The effect of valsartan on left ventricular myocardial functions in hypertensive patients with left ventricular hypertrophy.
BACKGROUND
It has been shown by various diagnostic methodologies that angiotensin receptor blockage reduces left ventricular mass, improves diastolic function and increases contractility in hypertensive left ventricular hypertrophy (LVH). We planned to detect the effect of angiotensin receptor blockage on midwall mechanics and myocardial dynamics in hypertensive patients with LVH.


METHODS
Angiotensin 2 type 1 receptor blocker (valsartan 80-160 mg) was administered to 38 previously untreated hypertensive patients with LVH for 6 months. Left ventricular midwall mechanics and tissue Doppler velocities were measured at baseline and at the end of the study.


RESULTS
Mean blood pressure was reduced from 152 ± 14/92 ± 8 to 131 ± 14/83 ± 9 mmHg (P < 0.05). Left ventricular mass index was decreased from 135 ± 15 to 114 ± 14 g/m(2) (P < 0.001). Midwall fractional shortening was increased from 19.0 ± 4 to 22.4 ± 3% (P < 0.05). Circumferential end-systolic wall stress was decreased from 131 ± 44 to 119 ± 37 × 10(3) dyn/cm(2) (P < 0.05). Left ventricular interventricular septal myocardial tissue peak systolic velocity was increased from 6.7 ± 1 to 8.1 ± 0.9 cm/s (P < 0.001) and lateral wall myocardial tissue peak systolic velocity was increased from 7.5 ± 1 to 9.0 ± 1 cm/s (P < 0.001), and E/E(m) ratio was significantly decreased (11.0 ± 0.3 to 8.90 ± 0.1, P < 0.05) with 6-month valsartan therapy.


CONCLUSIONS
This study suggests that valsartan exhibits not only blood pressure-lowering qualities but also cardioprotective actions in patients with hypertension because it enhances regression of LVH and improves left ventricular myocardial contractility and relaxation.
Department of Cardiology, Mustafa Kemal University School of Medicine, Antioch, Turkey. drnagehan@gmail.com
Nagehan
N
Kucukler
Ibrahim H
IH
Kurt
Caner
C
Topaloglu
Suleyman
S
Gurbuz
Fatih
F
Yalcin
D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001696:Biomechanical Phenomena; D001794:Blood Pressure / Q000187:drug effects*; 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; D009200:Myocardial Contraction / Q000187:drug effects; D011446:Prospective Studies; D020127:Recovery of Function; D013777:Tetrazoles / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D014633:Valine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000068756:Valsartan; D016277:Ventricular Function, Left / Q000187:drug effects*
D047228:Angiotensin II Type 1 Receptor Blockers; D000959:Antihypertensive Agents; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine