On the one hand, ARNI can inhibit enkephalinase and increase peptides (such as natriuretic peptides) degraded by enkephalinase level, play the role of vasodilator, diuresis, and natriuresis, increase the cardiovascular protective effect of natriuretic peptide, inhibit myocardial hypertrophy and fibrosis, reduce cardiac load, and finally improve cardiac function (Gu et al., 2010); on the other hand, ARNI can improve hemodynamics, reduce aldosterone levels, and inhibit ventricular remodeling by inhibiting the renin-angiotensin-aldosterone system (RAAS) (Burke et al., 2019). Here, REN is linked to cardiac hypertrophy.