Objective To evaluate the effects of sacubitril valsartan sodium on exercise tolerance, left ventricular end-diastolic diameter (LVEDD), and serum-related factors in elderly patients with chronic heart failure (CHF) via the construction of a multi-indicator response-based intervention program for chronic heart failure (CHF) in the elderly. Methods A total of 80 cases of elderly CHF patients admitted to Xixia County Hospital of Traditional Chinese Medicine during the period of May 2022 to May 2024 were selected for the study, and were divided into the control group (n=40, receiving conventional clinical treatment) and the observation group (n=40, receiving sakubatril valsartan sodium in addition to conventional clinical treatment) by using the coin-flip method. After continuous treatment for 3 months, the left ventricular function and left ventricular remodeling, exercise tolerance, serologyrelated factors and adverse reactions of the two groups of elderly patients with CHF before and after treatment were compared. Results Before treatment, the left ventricular conditions of the two groups of elderly CHF patients were comparable (P >0.05); after treatment, the left ventricular ejection fraction (LVEF) of the two groups of patients increased, with a more significant improvement in the observation group (P<0.05); the left ventricular end-diastolic volume (LVEDV), LVEDD and left ventricular posterior wall (LVPW) decreased, and that of the observation group was lower (all P<0.05). Before treatment, the 6-minute walking distance (6MWD) of the two groups of elderly CHF patients was comparable (P>0.05); after treatment, the 6MWD of the two groups of elderly CHF patients increased, and the observation group showed a higher improvement (P<0.05). Before treatment, the serum related factors of the two groups of elderly CHF patients were comparable (P >0.05); after treatment, the heart fatty acid binding protein (hFABP), serum lipoprotein-associated phospholipase (Lp-PLA2) and soluble stimulation 2 (sST2) of the two groups of patients decreased, and those of the observation group were lower (all P<0.05). The incidence of adverse reactions in the two groups of elderly CHF patients was comparable (P >0.05). Conclusion The multi-indicator responsebased intervention program for elderly CHF constructed in this study effectively improves left ventricular function and serum-related factor levels, inhibits left ventricular remodeling, and improves exercise tolerance in elderly patients with CHF, with a high degree of safety.