Prevalence of ectopic ventricular activity after left ventricular mass regression.
To assess the effects of left ventricular mass reduction on the prevalence of ventricular ectopic activity, we conducted a double-blind, placebo-controlled trial measuring ambulatory 48 h premature ventricular depolarizations in 27 patients with mild-to-moderate hypertension and an increased left ventricular mass index. Data was obtained at baseline and 6 +/- 2 months after randomization to either 25 mg captopril or placebo twice a day. Patients on captopril attained reduction in blood pressure from 167 +/- 11/103 +/- 6 to 136 +/- 10/85 +/- 5 mm Hg (P = .001), left ventricular mass index regression from 149 +/- 17 to 96 +/- 23 g/m2 (P = .001), and ventricular ectopic activity reduction from 413 +/- 172 to 77 +/- 27 ventricular extrasystoles/day (P = .001). Patients on placebo had no significant change in blood pressure (from 162 +/- 11/101 +/- 6 at baseline to 160 +/- 8/100 +/- 8 mm Hg after 6 months; P = NS). In the placebo group left ventricular mass index increased from 155 +/- 40 to 182 +/- 51 g/m2 (P = .01), and ventricular ectopic activity decreased from 634 +/- 293 to 562 +/- 260 ventricular extrasystoles/day (P = NS). Eight out of 14 patients on captopril (57%) and 1 out of 13 patients on placebo (8%) achieved reduction > 85% in ventricular ectopic activity per day (P = .004). Using multivariate logistic regression analysis, left ventricular mass index regression and reduction in systolic blood pressure were the most important correlates for this effect.(ABSTRACT TRUNCATED AT 250 WORDS)
González-Fernández
R A
RA
Department of Medicine, San Juan City Hospital, Puerto Rico University School of Medicine, Río Piedras.
Rivera
M
M
Rodríguez
P J
PJ
Fernández-Martínez
J
J
Soltero
L H
LH
Díaz
L M
LM
Lugo
J E
JE
D002216:Captopril / Q000627:therapeutic use; D005117:Cardiac Complexes, Premature / Q000209:etiology / Q000503:physiopathology*; D006332:Cardiomegaly / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D004311:Double-Blind Method; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016276:Ventricular Function
D002216:Captopril