J Cardiovasc Ultrasound.  2010 Sep;18(3):77-83. 10.4250/jcu.2010.18.3.77.

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

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea School of Medicine, Seoul, Korea. jhkmht@catholic.ac.kr

Abstract

BACKGROUND
The aim of this study was to evaluate the mid-term changes in cardiac function by transthoracic echocardiogram (TTE) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) according to valsartan dose.
METHODS
Between April 2006 and February 2009, 78 subjects (mean age: 57 +/- 12 years, M : F = 74 : 4) with STEMI who underwent primary PCI were enrolled. Fifty three patients received low dose valsartan (40 or 80 mg) and 25 patients received high dose valsartan (160 or 320 mg). Follow-up TTE was done approximately 2 years later. We evaluated the changes in left ventricular (LV) function between initial and final TTE after primary PCI and compared the changes between low and high dose valsartan group.
RESULTS
The mean follow-up TTE duration was 24 +/- 8 months. Deceleration time (188.6 +/- 56.3 msec vs. 221.5 +/- 71.3 msec, p = 0.01), E/e' (12.24 +/- 5.2 vs. 10.1 +/- 4.9, p = 0.002), ejection fraction (52.7 +/- 8% vs. 55.2 +/- 8.4%, p < 0.01), and wall motion score index (1.45 +/- 0.30 vs. 1.33 +/- 0.32, p < 0.01) showed significant changes during the follow-up period. Wall motion improvement in injured myocardial segments was more frequently observed in the high-dose valsartan group compared to the low-dose group [18/25 (72%) vs. 24/53 (43.7%), p = 0.03]. There was no significant difference in the changes in cardiac dimensions and function between the low and high dose valsartan group.
CONCLUSION
In patients with STEMI who undergoing primary PCI, high-dose valsartan treatment may be more helpful than low-dose in improving wall motion in the injured myocardium.

Keyword

Angiotensin II type 1 receptor blockers; Percutaneous transluminal coronary angioplasty; Myocardial infarction

MeSH Terms

Angioplasty, Balloon, Coronary
Angiotensin II Type 1 Receptor Blockers
Deceleration
Echocardiography
Follow-Up Studies
Humans
Myocardial Infarction
Myocardium
Percutaneous Coronary Intervention
Tetrazoles
Valine
Valsartan
Angiotensin II Type 1 Receptor Blockers
Tetrazoles
Valine

Figure

  • Fig. 1 Study design. STEMI: ST-segment elevation myocardial infarction, PCI: percutaneous coronary intervention, BP: blood pressure, TTE: transthoracic echocardiography.

  • Fig. 2 Comparison of the percent of patients according to improvement of wall motion in the injured myocardium between low- and high-dose valsartan groups


Cited by  1 articles

The Effect of High-Dose Valsartan on Left Ventricular Function Following Primary Percutaneous Coronary Intervention
Tae-Ho Park
J Cardiovasc Ultrasound. 2010;18(3):84-85.    doi: 10.4250/jcu.2010.18.3.84.


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