Early improvement of symptoms using LCZ696 in a patient with systolic heart failure and a reduced ejection fraction: a case report

Introduction: Heart failure is a progressive disease with high mortality and morbidity. LCZ696 is a drug that has recently shown its improved efficacy and safety in patients with systolic heart failure and a reduced ejection fraction. Reports on its impact on the improvement of clinical symptoms are, however, scarce. These are important because they improve a patient's compliance with treatment and their quality of life. Case presentation: We report on the case of a 71-year-old patient who had deteriorating symptoms and signs of heart failure (ejection fraction [EF] 34%) in whom we initiated LCZ696 treatment. After two months of LCZ696 treatment (including titration), the New York Heart Association (NYHA) classification had improved (III -> II/I) with no residual signs of acrocyanosis and orthopnea. While creatinine values remained stable, potassium increased to 5.0 mmol/l and brain natriuretic peptide (BNP) dropped from 1260 ng/l to 680 ng/ml. The final EF was 47%. The patient reported substantial improvement of his quality of life. Conclusion: We show, based on a case report, that symptoms associated with heart failure deterioration are improved early after the initiation of LCZ696. This should foster specific research into symptoms and quality of life improvements with LCZ696.