Modena M G, Masciocco G, Rossi R, Baraldi P, Mattioli G
Cardiology Department, University of Modena, Italy.
Cardiovasc Drugs Ther. 1994 Feb;8(1):153-60. doi: 10.1007/BF00877104.
Myocardial hypertrophy is a response to many diseases, above all hypertension, that involves morphological and functional damage and may be the basis for the development of myocardial dysfunction. We attempted to verify the effectiveness of a new calcium antagonist, isradipine 5 mg SRO, on the reversal of left ventricular hypertrophy. For this purpose 13 hypertensive patients (pts) were treated for 12 weeks, which is the minimum period described in the literature for the regression of hypertrophy. At the end of the study, blood pressure in all patients returned to normal levels (mean blood pressure from 120.15 +/- 4.4 to 108 +/- 6.4 mmHg, p < 0.001); end-systolic stress (from 128 +/- 30 to 65 +/- 14 g/cm2, p < 0.001), and left ventricular mass index (from 142 +/- 31 to 97 +/- 23 g/m2, p < 0.001) showed significant reduction. Moreover, Doppler-derived indexes of left ventricular filling improved, particularly early to late peak velocity of the mitral valve (E/A ratio) and deceleration time (from 235 +/- 37 to 198 +/- 17 msec, p < 0.001), which were normalized after 12 weeks. In conclusion isradipine shows rapid effects in the reversal of morphofunctional damage in hypertension. For this reason it also appears to be useful for the treatment of myocardial hypertrophy in the absence of chronic hypertension.
心肌肥厚是对多种疾病的一种反应，尤其是高血压，它涉及形态和功能损伤，可能是心肌功能障碍发展的基础。我们试图验证一种新型钙拮抗剂——5毫克控释型伊拉地平对逆转左心室肥厚的有效性。为此，对13例高血压患者进行了为期12周的治疗，这是文献中描述的肥厚消退的最短时间。研究结束时，所有患者的血压均恢复至正常水平（平均血压从120.15±4.4降至108±6.4 mmHg，p<0.001）；收缩末期应力（从128±30降至65±14 g/cm²，p<0.001）和左心室质量指数（从142±31降至97±23 g/m²，p<0.001）均显著降低。此外，经多普勒测量的左心室充盈指标有所改善，尤其是二尖瓣的早期至晚期峰值速度（E/A比值）和减速时间（从235±37降至198±17毫秒，p<0.001），12周后恢复正常。总之，伊拉地平在逆转高血压患者的形态功能损伤方面显示出快速的效果。因此，在无慢性高血压的情况下，它似乎也可用于治疗心肌肥厚。
