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Impact of azelnidipine and amlodipine on left ventricular mass and longitudinal function in hypertensive patients

Hirohiko Motoki1, Jun Koyama, Atsushi Izawa

  • 1Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan.

Echocardiography (Mount Kisco, N.Y.)
|March 21, 2014
PubMed

Insights

This study compared azelnidipine and amlodipine in hypertensive patients with left ventricular hypertrophy. Both drugs effectively reduced blood pressure and improved cardiac structure and function over 12 months.

Area of Science:

  • Cardiology
  • Pharmacology
  • Echocardiography

Background:

  • Long-acting calcium channel blockers (CCBs) impact on left ventricular (LV) function and morphology in hypertensive patients with LV hypertrophy is not fully understood.
  • This study investigates serial changes in LV function and morphology.
  • Comparison between azelnidipine and amlodipine is crucial for understanding their differential effects.

Purpose of the Study:

  • To compare the effects of azelnidipine and amlodipine on serial changes in left ventricular (LV) function and morphology.
  • To evaluate the impact of these calcium channel blockers (CCBs) in hypertensive patients with LV hypertrophy.
  • To utilize conventional and speckle tracking echocardiography for detailed assessment.

Main Methods:

  • 32 hypertensive patients with LV hypertrophy were prospectively assigned to receive either amlodipine (5 mg/day) or azelnidipine (16 mg/day).
  • Conventional and speckle tracking echocardiography were used to assess LV function and morphology.
  • Examinations were conducted at baseline and at 1, 3, 6, and 12 months post-treatment initiation.

Main Results:

  • Both amlodipine and azelnidipine significantly reduced systolic blood pressure by 1 month.
  • Significant reductions in septal thickness and LV mass index were observed at 6 and 12 months.
  • Improvements in global longitudinal strain were noted earlier (3 months) compared to transmitral flow and diastolic function (12 months). Global circumferential strain also improved by 3 months.

Conclusions:

  • Azelnidipine demonstrates beneficial effects on LV mass regression, transmitral flow, tissue Doppler, and LV longitudinal strain.
  • These effects are comparable to those of amlodipine.
  • Both CCBs offer significant improvements in cardiac remodeling and function in hypertensive patients with LV hypertrophy.
Abstract

Keywords:
left ventricular hypertrophyleft ventricular massstrain-strain rate

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