Inibitore del recettore dell'angiotensina e neprilisinasi nell'insufficienza cardiaca con eiezione preservata e regurgitazione mitrale secondaria: progetto e razionalità del trial PRAISE-MR.

BACKGROUND: Secondary or functional mitral regurgitation (FMR) of atrial origin is prevalent in heart failure with preserved ejection fraction (HFpEF) and portends a worse clinical course. Unlike ventricular FMR, it lacks evidence-based treatment and is often overlooked. Sacubitril-valsartan may provide benefit in this HFpEF phenotype. OBJECTIVE: To assess the impact of sacubitril-valsartan on exercise hemodynamics in patients with HFpEF and atrial FMR. METHODS: This multicenter, prospective, randomized, open-label trial with blinded endpoint assessment enrolls patients with stable HFpEF and at least moderate FMR documented within 1 year prior to enrollment. Participants are randomly assig