Teniente-Valente Raúl, Solorio Sergio, Vargas-Salado Enrique, Aguirre-Vázquez Carlos, Hernández-González Martha A, Olvera-Lopez José Antonio, Rodríguez-Mariscal Leticia, Luna-Ruiz Miguel Angel, Guillén Contreras José Manuel, Murillo Ortiz Blanca Olivia
Cardiology Department, UMAE 1 Bajio, Mexican Institute of Social Security, Leon, Guanajuato, Mexico.
Arch Cardiol Mex. 2008 Oct-Dec;78(4):392-9.
To evaluate the diastolic function after regression of left ventricular hypertrophy, in mild to moderate hypertension treated with angiotensin converting enzyme(ACE) inhibitor and, if necessary, with a diuretic.
Ninety-eight hypertensive patients with left ventricular hypertrophy (LVH) and abnormal left ventricle diastolic function indexes received captopril (Capotena) 50 to 200 mg/day plus chlortalidone during 12 months to reach blood pressure control, defined as a diastolic blood pressure < or =90 and systolic blood pressure < or =140 mm Hg. Left ventricular (LV) mass index was calculated by M mode and two-dimensional echocardiography, and left ventricular diastolic function was assessed by transmitral pulsed Doppler ultrasound every 3 months.
Sixty-three patients were women and 35 were men, mean age was 53.4 +/- 8.4 years (range 34-70). Thirty-six patients had mild (36.7%) and 62 (63.3%) moderate hypertension. Treatment reduced significantly both systolic pressure from 165 +/- 13 to 137 +/- 12.9 mm Hg (p<0.05) and diastolic pressure from 99 +/- 8.6 to 86 +/- 6.37 mm Hg (p<0.05). LV mass index decreased from 155.4 +/- 32.9 to 121.7 +/- 29.14 g/m2 (p<0.05). Late diastolic filling velocity (A wave) and the ratio of E/A waves improved (p<0.05), but early diastolic filling velocity (E wave) and isovolumetric relaxation time did not change with treatment.
Some indexes of diastolic function improved after regression of left ventricular hypertrophy and good blood pressure control with captopril and chlortalidone.
评估在轻度至中度高血压患者中，使用血管紧张素转换酶（ACE）抑制剂治疗，必要时联合利尿剂治疗后，左心室肥厚消退时的舒张功能。
98例左心室肥厚（LVH）且左心室舒张功能指标异常的高血压患者，接受卡托普利（开博通）50至200毫克/天加氯噻酮治疗12个月，以实现血压控制，定义为舒张压≤90毫米汞柱且收缩压≤140毫米汞柱。通过M型和二维超声心动图计算左心室（LV）质量指数，每3个月用经二尖瓣脉冲多普勒超声评估左心室舒张功能。
63例为女性，35例为男性，平均年龄为53.4±8.4岁（范围34 - 70岁）。36例患者患有轻度高血压（36.7%），62例（63.3%）患有中度高血压。治疗后收缩压从165±13显著降至137±12.9毫米汞柱（p<0.05），舒张压从99±8.6显著降至86±6.37毫米汞柱（p<0.05）。左心室质量指数从155.4±32.9降至121.7±29.14克/平方米（p<0.05）。舒张晚期充盈速度（A波）和E/A波比值改善（p<0.05），但舒张早期充盈速度（E波）和等容舒张时间在治疗后未改变。
使用卡托普利和氯噻酮使左心室肥厚消退并实现良好血压控制后，舒张功能的一些指标得到改善。
