Should there be a role for sacubitril-valsartan in the management of patients with heart failure with preserved ejection fraction?

When it comes to HFpEF, we don't have a lot of effective therapies in our armamentarium. SGLT2 inhibitors have known cardiovascular benefits and were shown primarily to reduce hospitalization in EMPEROR-Preserved and DELIVER. Arguably, spironolactone can be included here despite a trial (TOPCAT) that was marred by a suspicious regional variation, though I tend to use this agent in these patients based on an underpowered reanalysis of those data. Now the GLP-1 agonists showing promise as well.

Wi...