Conclusions
reduced cardiac chamber stiffness, hypertension, diabetes
ADVERSE EFFECTS, HYPERTENSION, DIABETES
The results of the PARABLE trial showed that sacubitril/valsartan can increase left atrial volume index in the setting of reduced markers of filling pressure in hypertension or diabetes in patients with pre-HFpEF. This may reflect improved vascular compliance and reduced cardiac chamber stiffness mediated pharmacologically by natriuretic peptide modulating therapy. However, more work is required to exclude adverse effects of increased chamber volumes and to understand the long-term benefits and risks of sacubitril/valsartan in treating pre-HFpEF.