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Others reported a significant reduction in the thinning rates of the left ventricular posterior wall and interventricular septum in 13 patients with Friedreich's ataxia.4The only scintigraphic studies of left ventricular function in patients with Friedreich's ataxia are those of Pentland and Fox5 and Therriault et al6 in which the ejection fraction was normal in most cases. We do not know of any radionuclide studies of the diastolic function of the left ventricle and the overall function ofthe right ventricle in this disease. We have assessed the function of both ventricles by radionuclide angiography in a group of patients with Friedreich's ataxia.Requests for reprints to Professor M Morpurgo, Via Boccaccio 24,

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The optimal use of sacubitril/valsartan in clinical practice needs further investigation, in particular for patients with multiple comorbidities, as such patients are usually poorly represented in clinical trials. To this end, well-documented case reports may add further evidence to the bulk of “field practice” experience on sacubitril/valsartan. We report here the case of a patient with heart failure with reduced ejection refraction with multiple comorbidities treated with sacubitril/valsartan. Overall, sacubitril/valsartan led to a prompt (within a few months) improvement in LVEF (+15%, from 38 to 53%), without any noticeable adverse events. This therapy also allowed the patient to discontinue furosemide.