Effect of regression of left ventricular hypertrophy following sotalol therapy on diastolic function in hypertensive patients.
The effects of changes in left ventricular mass following beta-adrenergic blockade therapy (sotalol) on left ventricular filling indices were examined in 16 patients with essential hypertension aged 46 +/- 8.3 years (mean +/- s.d.). The peak atrial to peak early diastolic velocity (A:E) ratio and the peak filling rate (PFR = peak early diastolic velocity X mitral annulus area) were measured by the use of pulsed Doppler left ventricular inflow time-velocity plots following placebo and after 8-12 weeks of sotalol monotherapy (160 mg/day). Compared with normal controls of similar age, our patients had a larger left ventricular mass and impaired left ventricular filling indices. Following sotalol, mean arterial pressure (MAP) decreased by 14%, the heart rate by 15% and left ventricular mass by 11%, while diastolic filling improved (A:E 17% and PFR 21%). Six patients had a decrease in left ventricular mass of greater than 15% (group A); other patients (group B) showed a smaller reduction. In spite of comparable changes in MAP and heart rate in groups A and B, the patients in group A showed a smaller degree of improvement in the A:E ratio. It is concluded that sotalol can induce regression of left ventricular hypertrophy and improve left ventricular filling in hypertensive patients, and it seems that improvement in diastolic filling is related to a reduction in afterload rather than to a decrease in left ventricular mass.
Ibrahim
M M
MM
Cardiac Department, Cairo University, Egypt.
Zaghloul
S S
SS
Helmi
S M
SM
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D006332:Cardiomegaly / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D003971:Diastole / Q000187:drug effects; D004452:Echocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D013015:Sotalol / Q000627:therapeutic use*
D013015:Sotalol