Valsartan improves left ventricle contractility and prevents its remodeling in patients with dual chamber pacemaker

Abstract Introduction Permanent right ventricle pacing leads to left ventricle dyssynchrony, systolic dysfunction, remodeling, and symptomatic heart failure in the long run. Valsartan is well known for its preventive anti-remodeling function in the post infarction heart remodeling. Objectives To assess the effect of valsartan on left ventricle contractility, measured as global longitudinal stain, and its remodeling in patients with second and third degree atrioventricular block with first-time implantation of dual chamber pacemaker. Methods This was a randomized, double-blind, placebo controlled single center study. One hundred eligible patients were assigned in a 1:1:1 fashion to receive placebo, valsartan 80mg or 160mg once daily, respectively. Echocardiographic assessment of left ventricle geometry, its systolic and diastolic function was performed at baseline and at twelve months. Global longitudinal strain (GLS) was measured off-line with EchoPac software. One patient from placebo group suffered stroke. We present the baseline date for 100 enrolled patients and follow-up data for 88 patients who have completed the study. Data in valsartan arms are pooled in one group. Results Results are presented in table. Data are presented as mean and standard deviation. Valsartan alleviates diastolic dysfunction, left ventricle dilation and protects from loss of systolic function. Conclusion Valsartan has protective effect of left ventricle contractile function and remodeling. It may be useful in prevention of pacing induced heart failure. (ClinicalTrials Identifier NCT01805804) Placebo (n=28) Valsartan (n=60) ANOVA baseline 12 mths baseline 12 mths GLS, % 18.7±2.4 14.2±3.1 19.1±3.3 17.5±2.5 0.01 LVEF, % 60±8 55±9 60±8 58±8 0.01 LVEDD, mm 48±5 50±4 48±6 49±5 NS LVESD, mm 29±4 32±5 29±5 31±4 NS LVEDV, mL 79±12 84±13 80±12 81±13 NS LVESV, mL 32±5 38±7 31±5 34±6 0.01 E/A 0.94±0.12 0.92±0.13 0.94±0.15 0.95±0.15 NS DecT, ms 211±38 226±43 223±45 218±37 0.01 IVRT, ms 98±14 108±17 101±17 99±18 0.01 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Medical University of Silesia