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Effects of a long-term treatment with alacepril on left ventricular hypertrophy and function in patients with
1Second Department of Internal Medicine, Ehime University School of Medicine, Japan.
Insights
Long-term treatment with alacepril, an angiotensin-converting enzyme inhibitor, effectively reduced left ventricular hypertrophy and improved cardiac function in hypertensive patients. This study highlights alacepril
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Left ventricular hypertrophy (LVH) is a common complication of essential hypertension.
- LVH is associated with impaired cardiac function and increased cardiovascular risk.
- Angiotensin-converting enzyme (ACE) inhibitors are a cornerstone in managing hypertension and its cardiac sequelae.
Purpose of the Study:
- To evaluate the long-term effects of alacepril on left ventricular hypertrophy reversal.
- To assess the impact of alacepril on left ventricular function in hypertensive patients.
- To determine if alacepril improves both systolic and diastolic cardiac function.
Main Methods:
- A 12-month open-label study involving ten patients with essential hypertension and LVH.
- Patients received alacepril monotherapy.
- Echocardiography was performed pre- and post-treatment to measure left ventricular dimensions, mass index, and function (ejection fraction, fractional shortening, peak shortening/lengthening rates).
Main Results:
- Alacepril significantly reduced blood pressure (163/98 to 142/86 mm Hg) and left ventricular mass index (146 to 119 g/m2).
- Cardiac function significantly improved, with increases in ejection fraction, fractional shortening, and peak shortening/lengthening rates.
- No significant change in heart rate or consistent augmentation of left ventricular contractility was observed.
Conclusions:
- Alacepril effectively reverses left ventricular hypertrophy in patients with essential hypertension.
- Long-term alacepril treatment improves both left ventricular systolic and diastolic function.
- Alacepril offers a beneficial therapeutic option for hypertensive patients with cardiac remodeling.
Abstract:
The authors examined the effects of a long-term treatment with the angiotensin-converting enzyme inhibitor, alacepril, with respect to the reversal of left ventricular hypertrophy and the improvement of left ventricular function. Ten uncomplicated essential hypertensive patients with left ventricular hypertrophy, aged 53 +/- 8 years, were treated with alacepril alone for 12 months. All patients underwent echocardiography to to assess left ventricular dimensions and function before and after the treatment. After the treatment, blood pressure was decreased significantly from 163 +/- 14.1/98 +/- 4.2 to 142 +/- 20.3/86 +/- 11.0 mm Hg (each, P less than .01), whereas heart rate did not change (66 +/- 6 versus 69 +/- 8 beats/min). The left ventricular mass index was decreased significantly from 146 +/- 27 to 119 +/- 29 g/m2 (P less than .01). Ejection fraction, fractional shortening, peak shortening rate, and peak lengthening rate all improved significantly after the treatment. There was a significant inverse relationship between fractional shortening and end-systolic wall stress before the treatment (r = .63, P less than .05), and this relationship did not change after the treatment. It is concluded that alacepril improved both left ventricular systolic and diastolic function without causing any consistent augmentation of left ventricular contractility.