MME and cardiac hypertrophy: Neprilysin, a membrane metalloendopeptidase enzyme, is responsible for the degradation of multiple vasoactive peptides and reduces preload and ventricular remodeling.41,42 Additionally, ARB blocks the receptor type-1 and decreases the effects of angiotensin II, which prevents vasoconstriction, water retention, and myocardial hypertrophy.43,44