title: Effect of valsartan on N-terminal pro-brain natriuretic Peptide in patient with stable chronic heart failure: comparison with enalapril.
abstract: OBJECTIVE
  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.
  
  
  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.
  
  
  CONCLUSIONS
  Valsartan is as effective on improving plasma NT-pro-BNP level as enalapril in patients with stable chronic HF.
authors: Department of Cardiology, Catholic University of Daegu, Daegu, Korea.
authors: Young Soo
authors: YS
authors: Lee
authors: Kee Sik
authors: KS
authors: Kim
authors: Jin Bae
authors: JB
authors: Lee
authors: Jae Kean
authors: JK
authors: Ryu
authors: Ji Yong
authors: JY
authors: Choi
authors: Byong-Kyu
authors: BK
authors: Kim
authors: Sung Gug
authors: SG
authors: Chang
authors: Seung Ho
authors: SH
authors: Hur
authors: Bong Ryeol
authors: BR
authors: Lee
authors: Byung Chun
authors: BC
authors: Jung
authors: Geu Ru
authors: GR
authors: Hong
authors: Byung Soo
authors: BS
authors: Kim
authors: Tae Ho
authors: TH
authors: Park
authors: Young Dae
authors: YD
authors: Kim
authors: Tae Ik
authors: TI
authors: Kim
authors: Dong Soo
authors: DS
authors: Kim