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MMP2 and MMP9 activity and TIMP1 protein levels were enhanced in haemodynamic models of HFpEF, while metabolic models showed no changes in MMP2, -8, -9, -11, -14, -15, TIMP-1, -2 and -3 mRNA expression.63 In a PARAGON-HF collagen biomarker substudy, sacubitril/valsartan decreased TIMP1 by 8% compared with valsartan alone, consistently in men and women and patients with LV ejection fraction (LVEF) above or below the median of 57%
It can stimulate sexual arousal, potentially leading to improved erectile function
10.1016/S1359-6446(04)03316-1 148 SamsonS
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Abnormal gastric slow waves, severe symptoms of gastroparesis and less improvement with gastric electrical stimulation is seen in the absence of ICC