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

Abstract

I In nt tr ro od du uc ct ti io on nAcute myocardial infarction (MI) is frequently associated with left ventricular (LV) remodeling leading to progressive heart failure (HF). LV remodeling after acute MI is an impor- DOI: 10.4250/jcu.2010.18.3.77 E Ev va al lu ua at ti io on n o of f C Ca ar rd di ia ac c F Fu un nc ct ti io on n b by y T Tr ra an ns st th ho or ra ac ci ic c E Ec ch ho oc ca ar rd di io og gr ra ap ph hy y i in n S Su ub bj je ec ct ts s w wi it th h S ST T--S Se eg gm me en nt t E El le ev va at ti io on n M My yo oc ca ar rd di ia al l I O OR RI IG GI IN NA AL L A AR RT TI IC CL LE EIn nf fa ar rc ct ti io on n F Fo ol ll lo ow wi in ng g P Pr ri im ma ar ry y P Pe er rc cu ut ta an ne eo ou us s C Co or ro on na ar ry y I In nt te er rv ve en nt ti io on n a ac cc co or rd di in ng g t to o V Va al ls sa ar rt ta an n D Do os se e: : T Th he e V Va al ls sa ar rt ta an n O On ne e C Ce en nt te er r T Tr ri ia al l 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. C Co on nc cl lu us si io on n: : 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.

Valsartan Dosage on Ventriculo-Vascular Coupling Index Dose-Dependency in Heart Failure Patients

“… 18 In another study, a higher dose of valsartan (160 mg or 320 mg per day) improved wall motion abnormalities better in patients with ST-segment elevation myocardial infarction who underwent primary percutaneous coronary intervention. 19 We can infer that higher doses, especially the CD, of valsartan are more effective in managing HF through a mechanism possibly involving angiotensin II receptors and the sympathetic nervous system. 18 20 21 In our study, the CD of valsartan improved not only systolic and diastolic parameters as measured by transthoracic echocardiography, but also interactions between the ventricles and arteries (VVI) in patients with HFrEF.…”