Effect of Valsartan on N-Terminal Pro-Brain Natriuretic Peptide in Patient With Stable Chronic Heart Failure: Comparison With Enalapril.
- Author:
Young Soo LEE
1
;
Kee Sik KIM
;
Jin Bae LEE
;
Jae Kean RYU
;
Ji Yong CHOI
;
Byong Kyu KIM
;
Sung Gug CHANG
;
Seung Ho HUR
;
Bong Ryeol LEE
;
Byung Chun JUNG
;
Geu Ru HONG
;
Byung Soo KIM
;
Tae Ho PARK
;
Young Dae KIM
;
Tae Ik KIM
;
Dong Soo KIM
Author Information
- Publication Type:Multicenter Study ; Original Article ; Clinical Trial
- Keywords: Brain natriuretic peptide; Angiotensin-converting enzyme inhibitors; Angiotensin receptor blocker; Congestive heart failure
- MeSH: Angiotensin-Converting Enzyme Inhibitors; Angiotensins; C-Reactive Protein; Enalapril; Heart; Heart Failure; Humans; Natriuretic Peptide, Brain; Peptidyl-Dipeptidase A; Plasma; Prospective Studies; Renin-Angiotensin System; Stroke Volume; Tetrazoles; Valine; Valsartan
- From:Korean Circulation Journal 2011;41(2):61-67
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND AND OBJECTIVES: The plasma concentration of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is a st-rong prognostic indicator for patients with heart failure (HF) across all stages of the condition. Several clinical trials have de-monstrated convincingly that neurohormonal modulation on the renin angiotensin system (RAS) decreases plasma NT-pro-BNP level and results in favorable outcomes. But there are still limited comparative data on the neuro-hormonal modulatory effects of two RAS inhibitors: angiotensin converting enzyme inhibitor and angiotensin receptor blocker. SUBJECTS AND METHODS: This study was a prospective, multi-center, randomized, open-label, controlled, and non-inferiority study involving 445 patients with left ventricular ejection fraction (LVEF) less than 45%. Patients were assigned to receive either valsartan (target dose of 160 mg bid) or enalapril (target dose of 10 mg bid) for 12 months. We compared plasma NT-pro-BNP, high sensitive C-reactive protein (hs-CRP) level and echocardiographic parameters before and after treatment with valsartan or enalapril. RESULTS: The NT-pro-BNP and hs-CRP levels were significantly decreased after 12 months of treatment with valsartan and enalapril. The percentage change was similar between both groups. LVEF improved and left ventricular internal dimensions were decreased in both groups, and there were no significant differences between two groups. CONCLUSION: Valsartan is as effective on improving plasma NT-pro-BNP level as enalapril in patients with stable chronic HF.
