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Abstract
Background
Left ventriculuar hypertrophy(LVH) detected by echocadiography has long been recognized as a consequence of hypertension as well as independent predictor of subsequent cardiovascular morbidity and mortality. Numerous studies have shown left ventricular hypertrophy regression in response to antihypertensive drug therapy. The advent of echocardiography has made possible the noninvasive estimation of left ventricular mass. In this study, we analysed hypertensive patients with LVH and without LVH by echocardiography to assees the changes of the left ventricular mass(LVM) and diastolic function after one year antihypertensive therapy.
Methods
Twenty patients with established hypertension were studied. No patients had a previos history of antihypertensive therapy. Patients were divided two group; patients with LVH(Group I), patients without LVH(Group II). We obtained the basal echocardiography at the diagnosis and follow-up echocardiography after 6months and 12months antihypertensive therapy with angiotensin converting enzyme inhibitor.
Results
1) Group I; Baseline blood pressure was 155/104mmHg and fell to 129/86mmHg (p<0.05) after 12 months antihypertensive therapy. There was no significant reduction in heart rate. Group II; Baseline blood pressure was 149/102mmHg and fell to 123/83mmHg (p<0.05) after 12 months antihypertensive therapy. There was no significant reduction in heart rate.
2) Group I; LVM was reduced significantly from 160g/m2 to 132g/m2 after 12months antihypertensive therapy. Group II; LVM was not significantly reduced after 12 months antihypertensive therapy.
3) Group I; Time velocity intergral dimension E(Ei) was increased from 9.1cm to 12.5cm significantly(p<0.05). and Ei/Ai was significantly increased from 1.7 to 2.1 (p<0.05) after 12 months antihypertensive therapy. Group II; There were no significantly interval changes in time velocity intergral dimension E(Ei), time velocity intergral dimension A (Ai) and Ei/Ai after 12 months antihypertensive therapy.
Conclusions
We concluded that antihypertensive therapy with ACE inhibitor reduced significantly the left ventricular mass and increased left ventricular diastolic function in hypertensive patients with LVH. We demonstrate the useful role that echocardiographic evaluation of left ventricular structure and function may play in hypertension research.
References
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Table 1.
고혈압 치료전고} 후의 혈압 및 심박수의변화 (Group I)
| 치료전 | 치료6개월 | 치료12개월 | |
|---|---|---|---|
| 수축기 혈압 (mmHg) | 155.4 ± 18.7 | 129.1 ± 15.6∗ | 138.3 ± 15.3∗∗ |
| 확장기 혈압 (mmHg) | 103.9 ± 5.0 | 86.3 ± 7.1∗ | 90.3 ± 6.7∗∗ |
| 심박수 (회/분) | 61.0 ± 19.1 | 64.7 ± 11.3 | 65.1 ± 7.0 |
Table 2.
고혈압 치료 전고- 후의 혈압 및 심박수의변화 (Group II)
| 치료전 | 치료6개월 | 치료12개월 | |
|---|---|---|---|
| 수축기혈압 (mmHg) | 149.0 ± 2.5 | 123.3 ± 10.3∗ | 131.4 ± 11.3 |
| 확장기혈압 (mmHg) | 102.3 ± 6.1 | 83.7 ± 4.3∗ | 84.3 ± 6.9∗∗ |
| 섬박수 (회/분) | 68.7 ± 4.8 | 72.0 ± 6.6 | 65.0 ± 8.0 |
Table 3.
고혈압 치료 전괴 후의 좌심실 형태학적변화 (Group I)
| 치료잔 | 치료6개월 | 치료12개월 | |
|---|---|---|---|
| LVIDd(mm) | 48.9 ± 5.3 | 50.3 ± 3.2 | 49.6 ± 4.0 |
| LVIDs(mm) | 30.5 ± 4.1 | 32.2 ± 3.7 | 30.5 ± 4.0 |
| IVSTd(mm) | 14.0 ± 1.8 | 11.4 ± 2.0∗ | 10.8 ± 1.1∗∗ |
| PWTd(mm) | 9.4 ± 1.4 | 9.1 ± 1.2 | 9.5 ± 1.3 |
| LVM(g) | 262.1 ± 78.5 | 212.5 ± 26.0 | 221.7 ± 36.0 |
| LVMI(g/m2) | 160.0 ± 54.1 | 126.7 ± 26.0∗ | 132.8 ± 18.4∗∗ |
| EF(%) | 67.2 ± 6.3 | 64.6 ± 7.5 | 67.6 ± 9.2 |
| Vcf(%) | 37.6 ± 4.7 | 36.2 ± 6.0 | 38.4 ± 6.9 |
Table 4.
고혈압 치료 전과 후의 좌심실 형태학적변화 (Group II)
Table 5.
고혈압 치료 전 과 후의 헐역학적 변화 (Group I)
| 치료전 | 치료6개월 | 치료12개월 | |
|---|---|---|---|
| Peak E (cm/sec) | 74.5 ± 13.0 | 73.8 ± 13.2 | 80.8 ± 15.6 |
| Peak A (cm/sec) | 75.9 ± 16.0 | 62.4 ± 13.2s | 68.5 ± 13.0 |
| E/A | 1.0 ± 0.2 | 1.2 ± 0.4 | 1.2 ± 0.3 |
| Integral E (cm) | 9.1 ± 2.4 | 10.8 ± 2.3 | 12.5 ± 2.5∗∗ |
| Integral A (cm) | 5.7 ± 1.6 | 5.5 ± 1.6 | 6.1 ± 1.6 |
| Ei/Ai | 1.7 ± 0.5 | 2.1 ± 0.7∗ | 2.1 ± 0.5∗∗ |
Table 6.
고혈압 치료 전과 후의 혈역학적 변화 (Group II)
| 치료전 | 치료6개월 | 치료12개월 | |
|---|---|---|---|
| Peak E(cm/sec) | 87.3 ± 11.0 | 64.0 ± 16.2∗ | 90.0 ± 20.6 |
| Peak A(cm/sec) | 72.0 ± 14.1 | 63.5 ± 16.2 | 70.0 ± 17.5 |
| E/A | 1.2 ± 0.2 | 1.3 ± 0.3 | 1.3 ± 0.4 |
| Integral E(cm) | 12.0 ± 1.3 | 10.8 ± 1.5 | 11.8 ± 2.6 |
| Integral A (cm) | 5.3 ± 1.0 | 5.2 ± 1.6 | 5.6 ± 1.1 |
| Ei/Ai | 2.3 ± 0.4 | 2.3 ± 0.7 | 2.1 ± 0.3 |
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