Clinical Research Directory

Inclusion Criteria: * Age ≥ 18 years old. * Both sexes. * Patients with a history of prosthetic heart valves. * Patients diagnosed with heart failure with reduced ejection fraction (HFrEF), defined as left ventricular ejection fraction (LVEF) ≤ 40% with New York Heart Association (NYHA) functional class II-IV. Exclusion Criteria: * Hemodynamic instability. * Use of a circulatory auxiliary circulation device. * Severe hepatic \[alanine aminotransferase (ALT) \>120 U/L\] and renal insufficiency \[estimated glomerular filtration rate (eGFR) \<30 mL/min\]. * Blood pressure \<100/60 mmHg. * Serum potassium \>5.3 mmol/L. * Severe pulmonary hypertension. * Malignant arrhythmia. * Malignant tumor. * Known history of hereditary or primary angioedema. * Serious adverse drug reactions or serious complications over the course of treatment.