The Influence of Diastolic Function on Angiotensin Receptor Blockade in Patients with Mild Left Ventricular Dysfunction

Abstract

Purpose: The aim of this study was to examine the influence of diastolic function on angiotensin II type I receptor blocker (ARB) in patients with mild left ventricular (LV) dysfunction already treated with angiotensin converting enzyme (ACE) inhibitors. Method: Diastolic function and neurohumoral variables were evaluated in 15 patients with mild LV dysfunction already treated with ACE inhibitors before and 4 weeks after administration of the ARB, telmisartan 40 mg. Diastolic function was determined by Doppler derivatives of mitral inflow (E/A ratio, deceleration time of early inflow) and pulmonary venous flow velocity (S/D ratio). B-natriuretic peptide (BNP), alpha-human atrial natriuretic peptide (HANP), plasma renin and plasma aldosteron were measured. Result: Arterial blood pressure decreased significantly after telmisartan (p 0.01). MV-E/A, deceleration time and isovolmic relaxation time did not changed after telmisartan. But pulmonary venous flow velocity improved significantly from 43 4 from 37 3 after telmisartan (p 0.05). Moreover, BNP decreased significantly from 143 85 to 76 47 pg/mL after telmisartan (p 0.05). Plasma renin, plasma aldosteron and HANP did not change after telmisartan. Conclusion: ARB telmisartan improves diastolic dysfunction in patients with mild LV dysfunction already treated with ACE inhibitors.