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Regression of left ventricular hypertrophy with isradipine antihypertensive therapy
G P Vyssoulis1, E A Karpanou, C E Pitsavos
1Department of Cardiology, University of Athens, Greece.
Insights
Isradipine antihypertensive therapy effectively reduces left ventricular (LV) mass and wall thickness in hypertensive patients. This beneficial LV remodeling occurs without negatively impacting LV pump function.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Hypertension is a significant risk factor for left ventricular hypertrophy (LVH).
- LVH is associated with adverse cardiovascular outcomes.
- Regression of LVH is a therapeutic goal in managing hypertension.
Purpose of the Study:
- To evaluate the effects of isradipine monotherapy on left ventricular (LV) structure and function in hypertensive patients.
- To determine if isradipine causes regression of LV hypertrophy.
- To assess the impact of isradipine on LV pump function.
Main Methods:
- Echocardiography was used to assess LV structural and functional changes.
- 45 hypertensive patients were studied.
- Patients received 2 weeks of placebo followed by 6 months of isradipine monotherapy.
Main Results:
- Isradipine significantly decreased LV wall thickness and LV mass index.
- LV cavity size remained unchanged.
- Cardiac index increased due to tachycardia and reduced peripheral resistance, without affecting LV fractional shortening.
Conclusions:
- Isradipine antihypertensive therapy promotes regression of LV hypertrophy.
- This regression is associated with beneficial LV remodeling.
- Isradipine effectively reduces LV mass without impairing LV pump function.
Abstract:
To assess left ventricular (LV) structural and functional changes, 45 hypertensive patients were studied by echocardiography after 2 weeks of placebo and 6 months of isradipine monotherapy. Although LV cavity size did not change, LV wall thickness decreased dramatically (P < .0001), producing a significant decrease in LV mass index (from 158 g/m2 to 136 g/m2; P < .0001). In addition, LV fractional shortening (FS) did not change (1.2%; P = NS) whereas the cardiac index increased (6.4%; P = .0007) due to a modest tachycardia accompanied by a reduction in total peripheral resistance (-22.1%; P < .0001). The magnitude of the reduction of LV mass was related to the degree of FS increase (r = -0.70; P < .0001), an indication of beneficial LV remodeling. It can be concluded that isradipine antihypertensive therapy leads to regression of LV hypertrophy without depression of LV pump function.