Valsartan Dosage on Ventriculo-Vascular Coupling Index Dose-Dependency in Heart Failure Patients
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Purpose: Heart failure (HF) poses significant morbidity and mortality. Recently, the ventriculo-vascular coupling index (VVI) wasintroduced as an independent prognostic factor reflective of the overall cardiovascular performance index in HF. We aimed to determinethe effectiveness of force-titration of valsartan on VVI values in HF patients. Materials and Methods: In this multicenter and prospective observational trial, the effect of valsartan was stratified according todosages [non-ceiling dose (NCD) vs. ceiling dose (CD)] in HF patients with left ventricular ejection fraction (LVEF) <55%. Biochemicalstudies, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiography with VVI, the treadmilltest, and the activity scale index were assessed at baseline and after 24 weeks of treatment. Results: One-hundred thirty-eight patients were force-titrated to either a CD group (n=81) or a NCD group (n=57). The mean age ofthe study participants was 59 years and 66% were male. After 6 months of follow up, left ventricular mass index (LVMI) values hadsignificantly improved in the CD group but not in the NCD group. Intriguingly, in HF patients with a reduced ejection fraction (HFrEF)(n=52, LVEF <40%), a significant improvement in VVI was only observed in the CD group (from 2.4±0.6 to 1.8±0.5, p<0.001). Conclusion: CDs of valsartan for 6 months showed better improvement in VVI, as well as LVMI, in patients with HFrEF, comparedwith NCDs.
Abstract
Purpose: Heart failure (HF) poses significant morbidity and mortality. Recently, the ventriculo-vascular coupling index (VVI) wasintroduced as an independent prognostic factor reflective of the overall cardiovascular performance index in HF. We aimed to determinethe effectiveness of force-titration of valsartan on VVI values in HF patients. Materials and Methods: In this multicenter and prospective observational trial, the effect of valsartan was stratified according todosages [non-ceiling dose (NCD) vs. ceiling dose (CD)] in HF patients with left ventricular ejection fraction (LVEF) <55%. Biochemicalstudies, including N-terminal pro-B-type natriuretic peptide (NT-proBNP), echocardiography with VVI, the treadmilltest, and the activity scale index were assessed at baseline and after 24 weeks of treatment. Results: One-hundred thirty-eight patients were force-titrated to either a CD group (n=81) or a NCD group (n=57). The mean age ofthe study participants was 59 years and 66% were male. After 6 months of follow up, left ventricular mass index (LVMI) values hadsignificantly improved in the CD group but not in the NCD group. Intriguingly, in HF patients with a reduced ejection fraction (HFrEF)(n=52, LVEF <40%), a significant improvement in VVI was only observed in the CD group (from 2.4±0.6 to 1.8±0.5, p<0.001). Conclusion: CDs of valsartan for 6 months showed better improvement in VVI, as well as LVMI, in patients with HFrEF, comparedwith NCDs.
참고문헌 (29)
- Ambrosy AP, "The global health and economic burden of hospitalizations for heart failure : lessons learned from hospitalized heart failure registries", J Am Coll Cardiol, 63, pp.1123~1133 (2014)
- Writing Committee Members, "2016 ACC", AHA, AHA guideline for the management of heart failure : a report of the American College of Cardiology, pp.American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America, Circulation[DOI]
- Ponikowski P, "2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure : the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology(ESC). Developed with the special contribution of the Heart Failure Association(HFA)of the ESC", Eur Heart J, 37, pp.2129~2200 (2016)
- Cohn JN, "A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure", N Engl J Med, 345, pp.1667~1675 (2001)
- Pfeffer MA, "Valsartan, captopril, or both in myocardial infarction complicated by heart failure, left ventricular dysfunction, or both", N Engl J Med, 349, pp.1893~1906 (2003)
