Improvement of diastolic function after regression of left ventricular hypertrophy.
OBJECTIVE
To evaluate the diastolic function after regression of left ventricular hypertrophy, in mild to moderate hypertension treated with angiotensin converting enzyme(ACE) inhibitor and, if necessary, with a diuretic.


METHODS
Ninety-eight hypertensive patients with left ventricular hypertrophy (LVH) and abnormal left ventricle diastolic function indexes received captopril (Capotena) 50 to 200 mg/day plus chlortalidone during 12 months to reach blood pressure control, defined as a diastolic blood pressure < or =90 and systolic blood pressure < or =140 mm Hg. Left ventricular (LV) mass index was calculated by M mode and two-dimensional echocardiography, and left ventricular diastolic function was assessed by transmitral pulsed Doppler ultrasound every 3 months.


RESULTS
Sixty-three patients were women and 35 were men, mean age was 53.4 +/- 8.4 years (range 34-70). Thirty-six patients had mild (36.7%) and 62 (63.3%) moderate hypertension. Treatment reduced significantly both systolic pressure from 165 +/- 13 to 137 +/- 12.9 mm Hg (p<0.05) and diastolic pressure from 99 +/- 8.6 to 86 +/- 6.37 mm Hg (p<0.05). LV mass index decreased from 155.4 +/- 32.9 to 121.7 +/- 29.14 g/m2 (p<0.05). Late diastolic filling velocity (A wave) and the ratio of E/A waves improved (p<0.05), but early diastolic filling velocity (E wave) and isovolumetric relaxation time did not change with treatment.


CONCLUSIONS
Some indexes of diastolic function improved after regression of left ventricular hypertrophy and good blood pressure control with captopril and chlortalidone.
Teniente-Valente
Raúl
R
Cardiology Department, UMAE 1 Bajio, Mexican Institute of Social Security, Leon, Guanajuato, Mexico. dr.teniente@yahoo.com
Solorio
Sergio
S
Vargas-Salado
Enrique
E
Aguirre-Vázquez
Carlos
C
Hernández-González
Martha A
MA
Olvera-Lopez
José Antonio
JA
Rodríguez-Mariscal
Leticia
L
Luna-Ruiz
Miguel Angel
MA
Guillén Contreras
José Manuel
JM
Murillo Ortiz
Blanca Olivia
BO
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D002216:Captopril / Q000627:therapeutic use; D002752:Chlorthalidone / Q000627:therapeutic use; D003971:Diastole / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D000959:Antihypertensive Agents; D002216:Captopril; D002752:Chlorthalidone