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Valsartan benefits left ventricular structure and function in heart failure: Val-HeFT echocardiographic study

Maylene Wong, MD, FACC^*,*, Lidia Staszewsky, MD, Roberto Latini, MD, Simona Barlera, MS, Alberto Volpi, MD, FACC, Yann-Tong Chiang, PhD, Raymond L. Benza, MD, FACC^||, Sidney O. Gottlieb, MD, FACC^¶, Thomas D. Kleemann, MD^#, Franco Rosconi, MD^**, Pieter M. Vandervoort, MD, FACC, Jay N. Cohn, MD, FACC Val-HeFT Heart Failure Trial Investigators

^* VA Greater Los Angeles Healthcare System and University of California at Los Angeles, California, USA
Istituto Mario Negri, Milan, Italy
Istituto Mario Negri and "C Borella" Hospital, Milan, Italy
Novartis Pharmaceuticals, East Orange, New Jersey, USA
^|| University of Alabama, Birmingham, Alabama, USA
^¶ Mid-Atlantic Cardiovascular Associates, Baltimore, Maryland, USA
^# Herzzentrum Ludwigshafen, Ludwigshafen, Germany
^** Ospedale Passirana di Rho, Milan, Italy
Hartcentrum Limburg, Genk, Belgium
University of Minnesota, Minneapolis, Minnesota, USA

View larger version (26K): [in a new window]   Figure 1 Effects of valsartan on left ventricular internal diastolic diameter/body surface area (LVIDd/BSA) and ejection fraction (EF) compared to placebo: change from baseline to month of observation. The histobars represent mean changes (adjusted for effects for treatment group, pooled center, baseline value, baseline use of angiotensin-converting enzyme inhibitor or beta blocker, and treatment by baseline value interaction by analysis of covariance) between baseline values and those at months 4, 12, 18, 24, and at end point (last observation available carried forward) for valsartan (black bars) and placebo (white bars). Baseline values at each observation period are adjusted for the number of patients with available data. Change is expressed in absolute units for EF (%) and LVIDd/BSA (cm/m2). The p values for the between-treatment comparison are determined from least-squares mean change.

View larger version (20K): [in a new window]   Figure 2 Effects of valsartan on left ventricular internal diastolic diameter/body surface area (LVIDd/BSA) and ejection fraction (EF) compared to placebo by co-treatment group: change from baseline to end point. The histobars represent mean changes (adjusted for effects for treatment group, pooled center, baseline value, baseline use of angiotensin-converting enzyme inhibitor [ACEI] and/or beta-blocker [BB], and treatment-by-baseline value interaction by analysis of covariance) between baseline values and those at end point (last observation available carried forward) for co-treatment subgroups randomized to valsartan (black bars) and placebo (white bars) groups. Baseline values at each observation period are adjusted for the number of patients with available end point data. Change is expressed in absolute units for EF (%) and LVIDd/BSA (cm/m2). The p values for the valsartan versus placebo comparison are determined from least-squares mean change. Subgroups are designated by (+) = co-treatment and (–) = not a co-treatment with ACEI and BB.