# Valsartan en linkerkamerremodellering na MI

*geplaatst 2018-04-01 · Algemeen · ESC heart failure · doi 10.1002/ehf2.12249 · https://hartvaat.nl/2018/04/01/valsartan-en-linkerkamerremodellering-na-mi/*

Studie naar de impact van valsartandosering op post-MI linkerkamerremodellering. Onderzoekt het dosis-responseffect van RAAS-blokkade na een infarct.

## English: The impact of a dose of the angiotensin receptor blocker valsartan on post-myocardial infarction ventricular remodelling.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: ESC heart failure, https://doi.org/10.1002/ehf2.12249. Bijgewerkt 2026-07-03T18:38:37Z. 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.