Regression of Left Ventricular Mass in Essential Hypertension

Choi, Tae Ryul; Kim, Jae Pil; Kang, Heung Sun; Choue, Chung Whee; Kim, Kwon Sam; Kim, Myung Shick; Song, Jung Sang; Bae, Jong Hoa

Abstract

BACKGROUND
Hypertension is the most common cause of left ventricular hypertrophy(LVH). Increased left ventricular mass(LVM) carries independent risk for congestive heart failure, coronary artery disease, sudden death, reduction of coronary reserve. The importance of treatment in systemic hypertension for cardiovascular morbidity and mortality has been estabilished. Regression of LVM occurs with a number of antihypertensive drugs. This study was designed to explore the relation between blood pressure control, LVM and left ventricular filling dynamics. METHODS: Twenty five patients (12 men, 13 women) with estabilished hypertension were studied. No patients had a previous history of antihypertensive therapy. We obtained the basal echocardiography at the diagnosis which were disclosed no definite LVH, and the follow-up echocardiography after 6 months antihypertensive therapy with angiotension converting enzyme inhibitor, fosinopril, in patients with untreated essential hypertension. RESULTS: 1) Baseline blood pressure was 150/125mmHg and fell to 104/85mmHg (p<0.001). There was no siginificant reduction in heart rate. LVM were reduced from 153gr/m2 to 129gr/m2. 2) Peak E velocity and Peak A velocity was 82.9cm/sec, 74.9cm/sec and reduced to 67.2cm/sec, 62.3cm/sec, (p<0.001). 3) Time velocity integral dimension E (Ei) and time velocity integral dimension A (Ai) was 13.0cm, 9.0cm and reduced to 8.6cm, 4.5cm respectively. But there was no significant inteval change in peak E/A velocity. Ei/Ai was increased from 1.7 to 2.1 (p<0.01). CONCLUSIONS: These results suggested that antihypertensive therapy with ACE inhibitor for 6 months reduced significantly the left ventricular mass in patients with untreated essential hypertension.