Background :
@EN Left ventricular hypertrophy(LVH) is the independent poor prognostic factor in hypertensives. But, it is uncertain that the reduction of LVH by antihypertensives therapy will improve the prognosis of hypertensive patients. The effect of
reduction of
LVH on LV function(espacially diastolic function) and the mechanism of reduction of LVH are not clarified also. The aim of this study was to ascertain whether reduction in LV mass with enalapril has a beneficial effect on LV diastolic filling in
hypertensive patients with diastolic dysfunction.
@ES Methods :
@EN Mild to moderate hypertensive patients were treated with ealapril(10-20mg once daily) for 4 months. Their blood pressure and pulse rate were reglarly measured every 2 weeks. Using M mode echocardiograms, LV dimensions at end-diastole and
end-systole, thicknesses of ventricular septum and LV free wall were measured. LV ejection fraction(EF), LV mass index(LVMI) and total peripheral resistance(TPR) were calculated. Pulsed doppler examination of transmitral flow for assessment of LV
diastolic function was performend from apical four chamber view. The peak flow velocities of the early and late waves and their ratio(PFVE, PFVA, PFVE/PFVA) were measured from comsecutive 3 cardiac cycles. In addition, the time velocity intergral
of the
early and late waves and their ratio(EA, AA, EA/AA) were measured. Echocardiographic evaluations were performed at baseline and at the end of treatment
@ES Results :
@EN Average systolic and didastolic blood pressure decreased after treatment with enalapril. But tere was no significant difference of pulse rate between basal and after treatment.
The LV dimensions at end-diastole and end-systole and the thickness of LV free wall didn't change significantly. The thickness of interventricular septum, LVMI and TPR reduced significantly after treatment.
The ejection fraction of LV didn't change significantly after treatment. There was no significantl change in PFVE, EA, AA and EA/AA. But PFVA was significantly decreased after treatment with enalapril for 4 months. PFVE/PFVA was significantly
increased
also.
@ES Conclusion :
@EN In conclusion, antihypertensive treatment with enalapril led to a significant reduction of LVH partially associated with Improvement in LV diastolic performance and no deterioration of LV systolic function.
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