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Sacubitril/valsartan (S–V) has been shown to reduce clinical outcomes in patients with heart failure with reduced ejection fraction (HFrEF). This benefit has been mostly attributed to an improvement in systolic function. This study aimed to evaluate longitudinal changes in several echocardiographic parameters of diastolic function in a cohort of patients with HFrEF receiving S–V. Echocardiographic parameters of consecutive patients receiving S–V, such as diastolic dysfunction (DD) grade and other individual diastolic and systolic function parameters, were prospectively collected at baseline and at 6-month follow-up. New York Heart Association (NYHA) functional class was also recorded. 65 patients (73.9% males; 61.5 ± 13 years) with HFrEF in NYHA class II–IV were evaluated. There was a significant reduction in DD grade after treatment with maximal tolerated doses (p

Background Chronic aortic regurgitation can be well tolerated for a long time. Some patients with normal ventricular function can even reach high levels of sporting performance. How the severity of regurgitation may change during exercise, however, is little known, although some studies suggest it diminishes. The present work examines, during exercise, the functional capacity, ventricular function, and regurgitation fraction (RF) in asymptomatic subjects with moderate or severe aortic regurgitation with preserved ejection fraction. Methods The study subjects ( n =32; 23 men, 9 women) were patients referred to our echocardiography laboratory with moderate or severe aortic regurgitation, preserved left ventricular systolic function, and sinus rhythm into NYHA functional class I. All underwent transthoracic echocardiography at rest and at peak effort during an exercise protocol involving an inclined cycloergometer. Left atrial and ventricular volume indices were recorded, along with diastolic and systolic function, cardiac index, peripheral resistance, and RF. Results The mean age of the subjects was 43.8±18.2years; 59% suffered moderate regurgitation, 41% severe aortic regurgitation, and 84% had a dilated left ventricle. All subjects managed exercise loads adequate for their age. Peak effort was associated with a significant reduction (mean 44.5% [range 10–95%]) in the RF (21.8±13.2 vs. 39.3%±14.7% at rest; p =0.0001). The absolute reduction in the RF at peak effort was greater among the subjects with severe aortic regurgitation (21.2% vs. 13.3% in those with moderate regurgitation; p =0.018). Conclusions The RF becomes smaller during exercise in asymptomatic subjects with moderate or severe aortic regurgitation and preserved ventricular function.