Heart failure & cardiomyopathies
Cardiac Remodeling in Subclinical Hypertrophic Cardiomyopathy: The VANISH Randomized Clinical Trial
Primary result · Composite z score changeResult — go to the resultMean change in composite z score −0.01 95% CI −0.29 to 0.26Authors' conclusion
In this exploratory cohort, valsartan was not proven to slow progression of subclinical HCM.
Study context
- Population
- Sarcomere variant carriers with subclinical hypertrophic cardiomyopathy (HCM) and early phenotypic manifestations but no LV hypertrophy; 17 sites in 4 countriesmean age 16 years
- Participants
- 34 carriers
- Comparison
- Valsartan vs placebo
- Valsartann = 18
- Placebon = 16reference
- Primary endpoint
- Composite z score of changes in 9 cardiac remodeling parameters (LV cavity volume, LVWT, LV mass, LA volume, E' and S' velocity, serum troponin and NT-proBNP)
- Follow-up
- 2 years
Methodological detailsmulticentre, double-blind, placebo-controlled, prespecified exploratory cohort, Conducted April 2014 to July 2019; data analysed March–December 2022
- Multicentre
- Double-blind
- Placebo-controlled
- Prespecified exploratory cohort
- Conducted April 2014 to July 2019; data analysed March–December 2022
Primary result
Composite z score change
Mean change in composite z score
−0.01
95% CI −0.29 to 0.26
P = 0.92
As reported in the abstract
Further findings
LA volume change (overall cohort) · 2 years
- Increase in LA volume
- 3.5 mL/m² (95% CI, 1.4-6.0 mL/m²); P = .002
Increased LVWT and clinically overt HCM (overall cohort)
- Increased LVWT
- 9 (26%)
- Developed clinically overt HCM
- 6 (18%)
Baseline predictors in those who developed HCM vs not
- Baseline LA volume index (LAVI)
- 35 vs 28 mL/m²; P = .01
- Interventricular septum thickness
- 8.5 vs 7.0 mm; P = .009
Original publication
Cardiac Remodeling in Subclinical Hypertrophic Cardiomyopathy: The VANISH Randomized Clinical Trial. JAMA Cardiol. Published 1 November 2023. doi:10.
Summarised from the published abstract; every number is checked against it