Purpose: This study was conducted to evaluate the influence of antihypertensive treatment with the calcium antagonist amlodipine on left ventricular structure and systolic and diastalic function in patients with essential hypertension.
Methods: Fifty-six patients (mean age 56 [+ or -] 6 years) with mild to moderate essential hypertension (diastolic blood pressure 95 to 114 m Hg) underwent M-mode echocardiography guided by 2-dimensional echocardiography and pulsed Doppler examination of transmitral blood flow at baseline and after 1 and 6 months' treatment with amlodipine (10 mg/day).
Results: Blood pressure level significantly decreased during treatment. Left ventricular mass index also decreased during the study period (from 143 [+ or -] 5 g/m2 at baseline to 128 [+ or -] 3 g/m2 after treatment; p [is less than] 0.01). Fractional shortening was not significantly modified during treatment. The peak velocity of early filling (E) increased progressively (0.54 [+ or -] 0.5 vs 0.63 [+ or -] 0.6 m/sec; p [is less than] 0,01), while the peak velocity of late filling (A) did not change significantly; therefore, the E/A ratio increased from 1.1 [+ or -] 0.1 to 1.24 [+ or -] 0.1 (p [is less than] 0,01).
Conclusion: This study demonstrated a significant decrease in left ventricular mass during treatment with the calcium antagonist amlodipine, and maintenance of left ventricular systolic performance after reversal of myocardial hypertrophy. Moreover, the decrease in left ventricular mass was associated with significantly improved diastolic filling.
Clinical Implications: The present study demonstrated the usefulness of amlodipine in reversing left ventricular hypertrophy, maintaining left ventricular systolic performance, and improving diastolic filling.
Supported by: Pfizer Pharmaceuticals
Djoko Trihadi(*) and R Hardjalukita. Department of Internal Medicine, Municipal Hospital, Semarang, Central Java, Indonesia.
COPYRIGHT 1999 American College of Chest Physicians
COPYRIGHT 2000 Gale Group
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