Betocchi S, Chiariello M
Department of Cardiology and Cardiac Surgery, 2nd School of Medicine, Federico II University, Naples, Italy.
J Cardiovasc Pharmacol. 1992;19 Suppl 5:S116-21.
In systemic hypertension, a certain degree of impairment of left ventricular diastolic function is often detectable, and is the consequence of two factors: elevated afterload and left ventricular hypertrophy. The goal of improving diastolic dysfunction can thus be achieved by lowering blood pressure and by inducing a regression in left ventricular hypertrophy. A reduction in blood pressure by intravenous administration of verapamil has proved capable of enhancing left ventricular filling properties in patients with hypertension. This finding has not been corroborated, however, in midterm protocols using an array of drugs (beta-blockers, dihydropyridines, diltiazem, and diuretics). Reduction in left ventricular mass can be achieved by several categories of drugs, and it has been shown that a decrease in mass is accompanied by an improvement in the early diastolic filling pattern. The kind of drug used to accomplish mass reduction seems to be irrelevant as far as the improvement in diastolic function is concerned. The pattern of left ventricular hypertrophy, however, might play a role in influencing the outcome on diastolic mechanics of left ventricular mass decrease.
在系统性高血压中，常常可检测到一定程度的左心室舒张功能受损，这是由两个因素导致的：后负荷升高和左心室肥厚。因此，改善舒张功能障碍的目标可以通过降低血压和促使左心室肥厚消退来实现。静脉注射维拉帕米降低血压已被证明能够改善高血压患者的左心室充盈特性。然而，在使用一系列药物（β受体阻滞剂、二氢吡啶类、地尔硫䓬和利尿剂）的中期方案中，这一发现并未得到证实。几类药物均可使左心室质量降低，并且已经表明，左心室质量降低伴随着舒张早期充盈模式的改善。就舒张功能的改善而言，用于降低左心室质量的药物种类似乎并不重要。然而，左心室肥厚的模式可能在影响左心室质量降低对舒张力学的结果方面发挥作用。
