Heart failure & cardiomyopathies
Valsartan and Cardiac Remodeling in Early-Stage Hypertrophic Cardiomyopathy: The VANISH Randomized Clinical Trial Cardiac Magnetic Resonance Substudy
Authors' conclusion
These findings enhance mechanistic insights into the effect of valsartan in early-stage HCM, showing potential benefits on biventricular remodeling and myocardial intracellular volume.
Study context
- Population
- Individuals aged 8 to 45 years with early-stage sarcomeric hypertrophic cardiomyopathy (HCM) and no or minimal symptomsof 178 VANISH participants
- Participants
- 137 individuals
- Comparison
- Valsartan vs placebo
- Primary endpoint
- Mean change in CMR parameters, including indexed extracellular volume (iECV), indexed intracellular volume (iICV) and late gadolinium enhancement (LGE)
- Follow-up
- Baseline to year 2
Methodological detailsprespecified cardiac magnetic resonance (CMR) substudy, 17 international sites, Conducted April 2014 through July 2019
- Prespecified CMR substudy
- 17 international sites
- Conducted April 2014 through July 2019
Primary result
As reported in the abstract
Valsartan vs PlaceboMD, mL/m2 (95% CI)P value
iICV progression
−5.0(−9.7 to −0.4)
P = 0.03iECV
0.0(−1.4 to 1.3)
P = 0.95Valsartan vs PlaceboMD, % (95% CI)P value
LGE progression
0.5(−0.4 to 1.3)
P = 0.30Further findings
| Outcome | MD (mL/m²) (95% CI) | P value | |
|---|---|---|---|
| LV end-diastolic volume index · Baseline to year 2 | 3.3 (0.4–6.2) | P = 0.03 | |
| −50510Difference, mL/m² (linear scale) |
| Outcome | MD (g/m²) (95% CI) | P value | |
|---|---|---|---|
| LV mass index · Baseline to year 2 | −2.9 (−6.1 to 0.2) | P = 0.07 | |
| −10−505Difference, g/m² (linear scale) |
LVEF and RV volumes · Baseline to year 2
- No significant impact on LVEF
- Valsartan appeared to reduce decline in RV volumes
Original publication
Valsartan and Cardiac Remodeling in Early-Stage Hypertrophic Cardiomyopathy: The VANISH Randomized Clinical Trial Cardiac Magnetic Resonance Substudy. JAMA Cardiol. Published 1 June 2025. doi:10.
Summarised from the published abstract; every number is checked against it