ARNI Combined With SGLT2 Inhibitors on Functional Mitral Regurgitation Remodeling

This study evaluates whether combining an ARNI medication (sacubitril/valsartan — a drug that helps the heart pump better) with SGLT2 inhibitors (a class of diabetes/heart failure drugs) can improve a heart problem called functional mitral regurgitation, where the mitral heart valve leaks because the heart muscle is weak. **You may be eligible if...** - You are 18 or older - Your heart's pumping function (ejection fraction) is below 50% - You have been diagnosed with functional mitral regurgitation (mild, moderate, or severe) on an echocardiogram (heart ultrasound) - Your heart rhythm is in normal sinus rhythm or controlled atrial fibrillation **You may NOT be eligible if...** - Your mitral valve leaks due to structural problems (degenerative or rheumatic disease), rather than heart muscle weakness - You have previously had mitral valve surgery or a catheter-based valve procedure - You had a heart failure episode requiring hospitalization in the last 4 weeks - You have severe kidney disease - Your echocardiogram images are of insufficient quality Talk to your doctor to see if this trial is right for you.