Related Experiment Videos
Improved left ventricular filling accompanies reduced left ventricular mass during therapy of essential hypertension
Insights
Antihypertensive therapy with nitrendipine can reduce left ventricular mass and improve heart diastolic function in hypertensive patients. This study shows improved cardiac function alongside reduced blood pressure.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Research
Background:
- Abnormal left ventricular diastolic performance is an early sign of hypertension.
- This diastolic dysfunction may precede left ventricular hypertrophy.
Purpose of the Study:
- To evaluate the impact of antihypertensive therapy on cardiac structure and function.
- To assess changes in left ventricular mass and diastolic filling rate.
Main Methods:
- 16 patients with hypertension received nitrendipine (alone or with propranolol/hydrochlorothiazide) for 6 months.
- Echocardiography measured left ventricular mass; radionuclide ventriculography assessed left ventricular filling rate.
- Measurements were taken before and after treatment to compare changes.
Main Results:
- Blood pressure significantly decreased from 156/103 to 137/89 mm Hg.
- Left ventricular mass decreased by >10% in 6 patients, accompanied by increased left ventricular filling rate.
- No significant changes in mass or filling occurred in 9 patients; one patient showed increased mass and decreased filling.
Conclusions:
- Regression of left ventricular mass during nitrendipine therapy correlates with improved diastolic function.
- Antihypertensive treatment can reverse early hypertensive heart disease manifestations.
- Nitrendipine-based therapy shows potential for improving cardiac diastolic performance in hypertensive individuals.
Abstract:
Abnormal left ventricular diastolic performance, an early manifestation of hypertension in the heart, may precede the development of left ventricular hypertrophy. To assess effects of antihypertensive therapy on the heart, left ventricular mass (determined by echocardiography) and rapid left ventricular filling rate (determined by radionuclide ventriculography) were compared before and after 6 months of treatment of 16 patients. Nitrendipine (a dihydropyridine calcium channel blocker) was given alone or in combination with either propranolol or hydrochlorothiazide, or both, and significantly reduced blood pressure (156/103 +/- 12/7 to 137/89 +/- 10/6 mm Hg). In 6 of the 16 patients, left ventricular mass decreased by more than 10% (270 +/- 95 to 193 +/- 47 g, p less than 0.01); in the same patients, left ventricular filling rate increased (2.03 +/- 0.35 to 2.30 +/- 0.45 end-diastolic counts/s [EDC/s], p less than 0.01). In the one patient whose left ventricular mass increased (137 to 195 g), left ventricular filling rate decreased from 2.01 to 1.78 EDC/s. In the remaining nine patients who had no change in left ventricular mass, there was no significant changes in left ventricular filling. The changes in ventricular mass and filling could not be related to the extent of change in blood pressure or heart rate. These data suggest that regression of left ventricular mass during antihypertensive therapy with nitrendipine is accompanied by improved diastolic function.