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Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR
Published on: April 8, 2013
Left ventricular mass regression and diastolic function improvement in mild and moderate hypertensive patients
R J Esper1, O H Burrieza, J L Cacharrón
1Division of Cardiology, Policlínica Bancaria, Buenos Aires, Argentina.
Insights
Lisinopril treatment significantly reduced blood pressure and left ventricular mass in patients over 16 weeks. This ACE inhibitor therapy also improved diastolic function, indicating better heart health.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Management
Background:
- Hypertension is a major risk factor for cardiovascular disease, often leading to left ventricular hypertrophy (LVH).
- Angiotensin-Converting Enzyme (ACE) inhibitors are a cornerstone in managing hypertension and its cardiac sequelae.
- Assessing the impact of ACE inhibitors on cardiac structure and function is crucial for optimizing treatment strategies.
Purpose of the Study:
- To evaluate the efficacy of lisinopril in reducing blood pressure and left ventricular mass.
- To assess the effect of lisinopril on left ventricular diastolic function using echo-Doppler.
- To compare clinic blood pressure measurements with ambulatory blood pressure monitoring (ABPM) during lisinopril treatment.
Main Methods:
- A prospective study involving 30 hypertensive patients treated with lisinopril (10-40 mg daily) for 16 weeks.
- Blood pressure was measured using both conventional clinic methods and 24-hour ABPM.
- Echocardiography (echo-Doppler) was employed to assess left ventricular mass, wall thickness, and diastolic function.
Main Results:
- Lisinopril significantly reduced clinic systolic and diastolic blood pressure (p < 0.005).
- ABPM showed a significant decrease in the frequency of elevated systolic (>140 mmHg) and diastolic (>90 mmHg) blood pressure readings (p < 0.005).
- Left ventricular mass, septal wall thickness, and posterior wall thickness all decreased significantly (p < 0.005), while diastolic function did not change significantly.
Conclusions:
- Lisinopril effectively lowers blood pressure, both in clinic and ambulatory settings.
- Treatment with lisinopril leads to a significant reduction in left ventricular mass and hypertrophy.
- Lisinopril demonstrates potential benefits in reversing cardiac structural changes associated with hypertension.
Abstract:
Thirty patients (18 male), mean age 49.5 +/- 6.3 years, were treated with lisinopril 10-40 mg once daily for 16 weeks. The effect of treatment on left ventricular mass and improvement in left ventricular diastolic function (measured by echo-Doppler) was assessed. Blood pressure changes were measured conventionally in the clinic and by ambulatory blood pressure monitoring. Clinic blood pressure decreased from 168.3 +/- 13.8/105.5 +/- 5.4 mm Hg to 137.5 +/- 4.1/88.8 +/- 4.1 mm Hg (p < 0.005 for both systolic and diastolic blood pressures), and the heart rate from 75.2 +/- 3.7 to 74.4 +/- 7.6 beats per minute (NS). The frequency of ambulatory systolic blood pressure values > 140 mm Hg decreased in percentage from 63.3 +/- 12.8 to 29.9 +/- 9.1% (p < 0.005) and the frequency of ambulatory diastolic blood pressure values > 90 mm Hg decreased in percentage from 61.1 +/- 12.8 to 28.6 +/- 7.5% (p < 0.005). Septal and left ventricular posterior wall thickness decreased from 11.2 +/- 0.9 to 10.3 +/- 0.6 mm and from 10.9 +/- 0.9 to 10.1 +/- 0.6 mm, respectively (both p < 0.005). Left ventricular diastolic diameter and the shortening fraction did not change significantly. Left ventricular mass, calculated from left ventricular wall thickness and diastolic diameter, decreased from 132.6 +/- 11.5 to 119.9 +/- 6.3 g/m2 (p < 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)
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