Effect of Sacubitril-Valsartan on Estimated Pulmonary Artery Systolic Pressure in Patients With Heart Failure With Reduced Ejection Fraction Heart Failure

Evaluate effect of Sacubitril-Valsartan on estimated pulmonary artery systolic pressure in patient with reduced ejection fraction heart failure

Inclusion Criteria: * Patients aged more than 18 years . * Diagnosed with HFrEF defined as those with an EF ≤40% . Exclusion Criteria: * Patients \< 18 years old * Patients with severe renal disease (i.e., estimated glomerular filtration rate according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation ≤30 mL/min/1.73 m2), * Patients with moderate-severe liver disease (i.e., a Child-Pugh score ≥7), * Patients with severe chronic obstructive pulmonary disease (i.e., Global Initiative for ---Chronic Obstructive Lung Disease class ≥3), History of acute pulmonary embolism * History of prior heart surgery with pericardial incision. * Pregnancy and lactation.