As pre-HF patients exhibit great heterogeneity and have various comorbidities, such as hypertension, obesity, and DM, their therapeutic response to Sacubitril/Valsartan may differ, and that the Sacubitril/Valsartan mediated reduction of Irf7 and improvements in cardiac structure and function reported in this study may be specific to diabetes-induced cardiac dysfunction in pre-HF populations. This evidence concerns the gene IRF7 and Obesity.