[Effect of calcium antagonist (diltiazem) on left ventricular diastolic properties in essential hypertension: a pulsed Doppler echocardiographic study].

To evaluate the acute effect of diltiazem on left ventricular diastolic properties, we measured transmitral flow in 15 patients with essential hypertension using pulsed Doppler techniques. Before administering diltiazem, the peak velocity (R) and the deceleration rate of rapid inflow decreased significantly as compared with healthy subjects, but the peak velocity during atrial contraction (A) and the A/R increased significantly. Immediately after the intravenous administration of 10 mg diltiazem, blood pressure decreased from 157 +/- 22/96 +/- 12 mmHg to 135 +/- 19/82 +/- 11 mmHg (p less than 0.001) and the heart rate increased from 69 +/- 10/min to 74 +/- 10/min (p less than 0.05). However, 30 minutes after the injection, these returned to control values. The peak velocity and deceleration rate of rapid inflow were 52 +/- 9 cm/sec and 227 +/- 65 cm/sec2, respectively, before administering diltiazem, and five minutes after injection, these parameters increased to 63 +/- 13 cm/sec (p less than 0.001) and 292 +/- 82 cm/sec2 (p less than 0.001), respectively. Thirty minutes later, these values leveled off at 58 +/- 12 cm/sec (p less than 0.01) and 257 +/- 76 cm/sec2 (p less than 0.05), respectively. The peak velocity during atrial contraction was 67 +/- 12 cm/sec before administration, and this did not change significantly after injecting diltiazem. Significant increases in peak velocity and deceleration rate of rapid inflow and decreases in the A/R continued after the blood pressure and heart rate returned to control values. It was therefore concluded that diltiazem improves impaired early diastolic left ventricular filling in essential hypertension.