A randomized, double-blind, placebo-controlled study to determine the effects of valsartan on exercise time in patients with symptomatic heart failure with preserved ejection fraction

Hari K. Parthasarathy, Burkert Pieske, Marianne Weisskopf, Chris D. Andrews, Patrick Brunel, Allan D. Struthers, Thomas M. MacDonald

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    Abstract

    Aims To determine whether valsartan improves treadmill exercise time, in patients with symptomatic heart failure with a preserved ejection fraction (HFPEF), compared with placebo.

    Methods and results In this multicentred, double-blind, 14-week study, patients were randomized to receive valsartan (V) 80 mg or placebo (P) once daily on top of background medications. The dose of valsartan was force-titrated up to 320 mg. A total of 152 patients were randomized (V = 70, P = 82). Most patients had well-controlled hypertension (V = 91.2%, P = 89.0%) (mean baseline systolic BP similar to 130 mmHg) and >50% were receiving an angiotensin-converting enzyme inhibitor and/or beta-blocker (V = 57.4%, P = 54.9%). The mean ejection fraction at baseline was 70.48% in the placebo group (n = 64) and 71.52% in the valsartan group (n = 79). Valsartan had no significant effect on exercise time (primary variable), gas exchange variables, 6 min walk test distance, exertion-related symptoms, brain natriuretic peptide levels, echocardiographic parameters, or quatity-of-life scores. Valsartan significantly lowered peak exercise systolic BP (-13.1 mmHg vs. placebo; P < 0.001) and improved ratings of perceived exertion (Borg score) (-0.69 vs. placebo; P = 0.008).

    Conclusion In this population, which predominantly included patients with well-controlled hypertension and symptomatic HFPEF, addition of valsartan did not increase exercise time within 14 weeks. However, valsartan 320 mg reduced blood pressure and improved symptoms of perceived exertion (Borg score) during exercise and was generally well-tolerated.

    Original languageEnglish
    Pages (from-to)980-989
    Number of pages10
    JournalEuropean Journal of Heart Failure
    Volume11
    Issue number10
    DOIs
    Publication statusPublished - Oct 2009

    Keywords

    • Heart failure with preserved ejection fraction
    • Echocardiography
    • Exercise time
    • Placebo
    • Quality of life
    • Valsartan
    • BLOOD-PRESSURE RESPONSE
    • BRAIN NATRIURETIC PEPTIDE
    • DIASTOLIC DYSFUNCTION
    • ANGIOTENSIN-II
    • TRIAL
    • HYPERTENSION
    • TOLERANCE
    • CANDESARTAN
    • ENALAPRIL
    • COMMUNITY

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