Regression of left ventricular hypertrophy in treated hypertensive patients with dilevalol and metoprolol--a double...

This study was designed to evaluate the effects of a new beta-adrenergic blocking agent with beta 2 agonist activity (dilevalol, an R-R' isomer of labetalol) on left ventricular hypertrophy regression as seen by M-mode echocardiography. The study design was a 2:1 double blind randomization of dilevalol versus metoprolol. There was an equal blood pressure reduction in the two groups (supine diastolic blood pressure fell from 101 +/- 4.5 mm Hg to 87 +/- 13.7 mm Hg, P less than .001 in the dilevalol group, and 101 +/- 4.3 mm Hg to 87 +/- 8.6 mm Hg, P less than .01, in the metoprolol group). At the end of 2 months, there was an overall 7.5% decrease in left ventricular mass index in the 16 dilevalol treated patients (this was due to a 4.4% decrease in posterior wall thickness, end diastolic dimension increased by only 1%). Of the seven patients with an increased left ventricular mass index, all demonstrated hypertrophy regression (mean 17.14%). In contrast, no significant change in left ventricular mass was seen in the metoprolol treated group. Echocardiographic left ventricular mass index and electrocardiographic evidence of left ventricular hypertrophy (using the Sokolow-Lyons criteria and Romhilt-Estes point score) had poor correlation (r = .30 and r = .38, respectively). Resting ejection fraction increased by 5% and velocity of circumferential fiber shortening by 14% in the dilevalol treatment group (not significant).(ABSTRACT TRUNCATED AT 250 WORDS)