- McMurray JJ, "Angiotensin-neprilysin inhibition versus enalapril in heart failure", N Engl J Med, 371, pp.993~1004 (2014)
- Khan MS, "Dose of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers and outcomes in heart failure : a meta-analysis", Circ Heart Fail, 10, pp.e003956~ (2017)
- He Z, "Efficacy and safety of supramaximal titrated inhibition of renin-angiotensin-aldosterone system in idiopathic dilated cardiomyopathy", ESC Heart Fail, 2, pp.129~138 (2015)
- Asanoi H, "Ventriculoarterial coupling in normal and failing heart in humans", Circ Res, 65, pp.483~493 (1989)
- Fox JM, "Ventriculovascular coupling in systolic and diastolic heart failure", Curr Heart Fail Rep, 2, pp.204~211 (2005)
- Ky B, "Ventricular-arterial coupling, remodeling, and prognosis in chronic heart failure", J Am Coll Cardiol, 62, pp.1165~1172 (2013)
- Sung J, "Development of Korean Activity Scale", Index(KASI), 2000, pp.30, 1004~1009
- McMurray JJ, "Dual angiotensin receptor and neprilysin inhibition as an alternative to angiotensin-converting enzyme inhibition in patients with chronic systolic heart failure : rationale for and design of the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial(PARADIGM-HF)", Eur J Heart Fail, 15, pp.1062~1073 (2013)
- Wong M, "Signs and symptoms in chronic heart failure : relevance of clinical trial results to point of care-data from Val-HeFT", Eur J Heart Fail, 8, pp.502~508 (2006)
- Latini R, "Incremental prognostic value of changes in B-type natriuretic peptide in heart failure", Am J Med, 119, pp.70~ (2006)
- 이영수, "Effect of Valsartan on N-Terminal Pro-Brain Natriuretic Peptide in Patient With Stable Chronic Heart Failure:Comparison With Enalapril", Korean Circulation Journal, 41(2), pp.61~67 (2011), 대한심장학회
- Berezin AE, "The utility of biomarker risk prediction score in patients with chronic heart failure", Clin Hypertens, 22, pp.3~ (2015)
- Latif F, "Angiotensin II type 1 receptor blockade with 80 and 160mg valsartan in healthy, normotensive subjects", J Card Fail, 7, pp.265~268 (2001)
- 김성식, "Evaluation of Cardiac Function by Transthoracic Echocardiography in Subjects with ST-Segment Elevation Myocardial Infarction Following Primary Percutaneous Coronary Intervention according to Valsartan Dose: The Valsartan One Center Trial", Journal of Cardiovascular Imaging, 18(3), pp.77~83 (2010), 한국심초음파학회
- Michael Böhm, "Renal Denervation for Chronic Heart Failure: Background and Pathophysiological Rationale", Korean Circulation Journal, 47(1), pp.9~15 (2017), 대한심장학회
- 박정의, "Valsartan", Amlodipine 160, Korean Circulation Journal, pp.2016, 46(2)[DOI]
- Cheng HM, "Usefulness of systolic time intervals in the identification of abnormal ventriculo-arterial coupling in stable heart failure patients", Eur J Heart Fail, 10, pp.1192~1200 (2008)
- Kosmala W, "Contributions of nondiastolic factors to exercise intolerance in heart failure with preserved ejection fraction", J Am Coll Cardiol, 67, pp.659~670 (2016)
- Cohn JN, "Effect of vasodilator therapy on mortality in chronic congestive heart failure. Results of a Veterans Administration Cooperative Study", N Engl J Med, 314, pp.1547~1552 (1986)
- Razzolini R, "Effects of carvedilol on ventriculo-arterial coupling in patients with heart failure", Ital Heart J, 5, pp.517~522 (2004)
- Dekleva M, "Improvement of ventricular-arterial coupling in elderly patients with heart failure after beta blocker therapy : results from the CIBIS-ELD trial", Cardiovasc Drugs Ther, 29, pp.287~294 (2015)
- 이혜림, "Left ventricular hypertrophy and diastolic function in children and adolescents with essential hypertension", Clinical Hypertension, 21(20), pp.1~6 (2015), 대한고혈압학회[DOI]
- Vizzardi E, "Effects of spironolactone on ventricular-arterial coupling in patients with chronic systolic heart failure and mild symptoms", Clin Res Cardiol, 104, pp.1078~1087 (2015)
- Lam CS, "Effect of antihypertensive therapy on ventricular-arterial mechanics, coupling, and efficiency", Eur Heart J, 34, pp.676~683 (2013)