What is a reverse mortgage, and how does it work?

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A reverse mortgage is a type of home loan for people age 62 or older. It’s for people who have gained equity in their home since originally buying it, and likely have paid off their mortgage already.

A forward mortgage — which you probably think of as a regular mortgage — is a type of loan you’d use to buy a home. You make monthly payments to the lender until the home is paid off, and over time, your debt decreases.

A reverse mortgage, on the other hand, is used after you’ve already bought the home. The lender pays you, and the money comes out of the equity you’ve

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Reverse mortgages may be helpful in retirement but mind the pitfalls

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If you’re thinking about a reverse mortgage, be prepared to learn a lot about a complicated financial commitment. 

With a reverse mortgage, you can convert part of the equity in your home into cash instead of selling, provided you’re at least 62 years old. As long as you continue paying taxes and maintaining the home, you cannot be evicted.

It may sound like the answer to your retirement cash prayers, but complexity and costs are among the factors to consider.

Here’s how it works. Instead of a debt that gets lower as you make payments to the bank for a regular mortgage, a reverse mortgage is the exact opposite.

You draw out funds and interest builds up, while the balance grows larger and you hold less equity in your home. 

Keep in mind, you must use the funds to first pay off any existing

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