Safety and Efficacy of ARNI After LVAD ImplanT (SEAL-IT) Study

Inclusion Criteria:

Adults (age ≥ 18 years)
Durable CF-LVAD for any indication
NYHA II to IV classification
LVEF < 40%
Written informed consent

Exclusion Criteria:

Inability to comply with the conditions of the protocol

Any patient with durable CF-LVAD who has any one of the following:

i. symptomatic hypotension or MAP < 60 mm Hg at randomization,

ii. eGFR < 30 mL/min/1.73 m2 at randomization,

iii. potassium > 5.4 mM at randomization,

iv. history of angioedema at randomization,

v. history of unacceptable side effects with ACE inhibitor, ARB, or sacubitril-valsartan therapy at randomization,

vi. use of vasoactive agents (e.g., dobutamine, dopamine, epinephrine, norepinephrine, phenylephrine, vasopressin, nitroglycerin, nitroprusside, epoprostenol) or parenteral diuretics in 24 hours preceding randomization.