Background: 

The aim of the work was to assess the effect of sacubitril/valsartan on the myocardial mechanics of the left ventricle in patients with reduced ejection fraction (HFrEF) versus patients with preserved ejection fraction (HFpEF).

Methods: 

This prospective randomized controlled study was carried out on 105 patients admitted with heart failure with either reduced (HFrEF) or preserved ejection fraction (HFpEF) at the International medical centre hospital in Jeddah and Banha University Hospital from November 2022 to November 2023. The patients were divided into three groups: Group I (N=35): Patients with heart failure with reduced ejection fraction (HFrEF) who were treated with sacubitril/valsartan along with standard GDMT, group II (N=35): Patients with heart failure with preserved ejection fraction (HFpEF) who were treated with sacubitril/valsartan along with standard GDMT, and group III (N=35): Patients with heart failure with reduced ejection fraction (HFrEF) who were treated with standard GDMT not including sacubitril/valsartan.

Results: 

There was a significant positive correlation between left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (LVGLS) (r= 0.225, P=0.021), and twist (r= 0.272, P=0.005). There was a significant negative correlation between LVEF and untwist rate (r= -0.217, P=0.026), untwist onset (r= -0.311, P=0.001), basal rotation (r= -0.254, P= 0.009) and apical rotation (r= -0.274, P=0.004). There was an insignificant correlation between LVEF and left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume (LVESV). The multiple logistic regression analysis revealed that LVEF, LVGLS and apical rotation were the only significant predictors for the improvement of EF.