Short-term effect of fosinopril on left ventricular hypertrophy and diastolic function in patients with essential hypertension

Abstract

to assess the effect of angiotensin-converting enzyme inhibitor fosinopril (FOS) on left ventricular (LV) diastolic function and LV mass in essential hypertension (EH) patients. 22 patients with EH (aged 44±9years) were treated 10 or 20 mg FOS daily for 8 weeks. The patients were examined by M-mode and Doppler echocardiography. LV mass index (LVMI), intraventicular septal thickness and posterior wall thickness in diastole, relative wall thickness (RWT), ejection fraction (EF), early filling velocity (E), late filling velocity (A), E/A ratio, time velocity integral of early filling (VTI E), time velocity integral of late filling, isovolumic relaxation time (IVRT), deceleration time were determined. Blood pressure (BP) was measured by 24-hour ambulatory monitoring. FOS 8-week treatment resulted in a significant fall of average 24-hour BP, average daytime BP, average nighttime BP. LVMI decreased from 129,9±10,5 to 113,9±7,5 g/m2 (p<0,05), RWT - from 0,40±0,01 to 0,36±0,01 (p<0,05). This reduction was associated with significant decreases in LV septal wall thickness (from 1,15±0,07 to 1,05±0,04 cm, p<0,05) without negative changes in LV systolic function (EF increased from 61,0±2,0 to 67,9±1,5 %, p<0,05). It was founded a modest relationship between reductions in BP and a decrease in LVMI. During treatment LV diastolic filling and relaxation were improved in EH patients with E/A<1: E (from 0,61±0,05 to 0,67±0,06 m/s, p<0,05), VTI E (from 0,087±0,01 to 0,099±0,01 m, p<0,05), E/A (from 0,92±0,1 to 1,05±0,1, p<0,05) and IVRT (from 100,0±4,2 to 94,2±3,9 ms, p<0,05). In spite of short period of treatment, FOS influence on LV mass and diastolic function in EH patients. These findings support the concept that nonhemodynamic mechanisms also participate in short-term therapeutic changes.