Nang emaw, i chhungkuaa tu emaw hian heart failure i nei em? Chutiang a nih chuan i doctor-in damdawi a pekte chu i ngaihtuah fo mai thei. I thinlung hian a chau deuh nia a hriat hian a pui thei tur damdawi te hriat reng a pawimawh hle. Vawiin hian damdawi thar tak, he natna enkawlna kawnga hlawhtlinna nasa tak nei tawh chungchang kan sawi dawn a ni. Chu chu ARNI a ni.
A awlsam zawngin ARNI chu eng nge ni?
ARNI hi a takah chuan damdawi pahnih inzawmkhawm a ni. A hming pum chu Angiotensin Receptor/Neprilysin Inhibitor a ni. A hming hi a buaithlak deuhin a lang thei a, mahse a takah chuan a awlsam khawp mai. Heart failure nei damlo enkawlna atana duan a ni.
He damdawi atana thil pawimawh pahnih chu:
1. ARB (Angiotensin II Receptor Blocker): Damdawi ‘Valsartan’ hi he pawla tel a ni.
2. Neprilysin Inhibitor: Damdawi ‘Sacubitril’ hi he pawla mi a ni.
Tuna khawvela ARNI damdawi awm zingah heng pahnih inzawmkhawmna awmchhun chu Sacubitril/Valsartan a ni. Hei hi kum 2015 khan pawm a ni.
He damdawi hian taksa chhungah engtin nge hna a thawh?
Awle, tunah hian heng damdawi pahnih hian i thinlung a puih theih dan tur i lo en ang u.
I taksaa thisen kalna kawngte chu tui phurtu pipe angin ngaihtuah rawh. A châng chuan heng pipe te hi a inkhar a, a tawi a, chu chuan i thinlung tan thisen pump a harsat phah thin.
- Valsartan (ARB class): He damdawi hian thisen kalna kawng tawi te chu a ti hahdam a, a tizau bawk. Pipe khar (clogged pipe) tihzauh ang mai a ni. Tichuan thisen chu taksa pum puiah engmah daltu awm lovin a luang chhuak thei a ni. Hei hian thisen sang a tihniam a ni.
- Sacubitril (Neprilysin Inhibitor): Hei hian thil pawimawh zawk a ti a ni. Kan taksa hian a pianphungah kan thinlung puitu hormone a siam chhuak thin. Mahse enzyme pakhat ‘Neprilysin’ an tih hian heng hormone tha tak takte hi a tichhia a ni. Sacubitril hian chu enzyme tha lo chu a thawk thei lo. A tawp chuan kan taksa hian:
- Taksa atanga sodium (salt) tul lo chu zun hmangin paih chhuak thin ang che.
- Thisen kalna kawng zau zawk siam rawh.
- Zun tam zawk siam chhuah leh taksaa tui tam lutuk tihtlem.
A awlsam zawngin sawi ila, heng damdawi pahnih inkawp hian thinlunga phurrit a tihziaawm a, a hnathawh pawh a ti awlsam hle. Mi thawkrim tak tanpui tura mi pahnih dang lo kal leh ang mai a ni.
ARNI hi tute tan nge recommend a nih?
He damdawi hi mi zawng zawng tan a ni lo. I doctor chuan he damdawi hi i tan a tha em tih chu thil engemaw zat atanga thlirin a rel ang.
| Eligible theihna tur | Hrilhfiahna |
|---|---|
| Heart pumping theihna tlahniam nei tan | Heart Failure i vei tih hmuhchhuah thar i nih a, i Ejection Fraction (EF), thinlung pumping efficiency tehna chu 40% aia tlem a nih chuan (mi hrisel takah chuan he value hi 55%-65% vel a ni). |
| Damdawi dang atanga inthlak danglam thinte tan | Heart failure avanga ACE inhibitor emaw ARBs emaw i ei tawh chuan ARNIs hmang lovin i hmang thei ang. |
Pawimawh tak: ACE inhibitor (e.g. Enalapril, Lisinopril) atanga ARNI i thlak dawn a nih chuan ACE inhibitor i tihtawp hnu darkar 36 hnuah ARNI i tan hmain nghak rawh. Chutianga tih loh chuan allergic reaction hlauhawm tak (angioedema) a thlen thei a, chu chu vun hnuai lam a hring chhuak thei a ni. Hemi chungchangah hian i doctor chuan thurawn a pe ang che.
ARNI hlawkna leh hman chhan
Mi tam tak chuan ARNIs hi an hmang thin a, a chhan chu a side effects, persistent cough ang chi, ACE inhibitor ang chi damdawi hlui nena lo awm thin vang a ni. Mahse chu chu a chhan awmchhun a ni lo. ARNI hman hian hlawkna tam tak a nei a.
- Nun chhung a tipung: Zirna hrang hrangah he damdawi hian thinlung natna nena inzawm thihna a ti tlem tih hmuhchhuah a ni.
