2008, Number 4
Arch Cardiol Mex 2008; 78 (4)
Teniente-Valente R, Solorio S, Vargas-Salado E, Aguirre-Vázquez C, Hernández-González MA, Olvera-Lopez JA, Rodríguez-Mariscal L, Luna-Ruiz MA, Guillén CJM, Murillo OBO
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ABSTRACTObjective: To evaluate the diastolic function after regression of left ventricular hypertrophy, in mild to moderate hypertension treated with angiotensin converting enzyme(ACE) inhibitor and, if necessary, with a diuretic. Methods: Ninety-eight hypertensive patients with left ventricular hypertrophy (LVH) and abnormal left ventricle diastolic function indexes received captopril (Capotena®) 50 to 200 mg/day plus chlortalidone during 12 months to reach blood pressure control, defined as a diastolic blood pressure £ 90 and systolic blood pressure £ 140 mm Hg. Left ventricular (LV) mass index was calculated by M mode and two-dimensional echocardiography, and left ventricular diastolic function was assessed by transmitral pulsed Doppler ultrasound every 3 months. Results: Sixty-three patients were women and 35 were men, mean age was 53.4 ± 8.4 years (range 34-70). Thirty-six patients had mild (36.7%) and 62 (63.3%) moderate hypertension. Treatment reduced significantly both systolic pressure from 165 ± 13 to 137 ± 12.9 mm Hg (p ‹ 0.05) and diastolic pressure from 99 ± 8.6 to 86 ± 6.37 mm Hg (p ‹ 0.05). LV mass index decreased from 155.4 ± 32.9 to 121.7± 29.14 g/m2 (p ‹ 0.05). Late diastolic filling velocity (A wave) and the ratio of E/A waves improved (p ‹ 0.05), but early diastolic filling velocity (E wave) and isovolumetric relaxation time did not change with treatment. Conclusions: Some indexes of diastolic function improved after regression of left ventricular hypertrophy and good blood pressure control with captopril and chlortalidone.