Effects of amlodipine on left ventricular diastolic function in patients with essential hypertension

ABSTRACT

BACKGROUND: In previous study, hypertensive patients with left ventricular diastolic dysfunction showed delayed relaxation time intervals and increased relaxation nonuniformity of regional wall motion. In this point of view, the effects of amlodipine on the regional wall motion and mitral flow patterns were evaluated. METHODS: Before and 32weeks after the antihypertensive medication of amlodipine, M-mode & Doppler echocardiogram were performed in 14 patients with moderate hypertension. We measured A2 to the peak thinning rate point of left ventricular(LV)posterior wall [A2-(-)dpw/dt] and the peak lengthening rate point of mitral annulus [A2-dL/dt] on M-mode echocardiogram and we defined nonuniformity as the time interval, (-)dpw/dt-dL/dt. RESULTS: 1) Mitral flow velocity E/A ratio was increased (0.95+/-0.4 vs 1.42+/-0.6, p<0.05) after amlodipine medication. 2) Heart rate and LV posterior wall thickness was decreased (79+/-9.3 vs 72+/-10.8 beats/min, 10.7+/-1.5 vs 9.4+/-2.0mm, p<0.05 respectively). 3) Long axis relaxation was improved (A2-dL/dt ; 165+/-44 vs 140+/-23msec, p<0.05) and nonuniformity index was decreased ((-)dpw/dt-dL/dt ; 63+/-49 vs 41+/-30msec p=0.07). CONCLUSION: Amlodipine improved E/A ratio of mitral flow (E/A ratio) in hypertensive patients with diastolic dysfunction, which could be attributed to the decreased heart rate, the decrease in wall thickness and the improvement in relaxation movement of LV long axis.