Valsartan decreases type I collagen synthesis in patients with hypertrophic cardiomyopathy.
BACKGROUND
Fibrosis, as well as myocyte hypertrophy, is the major determinant of prognosis in hypertrophic cardiomyopathy (HCM). Valsartan, an angiotensin II type 1 receptor blocker, may improve myocardial fibrosis in patients with HCM.


RESULTS
Twenty-three patients with HCM were randomly divided into 2 groups: 11 patients had valsartan added to conventional treatment (V group) and 12 patients received the conventional therapy (C group). Plasma concentrations of brain natriuretic peptide (BNP), troponin T (TnT), aldosterone (ALDO), procollagen type I (PIP) and procollagen type III aminoterminal peptide (PIIINP) were measured before and 12 months after this study. Left ventricular wall thickness (LVWT) and ejection fraction (LVEF) were measured by echocardiography. PIP was decreased in the V group (123.2+/-63.1 ng/ml to 102.8+/-37.6, p<0.05), but unchanged in C group (110+/-40.5 ng/ml to 119.9+/-47.4, p=0.22). ALDO concentration was unchanged in the V group (88.5+/-26.2 pg/ml to 91.2+/-26.8, p=0.27), and increased in C group (92.6+/-36.6 ng/ml to 116.0+/-33.3, p<0.05). BNP, PIIINP, and TnT were unchanged by the treatment. There was no significant difference between the 2 groups in either LVWT or LVEF.


CONCLUSIONS
Valsartan suppresses the synthesis of type I collagen in patients with HCM and this was associated with suppression of the increase in ALDO.
Kawano
Hiroaki
H
Department of Cardiovascular Medicine, Course of Medical and Dental Science, Graduate School of Biomedical Science, Nagasaki University, Japan. hkawano@net.nagasaki-u.ac.jp
Toda
Genji
G
Nakamizo
Reiichirou
R
Koide
Yuji
Y
Seto
Shinji
S
Yano
Katsusuke
K
D000328:Adult; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000008:administration & dosage*; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D024042:Collagen Type I / Q000096:biosynthesis*; D005260:Female; D005355:Fibrosis / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology*; D013777:Tetrazoles; D014633:Valine / Q000031:analogs & derivatives; D000068756:Valsartan
D047228:Angiotensin II Type 1 Receptor Blockers; D024042:Collagen Type I; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine