The Effect of Combination of Dapagliflozin and Sildenafil in Treatment of Heart Failure Patients With Secondary Pulmonary Hypertension

Inclusion Criteria: patients with established heart failure with secondary pulmonary hypertension seen by a primary care provider to diagnose a heart disease, the patient's symptoms which may experience: * Dizziness or fainting * Heart palpitations, which may feel like your heart fluttering or skipping beats * Shortness of breath Exclusion Criteria: * Patients with a history of severe allergic reactions or hypersensitivity to sildenafil, dapagliflozin, or related medications. * Individuals with contraindications to the use of sildenafil or dapagliflozin. * Patients with pulmonary arterial hypertension (PAH) due to conditions other than heart failure (e.g., idiopathic PAH). * severe hepatic impairment * aged less than 18 years. * valvular heart disease . * Patients with a known or suspected history of non-compliance with medical treatment or inability to adhere to study procedures. * life expectancy of less than 6 months . * Pregnant or breastfeeding women