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These include the phosphatidylinositol 3-kinase (PI3K)/Akt and PKA pathway [9,30]

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By inhibiting the NP (natriuretic peptide) system, sacubitril/valsartan increases natriuretic peptides (NPs) levels that, in turn, lead to vasodilation, natriuresis and RAAS inhibition through intracellular cyclic guanosine monophosphate (cGMP)-dependent pathways