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Sacubitril/valsartan (S/V) has shown to improve mortality and reduce hospitalizations for heart failure in patients with reduced ejection fraction (HFrEF). It has been analysed its improvement in ejection fraction and left ventricle volumes. Very few studies have analysed its effect on diastolic dysfunction. The aim of this study is to determine if the treatment with S/V in patients with HFrEF produces changes in diastolic function. Methods We performed a prospective observational study in ambulatory patients with HFrEF and sinus rhythm that, according to the ESC guidelines, had indication to initiate S/V. An echocardiographic examination was done previous to start with S/V and 6 month after having been treated with it. Results A total of 67 patients were included in the study (Figure 1). After six months of starting with S/V, there was a statistically significant improvement in diastolic parameters (results are illustrated in table 1): it was observed better values of E/A, E/e’, left atrial maximal volume and deceleration time, leading to a reduction in filling pressures and diastolic dysfunction. Furthermore, we analysed recent parameters that have been postulated as new predictors of diastolic dysfunction, such as left atrial minimal volume (LAVmin), left atrial ejection fraction (LAEF) and left atrial strain (LAStr). There was a statistically significant reduction in LAVmin and values of LAStr after treatment with S/V, but no significant differences were observed in LAEF (table 1). Conclusion Treatment with S/V in patients with HFrEF leads to an improvement in diastolic function. More studies need to be done to analyse if S/V could have the same effect in patients with heart failure and preserved ejection fraction. Figure 1: Population characteristics Gender (male, %) 74.6 High blood pressure (%) 53.7 Age (mean) 59.7 Diabetes mellitus (%) 40.3 Cardiomyopathy (%) Dyslipidaemia (%) 56.7 Ischemic 61.2 Smokers (%) 17.9 Non Ischemic 38.8 Treatment (%) Functional class (%) Beta-blockers 98.5 I 3 Aldosterone antagonists 91 II 71.6 Ivabradine 23.9 III 23.9 Diuretics 71.6 Abstract P1745 Table 1

P1745 Changes in diastolic function in patients with heart failure with reduced ejection fraction treated with sacubitril/valsartan