[Reparative effects of ACE inhibitors on the heart].
Diastolic dysfunction is often present in patients with arterial hypertension. It is not only the consequence of an increased left ventricular muscle mass but also due to a progressive fibrosis of the cardiac interstitium. Experimental studies have shown a close relationship between the degree of interstitial cardiac fibrosis and the activity of the renin-angiotensin system (RAS). Reversal of collagen deposition can be induced by inhibition of the RAS. The purpose of this study was to evaluate the therapeutic potential of ACE inhibitors not only in lowering blood pressure in patients with essential hypertension, but also in normalizing an impaired diastolic filling pattern in the left ventricle. Monotherapy with a single dose of 2.5-5 mg Cilazapril for a period of 6 months was effective in reducing mean arterial blood pressure by about 10 mmHg over the entire 24-h interval. The main reduction occurred throughout the day, but lower blood pressure values during the night were hardly affected at all. The pre- and post-treatment values of the 24-h blood pressure were subjected to a modified Fourier analysis, which did not reveal any disturbances in the circadian blood pressure rhythm by the ACE inhibitor. Left ventricular mass, as calculated from echocardiographic measurements, was reduced by 30% after 6 months of treatment. The degree of regression of LV hypertrophy was closely related to the drug-induced fall in mean arterial pressure. The abnormal left ventricular filling pattern before treatment with a predominance of the late diastolic filling period was corrected by 6 months of ACE inhibitor treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Dietz
R
R
Innere Medizin III (Abteilung für Kardiologie, Pulmologie, Angiologie), Universität Heidelberg.
Haberbosch
W
W
Osterziel
K J
KJ
Förderer
T
T
Busch
C
C
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D015924:Blood Pressure Monitors; D002306:Cardiac Volume / Q000187:drug effects*; D006332:Cardiomegaly / Q000188:drug therapy* / Q000503:physiopathology; D017315:Cilazapril; D004452:Echocardiography / Q000187:drug effects; D005260:Female; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011724:Pyridazines / Q000627:therapeutic use*
D000806:Angiotensin-Converting Enzyme Inhibitors; D011724:Pyridazines; D017315:Cilazapril
Kardioreparative Effekte der ACE-Hemmer.