Amici E, Patruno N, Natale E, Marsocci A, Gambelli G
Divisione di Cardiologia, Ospedale GB Grassi, Roma.
Cardiologia. 1993 Sep;38(9):585-91.
Left ventricular (LV) hypertrophy with increased LV mass is associated with abnormal LV diastolic filling in patients with hypertension. To assess the effect of antihypertensive therapy on LV mass (M), LV wall stress (SS) and rapid LV filling, 16 patients (12 males, 4 females), mean age 57 +/- 8 years, were treated with nifedipine slow release (NSR, 20 mg bid) for 12 months and evaluated by Doppler echocardiography at baseline and at 3, 6, 9, 12 months from the beginning of treatment. No other cardiovascular drugs were given during the study. Systolic and diastolic blood pressure (SBP, DBP), LVM/m2 body surface (bs; M/m2), LVSS, LV end-diastolic and end-systolic diameters (EDD/m2, ESD/m2) bs, left atrial diameter (LAD), fractional shortening index (FS%), isovolumic relaxation time (IVRT), E/A velocities ratio at mitral Doppler spectrum (E/A) were measured at each examination. During treatment, systolic and diastolic blood pressure, LVM, LVSS, LV end-systolic diameter and isovolumic relaxation time decreased and FS% and E/A significantly increased as compared with baseline values, EDD and LAD did not change significantly. The reduction of LVSS was of greater extent compared with that of LVM, at short and at mid-term, probably for a fibrotic component of LVM induced by chronic systolic overload. Changes of ESD and FS% were less evident compared with LVSS, possibly depending on their contribution to LVSS normalization. In conclusion, our experience indicates that NSR is an effective antihypertensive agent at short and mid-term.(ABSTRACT TRUNCATED AT 250 WORDS)
高血压患者左心室(LV)肥厚伴左心室质量增加与左心室舒张期充盈异常有关。为评估降压治疗对左心室质量(M)、左心室壁应力(SS)和左心室快速充盈的影响,对16例患者(12例男性,4例女性)进行了研究,平均年龄57±8岁,给予硝苯地平缓释片(NSR,20mg,每日2次)治疗12个月,并在治疗开始时及治疗后3、6、9、12个月通过多普勒超声心动图进行评估。研究期间未给予其他心血管药物。每次检查时测量收缩压和舒张压(SBP、DBP)、左心室质量/体表面积(bs;M/m2)、左心室壁应力、左心室舒张末期和收缩末期直径(EDD/m2、ESD/m2)bs、左心房直径(LAD)、缩短分数指数(FS%)、等容舒张时间(IVRT)、二尖瓣多普勒频谱E/A速度比值(E/A)。治疗期间,与基线值相比,收缩压和舒张压、左心室质量、左心室壁应力、左心室收缩末期直径和等容舒张时间降低,FS%和E/A显著增加,EDD和LAD无明显变化。短期和中期,左心室壁应力的降低幅度大于左心室质量,这可能是由于慢性收缩期负荷诱导的左心室质量纤维化成分所致。与左心室壁应力相比,ESD和FS%的变化不太明显,可能取决于它们对左心室壁应力正常化的贡献。总之,我们的经验表明,硝苯地平缓释片在短期和中期是一种有效的降压药物。(摘要截短为250字)