Abstract: AIM: To evaluate the effects of valsartan and spironolactone on collagen metabolism and heart function in patients with acute myocardial infarction (AMI). METHODS: Patients with first anterior AMI with aneurysm confirmed by left ventriculography were divided into two groups: 1) valsartan and spironolactone group, and 2) valsartan group. Serum PIII NP and PI CP were measured at 1, 2 and 12 weeks after onset of AMI. At 2 and 12 weeks after onset of AMI, the parameters of left ventricular end diastolic volume index (LVEDVI), left ventricular end systolic volume index (LVESVI), left ventricular ejection fraction (LVEF) and regional wall movement index (RWMI) were measured. RESULTS: At 12 weeks, serum PIIINP and PICP in valsartan and spironolactone group were significantly lower than in valsartan group (P<0.05), and the parameters of left ventricular function were better improved in valsartan and spironolactone group compared with valsartan group. CONCLUSION: Valsartan helps to reverse the formation of collagen and improve systolic and diastolic function in post-myocardial infarction. Combined therapy with valsartan and spironolactone is more effective than monotherapy and markedly improved systolic and diastolic function in post-myocardial infarction.