Franz I W, Tönnesmann U, Behr U, Ketelhut R
Klinik Wehrawald der BfA, Todtmoos.
Dtsch Med Wochenschr. 1990 Apr 20;115(16):603-9. doi: 10.1055/s-2008-1065053.
The effect of long-term therapy of hypertension with antihypertensive drugs was investigated in 117 previously untreated patients (15 women, 102 men; mean age 46.4 +/- 9 years) with echocardiographically proven left-ventricular hypertrophy. 22 patients (group 1) received 100 mg/d Gallopamil, 25 (group 2) received 200 mg/d Metoprolol, 35 daily received both 50 mg Atenolol and 20 mg Nifedipine (group 3), 14 received daily 200 mg Acebutolol plus 20 mg Nifedipine (group 4), and 21 (group 5) 50 mg Atenolol plus 10 mg Enalapril daily. The treatment period lasted a mean of 38 (36.2-42.3) months. Left-ventricular muscle mass index (LVMI) as well as septal and posterior-wall thickness decreased significantly after 12.8 and 38.5 months (P less than 0.001). After a mean of 38.5 months LVMI had decreased by 36.7% in group 1, 35.1% in group 2, 42.3% in group 3, 45% in group 4 and 39.6% in group 5. LVMI was within normal range (less than or equal to 95 g/m2) in 81 of the 117 patients (69.2%) at the end of the treatment period. There was, however, no significant increase of the end-diastolic dimension of the left ventricle, but a significant increase of "fractional shortening" as a measure of myocardial contractility.
对117例经超声心动图证实有左心室肥厚且此前未接受过治疗的患者(15名女性,102名男性;平均年龄46.4±9岁)进行了抗高血压药物长期治疗高血压效果的研究。22例患者(第1组)每日服用100 mg加洛帕米,25例(第2组)每日服用200 mg美托洛尔,35例每日同时服用50 mg阿替洛尔和20 mg硝苯地平(第3组),14例每日服用200 mg醋丁洛尔加20 mg硝苯地平(第4组),21例(第5组)每日服用50 mg阿替洛尔加10 mg依那普利。治疗期平均持续38(36.2 - 42.3)个月。12.8个月和38.5个月后,左心室肌肉质量指数(LVMI)以及室间隔和后壁厚度显著降低(P < 0.001)。平均38.5个月后,第1组LVMI降低了36.7%,第2组降低了35.1%,第3组降低了42.3%,第4组降低了45%,第5组降低了39.6%。治疗期末,117例患者中有81例(69.2%)的LVMI在正常范围内(≤95 g/m²)。然而,左心室舒张末期内径没有显著增加,但作为心肌收缩性指标的“缩短分数”显著增加。