Objectives: Angiotensin receptor-neprilysin inhibitors (ARNI), such as sacubitril/valsartan, induce systemic vasodilation, diuresis, and natriuresis.This study aims to evaluate the effect of ARNI therapy on the quality of life in patients with heart failure (HF). 

Methodology: A prospective cohort study was conducted on 50 patients diagnosed with ischemic heart disease and heart failure with reduced ejection fraction (HFrEF) (LVEF < 40%). Patients aged 18–80 underwent baseline and follow-up assessments, including clinical examination, echocardiography, laboratory testing, and gated SPECT myocardial perfusion imaging. Following eligibility screening, all 50 participants received ARNI therapy for six months, after which they were reassessed. Key endpoints included changes in New York Heart Association (NYHA) classification, lower limb edema (LLE), and cardiac function parameters such as LVEF, left ventricular end-diastolic volume (LVEDV), and left ventricular end-systolic volume (LVESV). 

Results: Significant improvements were observed following six months of ARNI therapy. NYHA class improved, with Class 0 increasing from 0% to 26.09% (P < 0.001). The prevalence of LLE decreased from 100% to 52.17% (P < 0.001). Heart rate significantly decreased (P < 0.001), while systolic and diastolic blood pressure (SBP and DBP) remained unchanged. Gated SPECT imaging revealed a significant increase in LVEF (31.02 ± 8.98% to 36.43 ± 8.39%; P < 0.001) and reductions in LVEDV and LVESV (P < 0.001). Summed rest scores (SRS) for the left anterior descending (LAD) artery, right coronary artery (RCA), and total SRS also showed statistically significant decreases (P < 0.05). 

Conclusions: ARNI therapy significantly improved cardiac function, reduced heart failure severity, and enhanced the quality of life in patients with HFrEF. These findings support ARNI as an effective therapeutic option for managing refractory HF. 

To be Updated