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Early regression of left ventricular diastolic abnormalities in hypertensive patients treated with nifedipine
I Sheiban1, G Covi, C Zenorini
1Centro Cardiopneumologico, Università di Verona, Ospedale Policlinico, Italy.
Insights
Nifedipine significantly reduced blood pressure and improved left ventricular structure in patients with essential hypertension. The medication decreased ventricular wall thickness and increased chamber dimensions, indicating a potential benefit for cardiac function.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Essential hypertension (EH) is a common condition associated with left ventricular hypertrophy (LVH) and diastolic dysfunction.
- Nifedipine is a calcium channel blocker used to treat hypertension.
Purpose of the Study:
- To evaluate the effects of nifedipine on blood pressure (BP), left ventricular hypertrophy, and diastolic function in patients with essential hypertension.
Main Methods:
- 14 patients with EH and 10 normotensive controls underwent complete echocardiograms (ECHO) at baseline and after 1 and 6 months of nifedipine therapy (20-40 mg/day).
- Echocardiographic parameters including left ventricular (LV) dimensions, wall thicknesses, mass, and ejection fraction (EF) were assessed using a computerized system.
- LV volume curves were analyzed to evaluate filling velocities and isovolumic relaxation period (IR).
Main Results:
- Nifedipine therapy significantly decreased systolic and diastolic BP after 1 month (p < 0.05).
- Interventricular septum (ST) and posterior wall thickness (PWT) were reduced, while LV end-diastolic diameter (EDD) and end-diastolic volume (EDV) increased (p < 0.01).
- LV mass and mass/volume (M/V) index showed slight reductions, and the end-diastolic diameter/thickness (D/Th) index increased significantly (p < 0.01).
Conclusions:
- Nifedipine effectively lowers blood pressure in patients with essential hypertension.
- The drug also leads to favorable changes in left ventricular structure, reducing hypertrophy and improving diastolic dimensions.
Abstract:
The effects of nifedipine on blood pressure (BP), left ventricular hypertrophy, and diastolic function were evaluated in 14 patients with essential hypertension (EH). All males with a mean age of 44 +/- 6 years (range 35-58 years), and in ten normotensive subjects (control group) aged 32-42 years (mean age 36 +/- 4). A complete echocardiogram (ECHO) was performed in basal conditions after 1 and 6 months of therapy with nifedipine (20-40 mg/day). Left ventricular echocardiograms (LV ECHO, M-mode, two-dimensional guided) were plotted with a simultaneous ECG tracing by means of a computerized system that allows evaluation of the following parameters: LV end-diastolic and systolic diameters (EDD, ESD); variations in LV diameter and volume during the entire cardiac cycle, and the velocities of such variations; end-diastolic thicknesses of the interventricular septum and posterior wall (ST, PWT); LV mass, mass/volume (M/V) index, end-diastolic diameter/thickness (D/Th) index, and LV ejection fraction (EF). Left ventricular volume curves were obtained and the contributions of rapid filling (RF) and atrial systole (AS) to EDV were evaluated. Filling velocities during RF (vRF) and AS (vAS) were estimated, as well as the isovolumic relaxation period (IR). No significant changes were observed in the heart rate. After 1 month of therapy, systolic and diastolic BP were significantly decreased (p less than 0.05). ST and PWT were reduced, with a simultaneous increase in EDD and EDV (p less than 0.01). LV mass was slightly reduced, as was the M/V index. The D/Th index was increased (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)