Assuntos
Enalapril/uso terapêutico , Hemodinâmica/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Rim/efeitos dos fármacos , Adulto , Avaliação de Medicamentos , Feminino , Taxa de Filtração Glomerular/efeitos dos fármacos , Humanos , Hipertensão/diagnóstico por imagem , Hipertensão/fisiopatologia , Rim/diagnóstico por imagem , Rim/fisiopatologia , Masculino , Pessoa de Meia-Idade , Renografia por Radioisótopo , Sistema Renina-Angiotensina/efeitos dos fármacos , Tecnécio Tc 99m Mertiatida , Fatores de TempoRESUMO
Sublingual nifedipine, 30 mg, was used to abolish hypertensive crises in 32 patients. A follow-up of changes in blood pressure, ECG, and echocardiographic parameters evaluating the cardiac performance and central hemodynamics was performed during 4 hours after the drug. The patients with profound myocardial hypertrophy and dilatation at a left ventricular myocardial weight of over 200 g at the peak of the antihypertensive effect occurred for 15-60 min exhibited transient ECG changes by the type of subendocardial ischemia despite an above 25% reduction in mean blood pressure and the lack of severe reflex tachycardia, the pump function of the heart showing no decreases. The ejection fraction increased from 51.0 +/- 2.8 to 62.0 +/- 2.5% (p less than 0.05) due to lower afterload. There were no clinical manifestations typical of myocardial ischemia.
