Management of a patient with heart failure by sacubitril/valsartan: improvement of functional capacity.

The main objectives of the treatment of heart failure (HF) are to improve patient clinical status, functional capacity and quality of life, as well as reducing re-hospitalization rate and mortality. A new compound, consisting of an angiotensin-receptor blocker (ARB) (valsartan) and a neprilysin (NEP) inhibitor (sacubitril), belonging to the newly established class of angiotensin receptor-neprilysin inhibitors (ARNIs) showed marked efficacy, without any relevant safety issue, in the treatment of patients with HF. We report a case of a 48 year old male with HF with reduced ejection fraction (HFrEF) due to hypertensive cardiomyopathy (New York Heart Association [NYHA] class III). Therapy with sacubitril/valsartan was initiated after some years of other treatments, which did not lead to any positive outcome in HF, quality of life and clinical functions. After only 1 month of sacubitril/valsartan therapy, the patient reported a significant improvement in quality of life, and in 6 months his NYHA class switched from III to I.