@scaredkat
It takes time for the Entresto to work. It will be important to see what next echo shows. There are a lot of other medications out there that can help with heart restructuring like Jardiance. Talk to your cardiologist about others that can be taken along with Entresto.

How is your blood pressure? Is your heart enlarged. A large heart has trouble contracting and can affect EF. An enlarged heart has many causes but a common one is high blood pressure.

Did your cardiologist tell you that EF for echocardiograms are subjective. You can have two cardiologist look at same echo and see a different number. Also the EF can fluctuate day to day. All coming from my Heart Failure Specialist and my Electrophysiologist at Mayo Jacksonville.

My EF when diagnosed was 48. It steadily went down to below 30 and that is when I got an ICD/Pacemaker. When your EF gets to 30 or below they normally order a ICD or dual device like mine ICD/Pacemaker. Why at 30 don't know just was told these by all my cardiologists.

My EF has been the same for over 10 years.