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Left ventricular function in mild hypertension after adrenergic blockade.

S B Dianzumba1, D DiPette, C R Joyner

  • 1Department of Medicine, Allegheny General Hospital, Allegheny-Singer Research Institute, Pittsburgh, PA 15212.

Hypertension (Dallas, Tex. : 1979)
|February 1, 1988
PubMed
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Labetalol improved left ventricular filling in mild hypertension, unlike atenolol. This combined alpha- and beta-blocker enhanced early filling velocity (E), improving the A/E and A/E/Age ratios.

Area of Science:

  • Cardiology
  • Pharmacology
  • Hypertension Research

Background:

  • Left ventricular filling abnormalities are detectable in mild hypertension using Doppler transmitral flow velocity ratios.
  • Previous studies utilized the A/E and age-adjusted A/E/Age ratios to identify these abnormalities in untreated patients.

Purpose of the Study:

  • To assess the double-blind effects of labetalol (combined alpha- and beta-blockade) versus atenolol (beta-blockade alone) on left ventricular filling in mild hypertension.

Main Methods:

  • Twenty-seven patients with mild hypertension were randomized to receive either labetalol or atenolol.
  • Echocardiographic and Doppler studies were conducted at baseline and after 6 weeks of therapy.
  • Key parameters analyzed included transmitral flow velocity ratios (E, A, A/E, A/E/Age), blood pressure, and left ventricular dimensions/mass.

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Main Results:

  • No significant differences were observed between the groups in age, blood pressure, left ventricular dimensions, wall thickness, systolic function, or late filling velocity (A).
  • Labetalol treatment significantly improved mean early filling velocity (E), and the A/E and A/E/Age ratios (p < 0.05).
  • Atenolol treatment did not result in significant changes in these Doppler-derived filling parameters.

Conclusions:

  • Combined alpha- and beta-blockade with labetalol positively impacts left ventricular filling in patients with mild hypertension.
  • The improvement is primarily attributed to an increase in early diastolic filling velocity (E).
  • Beta-blockade alone with atenolol did not demonstrate similar benefits on left ventricular filling dynamics in this patient group.