PMID- 12225725
OWN - NLM
STAT- MEDLINE
DCOM- 20020927
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 40
IP  - 5
DP  - 2002 Sep 4
TI  - Valsartan benefits left ventricular structure and function in heart failure: 
      Val-HeFT echocardiographic study.
PG  - 970-5
AB  - OBJECTIVES: The objective of the study was to evaluate the effect of an 
      angiotensin receptor blocker on left ventricular (LV) structure and function when 
      added to prescribed heart failure therapy. BACKGROUND: The clinical benefit 
      derived from heart failure therapy is attributed to the regression of LV 
      remodeling. METHODS: At 302 multinational sites, 5,010 patients in New York Heart 
      Association (NYHA) classification II to IV heart failure taking 
      angiotensin-converting enzyme inhibitor (ACEI) and/or beta-blocker (BB) were 
      randomized into valsartan and placebo groups and followed for a mean of 22.4 
      months. Serial echocardiographic measurements of left ventricular internal 
      diastolic diameter (LVIDd) and ejection fraction (EF) were recorded. Total study 
      reproducibility calculated to 90% power at 5% significance defined detectable 
      differences of 0.09 cm for LVIDd and 0.86% for EF. RESULTS: Baseline LVIDd and EF 
      for valsartan and placebo groups were similar: 3.6 +/- 0.5 versus 3.7 +/- 0.5 
      (cm/m(2)) and 26.6 +/- 7.3 versus 26.9 +/- 7.0 (%). Mean group changes from 
      baseline over time were compared. Significant decrease in LVIDd and increase in 
      EF began by four months, reached plateau by one year, and persisted to two years 
      in valsartan compared with placebo patients, irrespective of age, gender, race, 
      etiology, NYHA classification, and co-treatment therapy. Changes at 18 months 
      were -0.12 +/- 0.4 versus -0.05 +/- 0.4 (cm/m(2)), p < 0.00001 for LVIDd, and 
      +4.5 +/- 8.9 versus +3.2 +/- 8.6 (%), p < 0.00001 for EF. The exception occurred 
      in patients taking both ACEI and BB as co-treatment, in whom the decrease in 
      LVIDd and increase in EF were no different between valsartan and placebo groups. 
      CONCLUSIONS: The Val-HeFT echocardiographic substudy of 5,010 patients with 
      moderate heart failure demonstrated that valsartan therapy taken with either ACEI 
      or BB reversed LV remodeling.
FAU - Wong, Maylene
AU  - Wong M
AD  - VA Greater Los Angeles Healthcare System and University of California at, Los 
      Angeles, California 90073, USA. maylene.wong@med.va.gov
FAU - Staszewsky, Lidia
AU  - Staszewsky L
FAU - Latini, Roberto
AU  - Latini R
FAU - Barlera, Simona
AU  - Barlera S
FAU - Volpi, Alberto
AU  - Volpi A
FAU - Chiang, Yann-Tong
AU  - Chiang YT
FAU - Benza, Raymond L
AU  - Benza RL
FAU - Gottlieb, Sidney O
AU  - Gottlieb SO
FAU - Kleemann, Thomas D
AU  - Kleemann TD
FAU - Rosconi, Franco
AU  - Rosconi F
FAU - Vandervoort, Pieter M
AU  - Vandervoort PM
FAU - Cohn, Jay N
AU  - Cohn JN
CN  - Val-HeFT Heart Failure Trial Investigators
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Angiotensin Receptor Antagonists)
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Antihypertensive Agents)
RN  - 0 (Tetrazoles)
RN  - 80M03YXJ7I (Valsartan)
RN  - HG18B9YRS7 (Valine)
SB  - IM
MH  - Adrenergic beta-Antagonists/therapeutic use
MH  - Aged
MH  - *Angiotensin Receptor Antagonists
MH  - Angiotensin-Converting Enzyme Inhibitors/therapeutic use
MH  - Antihypertensive Agents/*pharmacology/therapeutic use
MH  - Echocardiography
MH  - Female
MH  - Heart Failure/*drug therapy/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Tetrazoles/*pharmacology/therapeutic use
MH  - Valine/analogs & derivatives/*pharmacology/therapeutic use
MH  - Valsartan
MH  - Ventricular Function, Left/*drug effects
MH  - Ventricular Remodeling/*drug effects
EDAT- 2002/09/13 10:00
MHDA- 2002/09/28 04:00
CRDT- 2002/09/13 10:00
PHST- 2002/09/13 10:00 [pubmed]
PHST- 2002/09/28 04:00 [medline]
PHST- 2002/09/13 10:00 [entrez]
AID - S0735109702020636 [pii]
AID - 10.1016/s0735-1097(02)02063-6 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2002 Sep 4;40(5):970-5. doi: 10.1016/s0735-1097(02)02063-6.