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Effects of enalapril on left ventricular mass and diastolic function in essential hypertension: special reference to

T Oki1, N Fukuda, A Iuchi

  • 1Second Department of Internal Medicine, Tokushima University School of Medicine, Tokushima, Japan.

Journal of Cardiac Failure
|December 1, 1995
PubMed

Insights

Enalapril improves heart function in hypertensive patients by enhancing diastolic hemodynamics, with greater benefits observed in those with shorter hypertension duration. This medication aids both with and without left ventricular hypertrophy.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Research

Background:

  • Essential hypertension often leads to left ventricular (LV) hypertrophy and diastolic dysfunction.
  • Enalapril is a commonly prescribed angiotensin-converting enzyme (ACE) inhibitor for hypertension.
  • Understanding enalapril's impact on LV structure and diastolic function is crucial for patient management.

Purpose of the Study:

  • To evaluate the effects of enalapril on LV hypertrophy and diastolic dysfunction in essential hypertension.
  • To assess the relationship between treatment-induced improvements and the duration of hypertension.
  • To determine if enalapril's efficacy differs based on the presence or absence of LV hypertrophy.

Main Methods:

  • M-mode and pulsed Doppler echocardiography were used to assess LV mass and diastolic function.
  • 30 previously untreated hypertensive patients were divided into non-hypertrophy and hypertrophy groups.
  • Patients received enalapril (5-10 mg daily) for 6 months, with measurements taken pre- and post-treatment.

Main Results:

  • Enalapril significantly improved early diastolic LV inflow (E) velocity and decreased the atrial systolic to early diastolic (A/E) ratio in both groups.
  • The drug shortened deceleration time and isovolumic relaxation time, indicating improved diastolic relaxation.
  • Improvements in A/E ratio and LV mass correlated positively with enalapril administration duration.

Conclusions:

  • Long-term enalapril administration improves LV diastolic hemodynamics in hypertensive patients, irrespective of LV hypertrophy.
  • The beneficial effects of enalapril on diastolic function are more pronounced in patients with shorter hypertension duration.
  • Enalapril demonstrates efficacy in managing hypertensive cardiovascular complications, particularly early in the disease course.

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