Acute administration of a single dose of valsartan improves left ventricular functions: a pilot study to assess the role of tissue velocity echocardiography in patients with systemic arterial hypertension in the TVE-valsartan study I.
BACKGROUND
The advent of colour-coded tissue velocity echocardiography (TVE) has now made it possible to quantify left ventricular (LV) functions in patients with systemic arterial hypertension (HTN). Hypothesis In this project, we have studied the cardiac effects of a single dose of orally administered valsartan in patients with known HTN.


METHODS
Fifty-five patients with HTN with a mean age of 56 +/- 10 years were given an early morning dose of 80 mg valsartan withholding regular antihypertensive medications on the day of investigation. TVE images, acquired on VIVID systems were digitized for postprocessing of longitudinal and radial peak systolic velocities, strain rate, and systolic and diastolic time intervals before (pre) and 5 h after (post) administration of the drug.


RESULTS
Blood pressure (mmHg) pre and post, respectively, were 147 +/- 15 versus 137 +/- 14 systolic and 90 +/- 7 versus 86 +/- 7 diastolic (all P<0.01). LV longitudinal systolic velocities (cm s(-1)) were significantly higher post in LV septum (5.7 +/- 1.1 versus 6.4 +/- 1.6; P<0.001) with similar results obtained in other LV walls. Radial strain rate (1 s(-1)) was significantly higher post compared with pre valsartan (2.1 +/- 0.6 versus 2.3 +/- 0.9; P<0.01). Regional diastolic filling and ejection times (ms) were significantly shorter post (390 +/- 122 versus 370 +/- 120 and 275 +/- 32 versus 163 +/- 36 respectively; all P<0.05).


CONCLUSIONS
Within 5 h after oral administration of valsartan, improvement in regional myocardial systolic functions could be registered. Although the changes could well be secondary to afterload reduction, additional effects of the drug, evidenced by improved strain rate that is relatively load-independent, may have contributed in this improvement.
Govind
Satish C
SC
BMJ Heart Center, Department of Non-invasive Cardiology, Bangalore, India.
Brodin
Lars-Ake
LA
Nowak
Jacek
J
Ramesh
S S
SS
Saha
Samir K
SK
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001783:Blood Flow Velocity / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D018618:Echocardiography, Doppler, Color; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000187:drug effects; D010865:Pilot Projects; D012107:Research Design; D013318:Stroke Volume / Q000187:drug effects; D013548:Sweden; D013777:Tetrazoles / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000068756:Valsartan; D016277:Ventricular Function, Left / Q000187:drug effects*
D000959:Antihypertensive Agents; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine