PURPOSES: Only scanty “real life” information about the effect of Sacubitril-Valsartan (ARNI) on cardiac function are available yet. In this study, we sought to evaluate the effects of one-year ARNI treatment on left ventricular (LV) systolic function and myocardial longitudinal strain in patients with heart failure and reduced ejection fraction (HFrEF). METHODS: This was an open-label, single-center, observational study on consecutive adult patients (93% recently implanted with defibrillator) fulfilling the same inclusion and exclusion criteria as from the PARADIGM-HF trial. They were regularly followed-up with a clinical check-up and strain-echocardiography imaging. RESULTS: 42 patients (32 males), aged 61.5±11.0 years were enrolled. 93% of them had been implanted with a defibrillator device. An ischemic etiology was present in 67% of cases. Over the follow-up period, clinical conditions dramatically ameliorated, whereas repeated echocardiography investigations revealed a more gradual improvement in LV ejection fraction (from 0.27±0.04 to 0.32±0.04, p=0.01) and global longitudinal strain (from 9.5±1.3% to 12.4±1.4%, p=0.01) during the follow-up. CONCLUSIONS: One-year ARNI treatment was demonstrated to improve LV ejection and GLS deformation, but in a more gradual way than their clinical benefit. The intricate relationship among clinical, biological and functional markers remains to be further elucidated.
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