Schneeweiss A, Rosenthal J, Marmor A
Cardiovascular Research Foundation, Geneva, Switzerland.
J Hum Hypertens. 1990 Oct;4(5):535-9.
The effect of cilazapril, 2.5 to 5.0 mg and hydrochlorothiazide, 25 to 50 mg, on diastolic cardiac function was studied by echocardiography and radionuclide ventriculography, using a double-blind randomized parallel-group design with a placebo run-in period, in 30 hypertensive patients. The measurements were made before and three hours after the first dose, and after ten weeks of treatment. Both drugs lowered the elevated blood pressure and did not impair the normal systolic cardiac function. In the patients treated with cilazapril an improvement in indices of diastolic function was observed after the first dose. The normalized peak filling rate significantly increased from 2.4 +/- 0.7 to 2.7 +/- 0.7 counts and time to peak filling rate was shortened from 169.4 +/- 31.0 to 151.6 +/- 40.1 msec. This improvement was sustained or even enhanced during chronic therapy. In contrast hydrochlorothiazide acutely impaired one index of diastolic function, the normalised peak filling rate, and did not alter the other indices. Long-term treatment with cilazapril, but not with hydrochlorothiazide, caused regression of left ventricular hypertrophy.
cilazapril is superior to hydrochlorothiazide in its effect on diastolic cardiac function in hypertensive patients. The beneficial effect is partially related to regression of left ventricular hypertrophy.
采用双盲随机平行组设计并设有安慰剂导入期，对30例高血压患者进行研究，观察2.5至5.0毫克西拉普利和25至50毫克氢氯噻嗪对舒张期心脏功能的影响，运用超声心动图和放射性核素心室造影术进行测量。测量在首次给药前、首次给药后三小时以及治疗十周后进行。两种药物均降低了升高的血压，且未损害正常的收缩期心脏功能。在接受西拉普利治疗的患者中，首次给药后观察到舒张功能指标有所改善。标准化峰值充盈率从2.4±0.7显著增加至2.7±0.7计数，峰值充盈时间从169.4±31.0缩短至151.6±40.1毫秒。这种改善在长期治疗期间得以持续甚至增强。相比之下，氢氯噻嗪急性损害了一项舒张功能指标，即标准化峰值充盈率，而未改变其他指标。长期使用西拉普利而非氢氯噻嗪可使左心室肥厚消退。
在对高血压患者舒张期心脏功能的影响方面，西拉普利优于氢氯噻嗪。其有益作用部分与左心室肥厚消退有关。
