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[Effects of verapamil and propranolol on the left-ventricular diastolic function in patients with primary arterial
R Trojnar1, B Rymar, A Wysokiński
1Kliniki Kardiologii AM w Lublinie.
Insights
Verapamil improved early diastolic flow velocity in hypertensive patients, unlike propranolol. This study highlights verapamil
Area of Science:
- Cardiology
- Pharmacology
- Medical Imaging
Background:
- Systemic hypertension affects left ventricular filling patterns.
- Doppler echocardiography is used to assess mitral inflow.
- Understanding drug effects on diastolic function is crucial.
Purpose of the Study:
- To evaluate the impact of verapamil and propranolol on mitral flow patterns in patients with essential hypertension.
- To compare the effects of these two antihypertensive drugs on diastolic function.
Main Methods:
- 40 patients with essential hypertension (WHO stage II) were randomized to verapamil or propranolol.
- Pulsed Doppler echocardiography measured early diastolic flow velocity (EDF) and late diastolic flow velocity (LDF) before and after 4-6 weeks of treatment.
- Heart rate and arterial pressure were also monitored.
Main Results:
- Both verapamil and propranolol significantly reduced heart rate and arterial pressure.
- Verapamil significantly increased EDF (61.2 to 78.2 cm/s) and the EDF/LDF ratio (1.02 to 1.30), with no change in LDF.
- Propranolol did not significantly alter EDF, LDF, or the EDF/LDF ratio.
Conclusions:
- Verapamil improves early diastolic filling in hypertensive patients.
- Propranolol does not significantly affect mitral inflow patterns in this patient group.
- Doppler echocardiography can detect drug-induced changes in diastolic function.
Abstract:
Mitral flow was assessed by Doppler echocardiography in patients with systemic hypertension. The study was carried out on 40 patients (27 men and 13 women) aged 24-50 years, mean 43 years with essential hypertension stage II according to WHO classification. No patient had other heart disease or diabetes. All patients were randomly assigned to verapamil (20 patients) or propranolol (20 patients). The daily dose of verapamil was 60-120 mg, mean 80 mg and propranolol 120-180 mg, mean 140 mg. Pulsed Doppler studies in all patients were performed before the treatment and after 4-6 weeks of the treatment. Echocardiographic examination was performed with Hewlett-Packard 707020 A ultrasound system using 2.5 MHz transducer. Two dimensionally guided pulsed Doppler echocardiograms were recorded with sample volume positioned in the inflow area below the mitral annulus. The following Doppler parameters were measured: early diastolic flow velocity (EDF), late diastolic flow velocity (LDF) and their ratio (EDF/LDF) which represents the ratio of early and late diastolic flow velocity of left ventricular filling. The study has showed that before treatment the value of EDF, LDF and EDF/LDF ratio in both groups did not significantly differ. Heart rate and arterial pressure in patients with systemic hypertension after treatment with verapamil or propranolol were significant lower than before treatment. Treatment with verapamil caused significant increase of EDF from 61.2 to 78.2 cm/sek and increase EDF/LDF ratio from 1.02 to 1.30. While LDF values were not changed. In the group of patients treated with propranolol the values of EDF, LDF and ratio EDF/LDF were similar to those before treatment.(ABSTRACT TRUNCATED AT 250 WORDS)