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This study aims to evaluate the torsional dynamics and 2D speckle tracking in heart failure with reduced ejection fraction on patients taking angiotensin receptor neprilysin inhibitors (ARNI) and none. ARNI has been shown to be superior to enalapril in the long term reducing the mortality and hospitalization of heart failure (HF). However short-term effects on diastolic function remain unclear. We sought to evaluate 6 months' effects of ARNI on left ventricular (LV) diastolic parameters determined by speckle tracking and tissue Doppler imaging. This study was carried out in Menoufia University Hospitals including 60 patients of HFrEF during the period from August 2019 to January 2020. (50%) of patients were treated with traditional treatment of heart failure and the remaining were treated with ARNI. Data were collected including history and clinical examination. ECG and speckle tracking and tissue Doppler imaging were done to evaluate the diastolic function. Our results showed no significant difference between the two groups at baseline. There was a significant improvement in the LV diastolic function parameters. Untwisting time and untwisting onset showed the highly significant parameters of improvement. This study concluded that ARNI showed short term improvement of diastolic function of the left ventricle that could be detected by STE.

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