Changes in Left Ventricular Diastolic Function after Antihypertensive Treatment in Patients with Hypertension

ABSTRACT

BACKGROUND: Left ventricular diastolic dysfunction is often observed in hypertensive patients with normal left ventricular systolic function and can cause heart failure symptoms. Doppler echocardiography has become a standard tool for examining left ventricular diastolic function. This study was performed to evaluate the left ventricular diastolic function in hypertensive patients with normal left ventricular systolic function and to determine the changes in left ventricular diastolic function after antihypertensive treatment. METHODS: Mitral inflow and pulmonary venous Row velocities were evaluated by transthoracic pulsed-wave Doppler study in patients with hypertension before antihypertensive treatment(n= 50) and after antihypertensive treatment for 4 months(n=24). The patients were randomly assigned to group I to receive ACE inhibitor or group II to receive other antihypertensive drugs. RESULTS: Before antihypertensive treatment, mitral inflow E/A ratio was 0.94+/-0.27, decele- ration time was 222+/-47 msec, and pulmonary venous flow S/D ratio was 1.62+/-0.42. Follow- up Doppler study was completed in 24 patients after 4 months of antihypertensive treatment. Mitral inflow E/A ratio was significantly increased(0.96+/-0.24 vs. 1.16+/-0.25, p<0.001), but deceleration time showed no significant changes. Pulmonary venous flow S/D ratio was signi- ficantly decreased(1.75+/-0.27 vs. 1.50+/-0.24, p<0.001). There was no significant difference in changes in mitral inflow E/A ratio, deceleration time and pulmonary venous flow S/D ratio between ACE inhibitor group and other antihypertensive group. CONCLUSION: There was some improvement in left ventricular diastolic function in patients with hypertension after 4 months of antihypertensive treatrnent. But, there was no significant difference in changes in diastolic parameters between ACE inhibitor group and other antihy- pertensive group.