{"id":"29d0f4e06e77","type":"article","url":"https://hartvaat.nl/2018/04/01/valsartan-en-linkerkamerremodellering-na-mi/","title":"Valsartan en linkerkamerremodellering na MI","title_en":"The impact of a dose of the angiotensin receptor blocker valsartan on post-myocardial infarction ventricular remodelling.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-hartfalen","bloeddrukbehandeling","secundaire-preventie","ventrikelfibrilleren"],"journal":"ESC heart failure","doi":"10.1002/ehf2.12249","source_url":"https://doi.org/10.1002/ehf2.12249","authors":["Kyungil Park","Young-Dae Kim","Ki-Sik Kim","Su-Hoon Lee","Tae-Ho Park","Sang-Gon Lee","Byung-Soo Kim","Seung-Ho Hur","Tae-Hyun Yang","Joo-Hyun Oh","Taek-Jong Hong","Jong-Sun Park","Jin-Yong Hwang","Byungcheon Jeong","Woo-Hyung Bae"],"significance":5,"published":"2018-04-01","source_date":"2018-04-01","image":"","kennis":[],"congress":"","summary_en":"This study examined the impact of valsartan dose on post-MI ventricular remodeling, testing whether achieving higher doses of ARB therapy provides additional structural cardiac benefit beyond lower-dose treatment.","created":"2026-07-03T10:27:12Z","updated":"2026-07-03T18:38:37Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie naar de impact van valsartandosering op post-MI linkerkamerremodellering. Onderzoekt het dosis-responseffect van RAAS-blokkade na een infarct.","abstract_original":"AIMS: Although clinical guidelines advocate the use of the highest tolerated dose of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers after acute myocardial infarction (MI), the optimal dosing or the risk-benefit profile of different doses have not been fully identified. METHODS AND RESULTS: In this multicentre trial, 495 Korean patients with acute ST segment elevation MI and subnormal left ventricular (LV) ejection fraction (<50%) were randomly allocated (2:1) to receive maximal tolerated dose of valsartan (titrated up to 320 mg/day, n = 333) or low-dose valsartan (80 mg/day, n = 162) treatment. The primary objective was to assess the changes in echocardiographic parameters of LV remodelling from baseline to 12 months after discharge. After treatment, end-diastolic LV volume (LVEDV) decreased significantly in the low-dose group, but the difference in LVEDV changes was insignificant between the maximal-tolerated-dose and low-dose groups. End-systolic LV volume decreased significantly in both groups, to a similar degree between groups. LV ejection fraction rose significantly in both study groups, to a similar degree. Changes in plasma levels of neurohormones were also comparable between the two groups. Drug-related adverse effects occurred more frequently in the maximal-tolerated-dose group than in the low-dose group (7.96 vs. 0.69%, P < 0.001). CONCLUSIONS: In the present study, treatment with the maximal tolerated dose of valsartan did not exhibit a superior effect on post-MI LV remodelling compared with low-dose treatment and was associated with a greater frequency of adverse effect in Korean patients. Further study with a sufficient number of cases and statistical power is warranted to verify the findings of the present study."}