The Effect of Sacubitril/Valsartan Versus Ramipril on Left Ventricular Function and Remodeling in Patients With Ischemic Heart Failure With Mid-range Ejection Fraction

Inclusion Criteria: * Written consent to participate in the study, expressed prior to any procedures related to the study. * Age 18 and over. * Symptomatic HF in NYHA class II to IV of ischemic etiology. * Left ventricular ejection fraction at screening visit ranged from 40-49%. * Elevated concentration of NT-proBNP natriuretic peptide ≥125 pg/ml. * Features of a structural / functional disease of the left ventricle. * Optimal pharmacotherapy with ACEI or ARB and beta-blocker, unless they are contraindicated. Exclusion Criteria: * History of hypersensitivity or allergy to any of the drugs tested or drugs of similar chemical class, ACEIs, ARBs or neprilysin inhibitors. * Previous history of intolerance to recommended ACEI or ARB target doses. * Known history of angioedema. * Requirement of simultaneous treatment with ACEI and ARB. * Acute decompensated HF within 6 weeks prior to screening visit. * Symptomatic hypotension systolic blood pressure \<100 mmHg at screening visit. * Current or previous treatment with sacubitril / valsartan. * Estimated creatinine clearance \<30 ml / min / 1.73 m2 at screening visit. * Serum potassium \>5.2 mmol / L at screening visit. * Acute coronary syndrome or elective revascularization within 6 weeks prior to screening. * Stroke, transient ischemic attack, carotid angioplasty, heart surgery, or any other major cardiovascular surgery in the 3 months prior to screening. * Implantation of a cardioverter defibrillator, pacemaker, or resynchronization therapy device incompatible with MRI. * Fixed atrial fibrillation.