- Nunphung a titha: Chauhna leh hahna ang chi natna lanchhuahna a tiziaawm a, hnathawh dan pangngaia thawk turin a pui bawk.
- Natna kal zel dan a control: Heart failure nasat dan a ti hniam.
- Damdawi ina dah a tihtlem: He damdawi ei thinte hian thinlung lam natna avanga damdawi ina enkawl an tlem zawk tih finfiah a ni.
- Lung hnathawh a tichak: Zirchianna pakhatah chuan kum khat chhung ARNI an ei hnuah damlote ejection fraction chu a vaiin 28% atanga 38% ah a pung tih hmuhchhuah a ni. Chumi awmzia chu thinlung pump theihna chu nasa takin a lo tha chho tihna a ni.
Zirchianna lian tak atanga a lan dan chuan ARNI ei thinte hian thinlung natna avanga thihna emaw damdawi ina dah emaw an hlauhawmna chu 20% in an tlahniam a ni.
He damdawi hi tuin nge hmang lo tur?
He damdawi hi mi thenkhat tan chuan a tha lo. Heng pawl zinga mi i nih chuan doctor-te chuan he damdawi hi ei loh tur an ti.
| Nihna | Chhan |
|---|---|
| Nu naupai emaw, nau hnute pe lai emaw | A chhan chu naute a tichhe thei a ni. |
| Tun hmaa angioedema vei tawhte | Tun hmaa angioedema, hmai emaw hmui emaw a hring, ACE inhibitor emaw ARB damdawi emaw avanga i lo vei tawh a nih chuan. |
| ACE inhibitor/ARB ei tawhte tan chuan | Damdawi pahnih ei dun hi a hlauhawm hle. |
| Thin natna khirh tak nei te | He damdawi hi liver function tha lo i neih chuan a tha lo. |
| Mite chuan Aliskiren an ei | Zunthlum emaw, kal natna emaw neia Aliskiren i ei chuan ARNI ei hi a tha lo. |
Side effects te pawh i zir ve ang u.
Damdawi dang ang bawkin ARNI hian side effect tenau te a thlen thei a ni. Mahse, mi zawng zawngin an hmu vek lo.
- Thisen sang hniam (Hypotension): I lu a na thei a, i lu a ti za thei bawk.
- Kidney function a nghawng dan: Mi thenkhat chuan kidney function a tlahniam deuh thei.
- Thisenah potassium level sang (Hyperkalemia): Hei hi mi thenkhatah pawh a thleng thei bawk.
- Angioedema: Hmai, hmui leh lei a hring. This is very rare , mahse a lo awm chuan a hlauhawm hle thei.
Hei vang hian i doctor chuan he damdawi i ei tan tirh atanga kar hmasa berah i thisen (i kal leh potassium level enfiah nan) leh thisen sang a enfiah ang. Harsatna a awm chuan i doctor chuan a dose a tihhniam emaw, i tih tur a hrilh emaw ang che. Doctor thurawn tel lo chuan he damdawi hi ei kha bansan ngai suh.
Heng side effects te hi kar hnih chhungin a bo tlangpui. An awm reng chuan doctor hnenah hriattir nghal rawh.
Engtikah nge Doctor ka hmuh ang?
ARNI i ei laiin heng symptoms te hi i neih chuan doctor nen inbia ngei ang che.
- Luak chhuak fo thin
- Lung hring (lightheadedness) a awm
- A chang chuan a muhil thin
- Thisen sang hniam tak (systolic reading 90 hnuai lam a nih chuan) .
Damdawi hlui i hman tawh chuan damdawi thara thlak chu i hlau deuh mai thei. Mahse enkawlna thar, tangkai tak tak zir leh i doctor nena an thatna leh that lohna chungchang sawipui hi i hriselna atan a pawimawh hle.
Take-Home Thuchah a ni
- ARNI hi damdawi hlawhtling tak, tunlai tak a ni a, lung lam natna enkawlna atana damdawi pahnih inzawmkhawm atanga siam a ni.
- Hei hian thisen kalna kawng a tizau a, taksa atanga chi leh tui tul lo tak tak a paih chhuak a, thinlunga phurrit a tihziaawm bawk.
- He damdawi hian hlawkna tam tak a pe a, chung zingah chuan dam rei zawng tihpun, nunphung tihchangtlun, leh damdawi ina enkawl tlem te pawh a tel.
- He damdawi hi naupai, a hmaa angioedema vei tawh leh damdawi lam harsatna dang thenkhat nei tan a tha lo.
- Side effects, luak chhuak leh thisen sang hniam te pawh a awm thei. Chuvangin doctor enkawlna hnuaia awm reng a pawimawh.
- Damdawi lam thurawn tel lo chuan he damdawi hi ei tan ngai suh la, chawlhsan ngai suh. Harsatna i neih chuan doctor rawn nghal tur a ni.
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