[A reduction of left ventricular hypertrophy and an improvement in diastolic function after therapy with nifedipine retard in patients with hypertensive cardiopathy].
Left ventricular (LV) hypertrophy with increased LV mass is associated with abnormal LV diastolic filling in patients with hypertension. To assess the effect of antihypertensive therapy on LV mass (M), LV wall stress (SS) and rapid LV filling, 16 patients (12 males, 4 females), mean age 57 +/- 8 years, were treated with nifedipine slow release (NSR, 20 mg bid) for 12 months and evaluated by Doppler echocardiography at baseline and at 3, 6, 9, 12 months from the beginning of treatment. No other cardiovascular drugs were given during the study. Systolic and diastolic blood pressure (SBP, DBP), LVM/m2 body surface (bs; M/m2), LVSS, LV end-diastolic and end-systolic diameters (EDD/m2, ESD/m2) bs, left atrial diameter (LAD), fractional shortening index (FS%), isovolumic relaxation time (IVRT), E/A velocities ratio at mitral Doppler spectrum (E/A) were measured at each examination. During treatment, systolic and diastolic blood pressure, LVM, LVSS, LV end-systolic diameter and isovolumic relaxation time decreased and FS% and E/A significantly increased as compared with baseline values, EDD and LAD did not change significantly. The reduction of LVSS was of greater extent compared with that of LVM, at short and at mid-term, probably for a fibrotic component of LVM induced by chronic systolic overload. Changes of ESD and FS% were less evident compared with LVSS, possibly depending on their contribution to LVSS normalization. In conclusion, our experience indicates that NSR is an effective antihypertensive agent at short and mid-term.(ABSTRACT TRUNCATED AT 250 WORDS)
Amici
E
E
Divisione di Cardiologia, Ospedale GB Grassi, Roma.
Patruno
N
N
Natale
E
E
Marsocci
A
A
Gambelli
G
G
D000328:Adult; D000368:Aged; D003692:Delayed-Action Preparations; D003971:Diastole / Q000187:drug effects; D004341:Drug Evaluation; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D013997:Time Factors; D016277:Ventricular Function, Left / Q000187:drug effects*
D003692:Delayed-Action Preparations; D009543:Nifedipine
Riduzione dell'ipertrofia ventricolare sinistra e miglioramento della funzione diastolica dopo terapia con nifedipina retard in pazienti con cardiopatia ipertensiva.