Benefit of ARNi in patient with HFrEF and COPD– case report

Introduction: Angiotensin Receptor – Neprilysin inhibitor (ARNi) is a drug specifically designed to treat heart failure and it consists of two components: an angiotensin receptor blocker (Valsartan) and a neprilysin inhibitor (Sacubitril). ARNi is currently used for the treatment of patients with heart failure with reduced ejection fraction. Case: Our case is of a 61y.o. man, who came to our clinic for yearly follow up. He had previously been treated for coronary artery disease, had coronary angiography with subsequent percutaneous coronary intervention. The patient also has Chronic Obstructive Pulmonary Disease and diabetes mellitus type 2 and receives treatment for them. On his yearly follow up he had clinical symptoms of heart failure, that was confirmed with echocardiography (ejection fraction of 38%) and was immediately treated with medication for heart failure with reduced ejection fraction according the latest guidelines (including ARNi and sodium-glucose co-transporter SGLT-2) Follow up: 4 months after the initial treatment for heart failure, patient had improved ejection fraction (50%) with no persistent clinical symptoms of heart failure. Conclusion: The use of ARNi in patients with heart failure with reduced ejection fraction, along with the other medications as per treatment guidelines, improves the ejection fraction and relives symptoms of heart failure. keywords: Angiotensin receptor – Neprilysin inhibitor, Heart failure, ejection fraction