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oai:figshare.com:article/32640246 2026-10-01T16:32:55Z portal_1172 item_type_8 month_year_10_2026

Investigating the impact of sacubitril/valsartan on cardiac structure, function, and remodelling in the diabetic heart Narainrit Karuna (21369757) PUREID: 614670934 diabetes mellitus cardiomyopathy sacubitril/valsartan heart failure diabetic cardiomyopathy Diabetic cardiomyopathy (DbCM), a pre-heart failure (HF) stage, is recognised as a key intermediate stage and determinant for the future development of HF. To date, there are limited therapeutic options for DbCM. Sacubitril/valsartan, an angiotensin receptor neprilysin inhibitor (ARNI), may have therapeutic potential to improve diabetes-induced cardiac abnormalities. This thesis studied the progression pattern of DbCM and potential benefits of sacubitril/valsartan. Plasma neprilysin activity was positively correlated with worsening cardiac function and structure. Sacubitril/valsartan could offer potential therapeutic benefits for preventing DbCM progression by modulating inflammatory responses via modulating interferon regulatory factor 7 (Irf7), thereby improving pro-fibrotic signalling. Furthermore, elevated B cell receptor-associated protein 31 (BAP31) in diabetic patients with pre-HFpEF receiving sacubitril/valsartan may mitigate the pathogenesis of DbCM. In summary, this thesis provides a signature of progression of DbCM and reveals a key driver in DbCM development. Sacubitril/valsartan may serve as therapeutic options in the context of preventing DbCM progression.<br><br><i>Thesis is embargoed until 31st December 2029</i>.<br><br><br> 2026-10-01T16:32:55Z Text Thesis 10.17034/32640246.v1 https://figshare.com/articles/thesis/Investigating_the_impact_of_sacubitril_valsartan_on_cardiac_structure_function_and_remodelling_in_the_diabetic_heart/32640246 All Rights Reserved Open Access after 2029-12-31