Combined use of the first representative of ARNI (sacubitril/valsartan) in combination with empagliflozin in a patient with terminal chronic heart failure

A clinical case of treatment of a patient suffering from severe chronic heart failure is presented. The patient’s medical history lasts more than 20 years. All possible methods of treatment, both therapeutic and surgical, were used to save the patient’s life. The patient was implanted with modern mechanical devices to support the heart muscle, which allowed him to remain functional for almost ten years, while maintaining a relatively satisfactory quality of life. However, despite the treatment, there was a gradual deterioration in health over the past year, a sharp decrease in tolerance to physical activity, increased swelling, the patient was not able to self-care. In July 2019, the patient was examined at the Institute of Transplantology n.a. V.I. Shumakov (Moscow), recommended heart transplantation. In order to prepare the patient and eliminate the manifestations of heart failure, the patient was admitted to a cardiology hospital. At this stage, a modern combination of drugs (sacubitril/valsartan complex and empagliflozin) was selected, which not only stabilized the patient’s condition, but also helped to reduce the number of daily medications taken, without reducing the effectiveness of the main therapy, which allowed the patient to be included in the waiting list for heart transplantation.