Cífková R, Niederle P, Romanovská L, Skibová J, Frídl P, Skalická H, Widimský J
Institute for Postgraduate Medical Education, Department of Cardiology, Prague, Czechoslovakia.
J Hypertens Suppl. 1987 Dec;5(5):S407-10.
Fifty-two middle-aged hypertensive males with left ventricular hypertrophy, diagnosed by echocardiography, were divided into two groups; 30 of them were treated with beta-blockers and 22 with methyldopa. Where blood pressure was insufficiently controlled, diuretics and, eventually vasodilating agents, were added to both treatment regimes. During 2 years of follow-up, blood pressure decreased significantly. The greatest decrease was observed during the first 3 months. Echocardiography revealed the greatest decrease in posterior wall and interventricular septal thickness also during the first 3 months. Posterior wall hypertrophy was reversed completely in the next 3 months, while further regression of interventricular septal hypertrophy was continuous during the remaining follow-up period. Left ventricular hypertrophy was reversed completely in 27 (51.9%) probands and remained unchanged in two patients. The regression was incomplete in 23 (44.2%) patients who were more obese and whose left ventricular hypertrophy was initially more pronounced. Regression of hypertrophy was not associated with a deterioration in left ventricular function and was achieved even after the addition of vasodilating drugs. No differences were observed between the treatment groups. The pathogenesis of left ventricular hypertrophy still remains unclear. After 2 years, no changes in peripheral vascular resistance in the forearm were observed at reactive hyperaemia. These results indicate that there might be a delay in the regression of vessel hypertrophy compared with that of the left ventricle.
52名经超声心动图诊断为左心室肥厚的中年男性高血压患者被分为两组；其中30人接受β受体阻滞剂治疗，22人接受甲基多巴治疗。若血压控制不佳，则在两种治疗方案中均加用利尿剂，并最终加用血管扩张剂。在2年的随访期间，血压显著下降。最大降幅出现在最初3个月。超声心动图显示，后壁和室间隔厚度在最初3个月也下降最大。后壁肥厚在接下来3个月完全逆转，而室间隔肥厚在剩余随访期持续进一步消退。27例（51.9%）先证者的左心室肥厚完全逆转，2例患者无变化。23例（44.2%）患者的肥厚逆转不完全，这些患者更肥胖，其左心室肥厚最初更明显。肥厚的逆转与左心室功能恶化无关，即使在加用血管扩张药物后仍可实现。治疗组之间未观察到差异。左心室肥厚的发病机制仍不清楚。2年后，在前臂反应性充血时未观察到外周血管阻力的变化。这些结果表明，与左心室相比，血管肥厚的逆转可能存在延迟。
