Sacubitril/valsartan, left ventricular reverse remodeling and advanced echocardiographic imaging: is it a resolved conundrum?

In this issue of Minerva Cardiology and Angiology, Öz et al.1 reported the effects of sacubitril/ valsartan on short-term left ventricular (LV ) reverse remodeling evaluated by 2D and 3D echocardiography and 3D strain analysis. In this prospective cohort study, the positive effects of sacubitril/valsartan were evaluated in two different populations of heart failure (HF) with reduced ejection fraction (HFrEF): ischemic vs nonischemic patients. The authors applied advanced multiparametric 2D and 3D echocardiographic parameters to detect short-term minimal changes in LV diameters, volumes, LVE F and myocardial strain parameters. This study was performed in a large dataset of 100 consecutive HFrEF patients eligible for treatment with sacubitril/valsartan, by 2D and, for the first time, 3D strain analysis.