Oki T, Fukuda N, Iuchi A, Tabata T, Sasaki M, Kawahara K, Ishimoto T, Tominaga T, Okushi H, Fujimoto T, Ito S
Second Department of Internal Medicine, Tokushima University School of Medicine, Tokushima, Japan.
J Card Fail. 1995 Dec;1(5):365-70. doi: 10.1016/s1071-9164(05)80005-3.
Using M-mode and pulsed Doppler echocardiography, the effects of enalapril on left ventricular (LV) hypertrophy and diastolic dysfunction in essential hypertension and the relation between improvement in these two parameters and duration of hypertension were evaluated. The subjects, 30 previously untreated hypertensive patients, were divided into nonhypertrophy (18 patients) and hypertrophy (12 patients) groups. All patients received enalapril at a daily dose of 5 to 10 mg for 6 months. Left ventricular mass by M-mode echocardiography and LV inflow (LVIF) velocity by transthoracic pulsed Doppler echocardiography were measured before and after enalapril therapy. In the nonhypertrophy group, enalapril significantly increased peak early diastolic LVIF (E) velocity (P < .05), slightly lowered peak atrial systolic LVIF (A) velocity, significantly decreased their ratio (A/E) (P < .01), and significantly shortened both the deceleration time, from the peak of the early diastolic wave, and isovolumic relaxation time (P < .05 and P < .01, respectively). In the hypertrophy group, enalapril significantly increased E (P < .05), slightly lowered A, significantly decreased A/E (P < .05), slightly shortened the deceleration time and isovolumic relaxation time, and slightly decreased LV mass. The administration of enalapril correlated significantly and positively with the duration of hypertension and the rates of change in A/E and LV mass in all of the hypertensive patients (P < .01 and P < .05, respectively). These results suggest that long-term administration of enalapril to hypertensive patients improves LV diastolic hemodynamics regardless of the presence or absence of LV hypertrophy and that the effects are most remarkable in patients with the shortest duration of hypertension.
采用M型和脉冲多普勒超声心动图，评估依那普利对原发性高血压患者左心室（LV）肥厚和舒张功能障碍的影响，以及这两个参数的改善与高血压病程之间的关系。研究对象为30例未经治疗的高血压患者，分为非肥厚组（18例患者）和肥厚组（12例患者）。所有患者接受依那普利治疗，每日剂量为5至10毫克，持续6个月。在依那普利治疗前后，通过M型超声心动图测量左心室质量，通过经胸脉冲多普勒超声心动图测量左心室流入（LVIF）速度。在非肥厚组中，依那普利显著增加舒张早期LVIF（E）峰值速度（P < 0.05），轻微降低心房收缩期LVIF（A）峰值速度，显著降低其比值（A/E）（P < 0.01），并显著缩短舒张早期波峰的减速时间和等容舒张时间（分别为P < 0.05和P < 0.01）。在肥厚组中，依那普利显著增加E（P < 0.05），轻微降低A，显著降低A/E（P < 0.05），轻微缩短减速时间和等容舒张时间，并轻微降低左心室质量。在所有高血压患者中，依那普利的给药与高血压病程以及A/E和左心室质量的变化率显著正相关（分别为P < 0.01和P < 0.05）。这些结果表明，对高血压患者长期给予依那普利可改善左心室舒张血流动力学，无论是否存在左心室肥厚，且在高血压病程最短的患者中效果最为显著。
