title: Valsartan decreases type I collagen synthesis in patients with hypertrophic cardiomyopathy.
abstract: 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.
authors.affiliation: Department of Cardiovascular Medicine, Course of Medical and Dental Science, Graduate School of Biomedical Science, Nagasaki University, Japan. hkawano@net.nagasaki-u.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kawano
authors.forename: Genji
authors.initials: G
authors.lastname: Toda
authors.forename: Reiichirou
authors.initials: R
authors.lastname: Nakamizo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Koide
authors.forename: Shinji
authors.initials: S
authors.lastname: Seto
authors.forename: Katsusuke
authors.initials: K
authors.lastname: Yano
mesh_terms: 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
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D024042:Collagen Type I; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine