Introduction
Sacubitril/Valsartan is a first-in-class combination of angiotensin
receptor blocker (ARB) and neprilysin inhibitor. It is now recommended
for the treatment of chronic heart failure with reduced ejection
fraction (HFrEF) that remains symptomatic despite optimal treatment as
per international guidelines. (1)
Compared with enalapril, sacubitril/valsartan reduced the composite
endpoint of cardiovascular death or HF hospitalization and is
recommended as an alternative for angiotensin‐converting enzyme
inhibitors (ACEI) and (ARB) in patients with HFrEF and New York Heart
Association (NYHA) class II–III symptoms. (2, 3)
In the randomized controlled trial PRIME (Pharmacological Reduction of
Functional, Ischemic Mitral Regurgitation) sacubitril/valsartan
treatment resulted in a greater reduction of Mitral Regurgitation (MR)
associated with HF compared to valsartan alone. (4)
In our patient, who presented with acute decompensated HF, dramatic
reduction in secondary MR severity as well as significant left
ventricular (LV) function improvement were achieved after using
Angiotensin Receptor-Neprilysin inhibitor (ARNI)