Efficacy of Sacubitril/Valsartan in a Patient With Heart Failure and Impaired Secretion of Atrial Natriuretic Peptide Due to Long-Standing Persistent Atrial Fibrillation.

Atrial natriuretic peptide (ANP) is a circulating hormone released from the atria in response to wall stretch and volume overload in the setting of heart failure. When atrial fibrillation (AF) becomes long-standing persistent, ANP secretion in response to volume overload is impaired due to degenerative changes of the atria. Here, we report a case of heart failure with preserved ejection fraction and impaired ANP secretion due to long-standing AF.