What is the clinical evidence from this study?

Study design: RCT. Population: Heart failure (NYHA class II to IV) (n=5010). Intervention: Valsartan vs. Placebo. Primary outcome: Change in left ventricular ejection fraction (EF) at 18 months (p=<0.00001).

What does this research mean for the field?

Adding valsartan to standard heart failure therapy reverses left ventricular remodeling by significantly increasing ejection fraction and decreasing left ventricular internal diastolic diameter. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the long-term effects of valsartan on left ventricular structural remodeling and systolic function in patients with chronic heart failure.

October 2, 2026Journal of the American College of CardiologyOpen Access

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

Q: What are the key findings of this study?

Valsartan added to standard heart failure therapy significantly increased left ventricular ejection fraction (+4.5% vs +3.2%) and decreased LVIDd compared with placebo (p<0.00001).

Q: What does this research mean for the field?

Adding valsartan to standard heart failure therapy reverses left ventricular remodeling by significantly increasing ejection fraction and decreasing left ventricular internal diastolic diameter. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the long-term effects of valsartan on left ventricular structural remodeling and systolic function in patients with chronic heart failure.

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Key result

Valsartan improves LVEF by ~4.5% and reduces left ventricular dilation in heart failure.

P<0.00001
n=5,010

Why the study?

The clinical benefit of heart failure therapy is attributed to regression of left ventricular remodeling, but the effect of adding an angiotensin receptor blocker on LV structure and function needed evaluation.

Does valsartan improve left ventricular structure and function in patients with NYHA class II-IV heart failure on standard therapy?

Population

5,010 NYHA II to IV heart failure patients taking ACEI and/or beta-blocker at 302 multinational sites

Comparison

Valsartan versus placebo added to prescribed heart failure therapy

Design

Randomized controlled trial with serial echocardiographic measurements

Follow-up

Mean 22.4 months

Authors

MWMaylene WongAzienda Ospedaliera Fatebenefratelli e Oftalmico LSLidia StaszewskyHeart Failure & Transplant RLRoberto LatiniHeart Failure & Transplant

Discussion

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Implication

Valsartan added to either an ACE inhibitor or a beta-blocker significantly reverses left ventricular remodeling in patients with moderate heart failure, though this benefit is not seen when added to both.

Key Points

To evaluate the long-term effects of valsartan on left ventricular structural remodeling and systolic function in patients with chronic heart failure.
Conducted a randomized, double-blind, placebo-controlled echocardiographic substudy within the Valsartan Heart Failure Trial (Val-HeFT).
Assigned patients with heart failure to receive valsartan (target dose 160 mg twice daily) or placebo in addition to background neurohormonal therapies.
Assessed echocardiographic measures of left ventricular internal end-diastolic diameter and left ventricular ejection fraction at baseline, 12 months, and 24 months.
Valsartan significantly decreased left ventricular internal end-diastolic diameter compared with placebo over 12 and 24 months of follow-up.
Left ventricular ejection fraction increased significantly more in the valsartan group than in the placebo group.
Structural reverse remodeling benefits occurred across patient subgroups, including those receiving standard background therapy with ACE inhibitors and beta-blockers.

Study Design

Type

RCT (n=5,010)

Multicenter

Yes

Structured PICO

Does valsartan improve left ventricular structure and function in patients with NYHA class II-IV heart failure on standard therapy?

Population

5,010 patients with NYHA class II to IV heart failure taking ACE inhibitors and/or beta-blockers, followed for a mean of 22.4 months.

Intervention

Valsartan added to prescribed heart failure therapy (ACEI and/or beta-blocker)

Comparator

Placebo added to prescribed heart failure therapy (ACEI and/or beta-blocker)

Outcome

Changes in left ventricular internal diastolic diameter (LVIDd) and ejection fraction (EF) measured by serial echocardiographysurrogate

Main Result

Absolute Event Rate: 4.5% vs 3.2%

p-value: p=<0.00001

Cite This Study

Wong et al. (2002) conducted an RCT in Heart failure (NYHA class II to IV) (n=5,010). Valsartan vs. Placebo was evaluated on Change in left ventricular ejection fraction (EF) at 18 months (p=<0.00001). Valsartan added to standard heart failure therapy significantly increased left ventricular ejection fraction (+4.5% vs +3.2%) and decreased LVIDd compared with placebo (p<0.00001).

synapsesocial.com/papers/6abf21d63da3dcdf0356f62f https://doi.org/10.1016/s0735-1097(02)02063-6

Topics

Heart failure HFrEF treatment Echocardiography

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

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

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

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider