PMID- 12791814
OWN - NLM
STAT- MEDLINE
DCOM- 20030724
LR  - 20161124
IS  - 0161-5505 (Print)
IS  - 0161-5505 (Linking)
VI  - 44
IP  - 6
DP  - 2003 Jun
TI  - Addition of valsartan to an angiotensin-converting enzyme inhibitor improves 
      cardiac sympathetic nerve activity and left ventricular function in patients with 
      congestive heart failure.
PG  - 884-90
AB  - We determined whether the addition of the angiotensin-receptor blocker valsartan 
      to an angiotensin-converting enzyme (ACE) inhibitor improves cardiac sympathetic 
      nerve activity and left ventricular function in patients with congestive heart 
      failure (CHF). METHODS: Thirty-two patients with CHF (left ventricular ejection 
      fraction [LVEF] < 40%; mean, 33% +/- 6%) were treated with an ACE inhibitor and a 
      loop diuretic. Sixteen patients (group A) were randomized to additionally receive 
      valsartan (40-80 mg/d), and the remaining 16 patients (group B) continued their 
      current regimen. Patients were studied before and 6 mo after treatment. The 
      delayed heart-to-mediastinum count ratio (H/M ratio), delayed total defect score 
      (TDS), and washout rate (WR) were determined from (123)I-metaiodobenzylguanidine 
      images. The left ventricular end-diastolic volume (LVEDV) and LVEF were 
      determined by echocardiography, and New York Heart Association (NYHA) functional 
      class was estimated. RESULTS: Before treatment, TDS, H/M ratio, WR, LVEDV, LVEF, 
      and NYHA functional class were similar in both groups. After treatment in group 
      A, TDS decreased from 37 +/- 8 to 31 +/- 9 (P < 0.001), H/M ratio increased from 
      1.66 +/- 0.23 to 1.81 +/- 0.23 (P < 0.001), and WR decreased from 47% +/- 9% to 
      39% +/- 10% (P < 0.01). In addition, the LVEDV decreased from 193 +/- 36 mL to 
      169 +/- 51 mL (P < 0.005), and LVEF increased from 32% +/- 7% to 41% +/- 13% (P = 
      0.0005). In group B, these parameters did not change significantly. NYHA 
      functional class improved in both groups (in group A, from 3.3 +/- 0.5 to 1.7 +/- 
      0.6 [P < 0.0005]; in group B, from 3.3 +/- 0.5 to 2.4 +/- 0.6; [P < 0.005]). The 
      improvement was significantly greater in group A than in group B (P < 0.05). 
      CONCLUSION: The addition of valsartan to an ACE inhibitor improves cardiac 
      sympathetic nerve activity, left ventricular function, and symptoms in patients 
      with CHF.
FAU - Kasama, Shu
AU  - Kasama S
AD  - Second Department of Internal Medicine, Gunma University School of Medicine, 
      Maebashi, Japan. s-kasama@bay.wind.ne.jp
FAU - Toyama, Takuji
AU  - Toyama T
FAU - Kumakura, Hisao
AU  - Kumakura H
FAU - Takayama, Yoshiaki
AU  - Takayama Y
FAU - Ichikawa, Shuichi
AU  - Ichikawa S
FAU - Suzuki, Tadashi
AU  - Suzuki T
FAU - Kurabayashi, Masahiko
AU  - Kurabayashi M
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Nucl Med
JT  - Journal of nuclear medicine : official publication, Society of Nuclear Medicine
JID - 0217410
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
RN  - 0 (Radiopharmaceuticals)
RN  - 0 (Tetrazoles)
RN  - 35MRW7B4AD (3-Iodobenzylguanidine)
RN  - 80M03YXJ7I (Valsartan)
RN  - HG18B9YRS7 (Valine)
SB  - IM
MH  - 3-Iodobenzylguanidine
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiotensin-Converting Enzyme Inhibitors/*administration & dosage
MH  - Drug Synergism
MH  - Drug Therapy, Combination
MH  - Female
MH  - Heart Failure/complications/diagnostic imaging/*drug therapy
MH  - Heart Ventricles/diagnostic imaging/drug effects/innervation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Radionuclide Imaging
MH  - Radiopharmaceuticals
MH  - Stroke Volume
MH  - Sympathetic Nervous System/diagnostic imaging/*drug effects
MH  - Tetrazoles/*administration & dosage
MH  - Treatment Outcome
MH  - Ultrasonography
MH  - Valine/*administration & dosage/*analogs & derivatives
MH  - Valsartan
MH  - Ventricular Dysfunction, Left/diagnostic imaging/*drug therapy/etiology
EDAT- 2003/06/07 05:00
MHDA- 2003/07/25 05:00
CRDT- 2003/06/07 05:00
PHST- 2003/06/07 05:00 [pubmed]
PHST- 2003/07/25 05:00 [medline]
PHST- 2003/06/07 05:00 [entrez]
PST - ppublish
SO  - J Nucl Med. 2003 Jun;44(6):884-90.