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Val-HeFT: changing the heart failure horizon

J.N. Cohn*

University of Minnesota, Minneapolis, Minnesota, U.S.A.

* Jay N. Cohn, University of Minnesota, 401 E River Rd, Minneapolis, MN 55455, U.S.A.

Abstract

The Valsartan Heart Failure Trial (Val-HeFT) established that the angiotensin receptor blocker valsartan is effective for reducing morbidity and slowing the progression of heart failure in patients already taking angiotensin-converting enzymes or beta blockers. In patients not receiving ACE inhibitors, valsartan significantly improves mortality. This review surveys the results from Val-HeFT and makes the point that the concordance between mechanistic data and overall clinical outcomes indicates that neurohormones, echocardiographic data and other parameters might be legitimate surrogate markers in place of clinical outcomes in future heart-failure trials.

Key Words: ACE inhibitor intolerance • angiotensin receptor • blocker • echocardiography • neurohormones • valsartan

References

  1. Cohn JN, Tognoni G, Valsartan Heart Failure Trial Investigators. A randomized trial of the angiotensin-receptor blocker valsartan in chronic heart failure. N Engl J Med. 2001;345:1667–1675[Abstract/Free Full Text]
  2. Carson P, Cohn J. Effect of valsartan on time-adjusted and hospitalization frequency rate in the valsartan heart failure trial. J Am Coll Cardiol. 2002;39:168A
  3. Holwerda NJ, Opie L, Feliciano N, et al. Effect of valsartan on morbidity in heart failure patients with a history of hypertension: results from the Valsartan Heart Failure Trial. [abstract]J Am Coll Cardiol. 2002;39(suppl A):843FO–845FO
  4. Wong M, Staszessky L, Latini R, et al. Valsartan benefits left ventricular structure and function in heart failure: Val-HeFT echocardiographic study. J Am Coll Cardiol. 2002;40:970–975vi[Abstract/Free Full Text]
  5. Latini R, Masson S, Anand I, et al. Effects of valsartan on circulating brain natriuretic peptide and norepinephrine in symptomatic chronic heart failure: the Valsartan Heart Failure Trial (Val-HeFT). Circulation. 2002;106:2454–2458[Abstract/Free Full Text]
  6. Anand I, Latini R, Masson S, et al. Valsartan caused as sustained decrease in plasma aldosterone in Val-HeFT independent of concomitant ACE-inhibitor and/or beta-blocker therapy. Circulation. 2002;106:II-1–II-992
  7. Anand I, Latini R, Masson S, et al. The predictive value of combinations of different levels of brain natriuretic peptide and norepinephrine in the Val-HeFT trial. J Am Coll Cardiol. 2002;39:269A
  8. Maggioni AP, Anand I, Gottlieb SO, et al. Effects of valsartan on morbidity and mortality in patients with heart failure not receiving angiotensin-converting enzyme inhibitors. J Am Coll Cardiol. 2002;40:1414–1421[Abstract/Free Full Text]
  9. The CONSENSUS Trial Study Group. Effects of enalapril on mortality in severe congestive heart failure. Results of the Cooperative North Scandinavian Enalapril Survival Study (CONSENSUS). N Engl J Med. 1987;316:1429–1435[Web of Science][Medline]
  10. Campbell DJ, Aggarwal A, Esler M, et al. ß-blockers, angiotensin II, and ACE inhibitors in patients with heart failure. Lancet. 2001;358:1609–1610[CrossRef][Web of Science][Medline]
  11. Swedberg K, Pfeffer M, Granger C, et al. Candesartan in heart failure — assessment of reduction in mortality and morbidity (CHARM): rationale and design. CHARM Programme Investigators. J Card Fail. 1999;5:276–282[CrossRef][Medline]
  12. Pfeffer MA, McMurray J, Leizorovicz A, et al. Valsartan in acute myocardial infarction trial (VALIANT): rationale and design. Am Heart J. 2000;140:727–730[CrossRef][Web of Science][Medline]
  13. Bart BA, Gattis WA, Diem SJ, et al. Reasons for the under-use of angiotensin-converting enzyme inhibitors in patients with heart failure and left ventricular dysfunction. Am J Cardiol. 1997;79:1118–1120[CrossRef][Web of Science][Medline]
  14. Bungard TJ, McAlister FA, Johnson JA, et al. Underutilisation of ACE inhibitors in patients with congestive heart failure. Drugs. 2001;61:2021–2033[CrossRef][Web of Science][Medline]
  15. McDermott MM, Feinglass J, Lee P, et al. Heart Failure between 1986 and 1994: temporal trends in drug-prescribing practices, hospital readmissions, and survival at an academic medical center. Am Heart J. 1997;134:901–909[CrossRef][Web of Science][Medline]
  16. Rich MW, Brooks K, Luther P. Temporal trends in pharmacotherapy for congestive heart failure at an academic medical center: 1990–1995. Am Heart J. 1998;135:367–372[CrossRef][Web of Science][Medline]
  17. Reis SE, Holubkov R, Edmundowicz D, et al. Treatment of patients admitted to hospital with congestive heart failure: specialty-related disparities in practice patterns and outcome. J Am Coll Cardiol. 1997;30:733–738[Abstract]
  18. Bart BA, Ertl G, Held P, et al. Contemporary management of patients with left ventricular systolic dysfunction. Results from the Study of Patients Intolerant of Converting Enzyme Inhibitors (SPICE) Registry. Eur Heart J. 1999;20:1182–1190[Abstract/Free Full Text]
  19. Gattis WA, Larsen RL, Hasselblad V, et al. Is optimal angiotensin-converting enzyme inhibitor dosing neglected in elderly patients with heart failure? Am Heart J. 1998;136:43–48[CrossRef][Web of Science][Medline]
  20. Howard PA, Shireman TI, Dhingra A, et al. Patterns of ACE inhibitor use in elderly medicated patients with heart failure. Am J Geriatr Cardiol. 2002;11:287–294[Medline]
  21. Shah MR, Hasselblad V, Stevenson LW, et al. Advanced heart failure patients unable to reach ACE inhibitor targets: a high risk population identified during hospitalisation. [abstract]J Am Coll Cardiol. 2002;39(suppl A):858
  22. Marentette MA, Gerth WC, Billings DK, et al. Antihypertensive persistence and drug class. Can J Cardiol. 2002;18:649–656[Web of Science][Medline]
  23. Degli Esposti E, Sturani A, Di Martino M, et al. Long-term persistence with antihypertensive drugs in new patients. J Hum Hypertens. 2002;16:439–444[CrossRef][Web of Science][Medline]

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