Effect of amlodipine and lacidipine on left ventricular diastolic and long axis functions in arterial hypertension and stable angina pectoris.
OBJECTIVE
Impaired left ventricular (LV) diastolic and long axis functions are common in arterial hypertension and stable angina pectoris patients despite normal LV ejection fraction. Data concerning the effect of calcium channel blockers (CCB) on the LV long axis function in this context are lacking.


RESULTS
Fifty-nine hypertensive patients with associated coronary artery disease (stable angina pectoris) and isolated diastolic dysfunction were randomized to receive amlodipine (30 patients) or lacidipine (29 patients) for 4 weeks. Clinical investigation, exercise testing, echocardiography were performed before and after the active treatment period. LV diastolic function was analysed from transmitral flow using Doppler echocardiography. Mitral annulus motion was investigated for LV long axis function analysis using 2-D guided M-mode echocardiography (amplitudes of motion) and pulsed wave tissue Doppler (velocities). Amlodipine and lacidipine affected LV diastolic and long axis functions differently: during treatment with amlodipine isovolumic relaxation time (IVRT) and deceleration time of LV early filling (DT) decreased (IVRT--from 93 +/- 19 ms to 79 +/- 15 ms, DT--from 206 +/- 36 ms to 188 +/- 27 ms; p < 0.05), early diastolic velocity of mitral annulus motion (E') increased (from 10.0 +/- 1.9 cm/s to 10.8 +/- 1.8 cm/s after treatment; p < 0.05). Lacidipine did not significantly change these parameters (IVRT-- 88 +/- 15 ms before, 87 +/- 13 ms after treatment, DT--214 +/- 34 ms and 218 +/- 42 ms, E'-- 10.4 +/- 1.5 cm/s and 10.6 +/- 1.5 cm/s, respectively). More favourable effects of CCB on LV long axis function was found in patients with post-systolic shortening.


CONCLUSIONS
Amlodipine can improve diastolic and long axis functions of the left ventricle in patients with arterial hypertension and stable angina pectoris.
Department of Cardiology, Kaunas University of Medicine, Kaunas, Lithuania.
Remigijus
R
Zaliunas
Renaldas
R
Jurkevicus
Vytautas
V
Zabiela
Julija
J
Brazdzionyte
D000368:Aged; D017311:Amlodipine / Q000494:pharmacology*; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology*; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000503:physiopathology; D003971:Diastole; D004095:Dihydropyridines / Q000494:pharmacology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology; D018608:Ultrasonography, Doppler; D016277:Ventricular Function, Left / Q000187:drug effects*
D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D017311:Amlodipine; C060285:lacidipine