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Comprehensive Echocardiographic Assessment of Right Ventricle Function in a Rat Model of Pulmonary Arterial Hypertension
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Effect of valsartan on systemic right ventricular function: a double-blind, randomized, placebo-controlled pilot
Teun van der Bom1, Michiel M Winter, Berto J Bouma
1Department of Cardiology, Academic Medical Center, Amsterdam, Netherlands.
Circulation
|December 19, 2012
Summary
Valsartan did not improve systemic right ventricular ejection fraction in patients with transposition of the great arteries. However, valsartan therapy did reduce increases in right ventricular volumes and mass over three years.
Area of Science:
- Cardiology
- Clinical Trials
- Pharmacology
Background:
- The efficacy of angiotensin II receptor blockers (ARBs) in patients with a systemic right ventricle remains unclear.
- Transposition of the great arteries (TGA) can result in a systemic right ventricle, a condition with significant clinical implications.
Purpose of the Study:
- To investigate the role of the ARB valsartan in managing patients with a systemic right ventricle.
- To assess the impact of valsartan on right ventricular function, exercise capacity, and quality of life in TGA patients.
Main Methods:
- A multicenter, double-blind, randomized controlled trial involving 88 patients with systemic right ventricle due to TGA.
- Patients received either valsartan 160 mg twice daily or placebo for three years.
- Primary endpoint: change in right ventricular ejection fraction assessed by cardiovascular magnetic resonance imaging or multirow detector computed tomography.
Main Results:
- Three-year valsartan therapy showed no significant effect on systemic right ventricular ejection fraction, exercise capacity, or quality of life.
- Valsartan was associated with a similar safety profile to placebo, with no serious adverse events reported.
- A significantly smaller increase in right ventricular end-diastolic volume and mass was observed in the valsartan group compared to placebo.
Conclusions:
- Valsartan does not offer significant benefits for right ventricular ejection fraction, exercise capacity, or quality of life in patients with a systemic right ventricle.
- Valsartan demonstrated a favorable effect on mitigating the increase in right ventricular volumes and mass.
- The study suggests a potential role for valsartan in managing ventricular remodeling in this patient population.
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