Grandi Anna Maria, Laurita Emanuela, Solbiati Francesco, Marchesi Chiara, Maresca Andrea Maria, Nicolini Eleonora, Guasti Luigina, Venco Achille
Department of Clinical Medicine, University of Insubria, Varese, Italy.
J Cardiovasc Pharmacol. 2006 Nov;48(5):207-11. doi: 10.1097/01.fjc.0000246850.41277.31.
In our retrospective study, we evaluated whether ACE inhibitors can influence left ventricular (LV) morphofunctional characteristics in essential hypertension independently of the antihypertensive effect. We studied 21 hypertensive patients (group 1) before and after at least 18 months of treatment with ACE inhibitors that did not induce any blood pressure (BP) reduction; as a control group, we evaluated 19 hypertensive patients (group 2) not treated with antihypertensive drugs during the same period. At baseline, the 2 groups, neither one previously treated with antihypertensive drugs, were not significantly different with regard to sex, age, body mass index, 24-hour BP, and heart rate; LV mass index was similar between the groups, whereas LV diastolic indices were significantly lower in group 1. At the second evaluation, body mass index, 24-hour BP, and heart rate were unchanged in both groups; LV mass index was significantly decreased in group 1 and increased in group 2. LV diastolic parameters were significantly improved in group 1, whereas in group 2, diastolic function was significantly deteriorated. In conclusion, our clinical study shows that ACE inhibitors can induce LV hypertrophy regression and improvement of diastolic function also in the absence of any antihypertensive effect.
在我们的回顾性研究中，我们评估了血管紧张素转换酶（ACE）抑制剂是否能在不依赖降压作用的情况下影响原发性高血压患者的左心室（LV）形态功能特征。我们研究了21例高血压患者（1组），这些患者在接受至少18个月的ACE抑制剂治疗前后，血压（BP）未出现任何降低；作为对照组，我们评估了19例高血压患者（2组），他们在同一时期未接受抗高血压药物治疗。在基线时，两组患者（均未接受过抗高血压药物治疗）在性别、年龄、体重指数、24小时血压和心率方面无显著差异；两组间左心室质量指数相似，但1组的左心室舒张指标显著较低。在第二次评估时，两组患者的体重指数、24小时血压和心率均未改变；1组的左心室质量指数显著降低，2组则升高。1组的左心室舒张参数显著改善，而2组的舒张功能显著恶化。总之，我们的临床研究表明，ACE抑制剂在无任何降压作用的情况下也可诱导左心室肥厚消退并改善舒张功能。
