Sacubitril/valsartan: Where mechanism meets evidence‐based medicine.

This article discusses the use of sacubitril/valsartan, a medication that inhibits the renin-angiotensin-aldosterone system and increases the level of vasodilatory peptides, in the treatment of heart failure with reduced ejection fraction (HFrEF). The article highlights the uncertainty surrounding the underlying mechanisms of sacubitril/valsartan and the limited studies on its effects on myocardial performance and oxygen metabolism. A recent study conducted on stable patients with HFrEF found that sacubitril/valsartan had a myocardial oxygen-sparing effect compared to valsartan, although it did not significantly improve cardiac efficiency. The article concludes that further investigations are needed to fully understand the effects of sacubitril/valsartan on ventricular remodeling and clinical outcomes. [Extracted from the article]