Role of ARNi in Ventricular Remodeling in Hypertensive LVH (REVERSE-LVH)

  • End date
    Dec 31, 2023
  • participants needed
  • sponsor
    National Heart Centre Singapore
Updated on 14 May 2022


In Singapore, hypertension is very common in the adult population. Hypertensive heart disease is a leading cause of heart failure and cardiovascular death. Current management relies primarily on achieving blood pressure targets. However, the optimal blood pressure goals are controversial and there are inherent difficulties in measuring blood pressure using external devices applied to peripheral arteries. As a result of (usually longstanding) hypertension, the heart thickens (i.e. hypertrophies) to maintain function. Ultimately, HF may occur due to long standing energy deficits, muscle injury/death and diffuse interstitial fibrosis (heart muscle scarring). In an ongoing study (REMODEL, Identifier NCT02670031), we have been able to undertake preliminary analyses with respect to factors associated with the development of fibrosis. In this randomize controlled trial, we will be examining a novel therapy that has the potential to induce regression cardiac hypertrophy and fibrosis.

Condition Hypertensive Heart Disease
Treatment Valsartan, Entresto
Clinical Study IdentifierNCT03553810
SponsorNational Heart Centre Singapore
Last Modified on14 May 2022


Yes No Not Sure

Inclusion Criteria

Increased left ventricular mass on cardiovascular magnetic resonance (based on established local age- and sex-specific CMR ranges)
Essential hypertension

Exclusion Criteria

Known secondary causes of hypertension
Previous intolerance to angiotensin receptor blockers
History of heart failure
Stage IV/V chronic renal disease (eGFR < 30ml/min/1.73m2)
Patients with serum potassium > 5.2 mmol/L (mEg/L) at Visit 1
History of cardiovascular events (myocardial infarction, strokes and transient ischemic attacks)
Known atrial fibrillation
Being unable to understand or comply with study procedures (including CMR)
History or presence of any other disease with a life expectancy of < 3 years
Pregnant or nursing (lactating) women
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