Impact of sacubitril/valsartan on right ventricular myocardial performance index in patients with biventricular heart failure

Background: Heart failure is a global health issue caused by impaired cardiac function. Sacubitril/valsartan, an ARNI, has been shown to reduce symptoms and risks in patients with HFrEF. Aim: This study aims to evaluate sacubitril/valsartan's effects on global RV function by the right ventricular index of myocardial performance (RIMP) in patients with HFrEF and impaired RV function. Patents and methods: The study evaluated 102 patients with bi-ventricular heart failure by RIMP. The patients were over 18, had reduced EF, RV impairment, and New York Heart Association Class II, III, or IV symptoms. Exclusions included older patients, severe renal disease, primary valvular heart disease, chronic thromboembolic pulmonary hypertension, already on sacubitril/valsartan, or symptomatic hypotension. Results: Median age was 58 and all patients had dyspnea and lower limb edema. Most had IHD, hypertension, diabetes, and COPD. After initiation of sacubitril-valsartan treatment, there was no significant change in b-blockers, spironolactone, and diuretics use. Clinical examination showed decreased average temperature, HR, SBP, and DBP, and decreased congested neck veins and LL edema. Laboratory data showed no significant difference in Na, S. creatinine, eGFR, and INR, but increased K and albumin readings. Conclusion: Sacubitril/valsartan significantly enhances global right ventricular function in heart failure patients, reducing ejection fraction, tricuspid and mitral regurgitation, and promoting overall cardiac function, thus supporting its effectiveness.