Comparison study of olmesartan and valsartan on myocardial metabolism in patients with dilated cardiomyopathy trial

Abstract

Abstract Background Patients with dilated cardiomyopathy (DCMP) have overactivation of the renin-angiotensin-aldosterone systems, which can adversely affect myocardial metabolism. The impairment of myocardial metabolism can contribute to the progression of left ventricular remodeling and contractile dysfunction in heart failure. The objective of this study is to compare the effects of olmesartan and valsartan on myocardial metabolism in patients with DCMP. Methods The OVOID study (a comparison study of Olmesartan and Valsartan On myocardial metabolism In patients with Dilated cardiomyopathy) was a non-blinded, open-label, parallel-group, prospective, randomized, controlled, multicenter clinical trial. that 40 patients with DCMP. Patients with DCMP were randomized into the olmesartan or the valsartan group. To measure myocardial metabolism, 18F-fluoro-2-deoxyglucose (FDG) cardiac positron emission tomography (PET) was performed at baseline and six months after receiving the study agent. The primary endpoint was myocardial metabolism as measured by standardized uptake value ratio (SUVR) at 6 months after treatment. Results The baseline clinical characteristics and 18F-FDG PET data did not differ between the olmesartan and valsartan groups. LVEF rose significantly from baseline in both groups to a similar degree between the two groups (both P < 0.01). The level of N-terminal pro hormone B-type natriuretic peptide (NT-proBNP) decreased significantly from baseline in the both high- and usual-dose groups (both P < 0.01). The magnitude of NT-proBNP change was not significantly different between the two groups (P = 0.33). However, six-month follow-up 18F-FDG PET showed that SUVG value was significantly lower in the olmesartan group than the valsartan (3.76±2.12 versus 7.33±4.08, P = 0.01). Conclusions Compared to valsartan, six months of olmesartan therapy significantly improved myocardial metabolism in DCMP patients.