Sagastagoitia J D, Morillas M, Martínez A, Lage E, Pallarés C, Ugartemendía C, Asín E, Barrios V, Julia J, Sánchez P, Calvo C, González J, Piña C, García-Barbal J, Arnau C
Servicio de Cardiología y Unidad Coronaria. Hospital de Basurto, Bilbao, Bizkaia.
Rev Clin Esp. 1998 Jan;198(1):15-22.
An open and multicentric study was conducted with 66 patients with mild to severe diastolic arterial hypertension and echocardiographic left ventricular hypertrophy, the evolution of diastolic function, by means of doppler transmitral flow echocardiography, under treatment with ramipril, an angiotensin converting enzyme inhibitor, at a dose of 2.5 and 5 mg/day, or combined with a diuretic, after three and six months of treatment. Despite not obtaining the tensional control in all patients, a decrease in the mass, both in absolute values and mass index, was obtained. This decrease was observed both in male and female patients from the first three months, which went on until the sixth month, thus suggesting an independent action of the hemodynamic load decrease for the obtention of this effect. There was also a change in the ventricular geometry with a displacement of patients from concentric enlargement to normal, remodelling and eccentric enlargement. The diastolic function improved both for the early and for the late maximal filling velocity, relationship between both, and deceleration time, although the time during which this improvement occurred was different for each parameter, thus indicating the different influence of the dynamic and structural factors on these parameters. No correlation was found between the improvement in diastolic function and hypertrophy regression. We can conclude that ramipril is useful for the control of the left ventricular hypertrophy and diastolic function, irrespective of arterial tension values.
对66例轻至重度舒张期动脉高血压且伴有超声心动图左心室肥厚的患者进行了一项开放性多中心研究，采用多普勒经二尖瓣血流超声心动图观察在接受雷米普利（一种血管紧张素转换酶抑制剂，剂量为2.5和5mg/天）治疗时，或与利尿剂联合使用时，治疗3个月和6个月后舒张功能的变化。尽管并非所有患者都实现了血压控制，但无论是绝对值还是质量指数，左心室质量均有所下降。从最初的三个月起，男性和女性患者均观察到这种下降，并持续至第六个月，这表明获得此效应的原因是血流动力学负荷降低的独立作用。心室几何形态也发生了变化，患者从向心性扩大转变为正常、重塑和离心性扩大。舒张功能在早期和晚期最大充盈速度、两者之间的关系以及减速时间方面均得到改善，尽管每个参数出现改善的时间不同，这表明动态和结构因素对这些参数有不同影响。未发现舒张功能改善与肥厚消退之间存在相关性。我们可以得出结论，无论动脉血压值如何，雷米普利都有助于控制左心室肥厚和舒张功能。
