Body Mass Index, Valsartan, and Myocardial Remodeling in Early-Stage Hypertrophic Cardiomyopathy: A Secondary Analysis of the Randomized VANISH Trial.

What was studied

This was a later look at the VANISH trial of valsartan. The people had early hypertrophic cardiomyopathy, a heart muscle disease. The team asked about body mass index, or BMI. Heart scans and exercise were compared by starting BMI and by 2-year BMI change. 171 people were included. 82 had a nonelevated BMI and 89 had an elevated BMI.

What they found

Higher starting BMI went with lower peak oxygen uptake and higher left ventricle mass. Bigger BMI gains over 2 years went with bigger drops in peak oxygen uptake. Late gadolinium enhancement was more common over 2 years in people with elevated BMI. The odds ratio was 3.6. Valsartan appeared to slightly blunt weight gain versus placebo. BMI did not appear to change the effect of valsartan on heart remodeling.

What it means for patients

The authors said elevated BMI was common in early disease. They said it went with more hypertrophic, eccentric and fibrotic remodeling. They said BMI gains went with more disease progression. They said preventing and treating elevated BMI may slow progression of the disease.

Why it is not certain yet

This was a post hoc analysis of a trial. The authors call the weight effect of valsartan modest. Most participants were White. The mean age was 23 years.

Source

Body Mass Index, Valsartan, and Myocardial Remodeling in Early-Stage Hypertrophic Cardiomyopathy: A Secondary Analysis of the Randomized VANISH Trial.

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