P778Valsartan reduces level of soluble ST2 and left ventricle remodeling in patients with dual chamber pacemaker
Abstract Introduction Permanent right ventricle pacing leads to left ventricle remodeling, its systolic dysfunction 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 eff...
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Veröffentlicht in: | European heart journal 2019-10, Vol.40 (Supplement_1) |
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Sprache: | eng |
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Zusammenfassung: | Abstract
Introduction
Permanent right ventricle pacing leads to left ventricle remodeling, its systolic dysfunction 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 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. 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. Concentration of soluble ST2 was measured in duplicates with Aspect Reader (Critical Diagnostics).
Results
Results are presented in table. Data are presented as mean and standard deviation.
Table 1
Placebo (n=28)
Valsartan (n=60)
ANOVA
Baseline
12 mths
Baseline
12 mths
sST2, ng/mL
36.0±16.0
39.4±15.3
35.1±15.2
19.9±6.5
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
Conclusion
Valsartan has protective effect of left ventricle remodeling and function. It may be useful in prevention of pacing induced heart failure. Decrease in soluble ST2 concentration may help explain the alternative mechanism for protective role of valsartan. (NCT01805804) |
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ISSN: | 0195-668X 1522-9645 |
DOI: | 10.1093/eurheartj/ehz747.0378 |