Influence of valsartan on morphofunctional state of left ventricle in hypertensive patients
Abstract
Aim of this study were determination of morphofunctional state of left ventricle (LV) in hypertensives with different type of LV remodeling and changes of ones under valsartan treatment. 39 new founded hypertensives before and after 6-mounthly therapy of valsartan and 18 healthy volunteers were examined for determination type of LV remodeling and parameters of LV's morpho-functional state. Thickness of interventricular septum and LV's posterior wall, relative wall thickness by ASE, LV myocardial mass by Penn convention, indexed by body surface, endsystolic and enddiastolic myocardial tension and LV myocardial rigidity by Flashskampf F.A. et al were estimate with echocardiography and pulse-wave Doppler. Distribution of LV remodeling types was: normal geometry of LV (NG) - 36%, concentric transformation of LV (CT) - 49% and eccentric hypertrophy of LV (EH) - 15%. In the time of treatment we observed decrease of absolutely and relative LV wall thickness result in LV myocardial mass index decrease on 12.6±4.8% (p<0.01) in CT (vs. 11.2±5,7% (p<0.05) in NG and 9.3±6.8% (p<0.05) in EG (pANOVA<0.05)). Index of LV hypertrophy compensation (EDV/MMLV) increased to (NG/CT/EH) 68.5±4.8/57.8±5.3/59.4±7.2 vs. 74.0±9.6 in control group (on 11.5±4.8% (p<0.05)/29.6±6.3% (p<0.01)/13.7±7.8% (p<0.05), accordingly, pANOVA<0.05). Decrease of blood pressure and postload results in decrease of endsystolic myocardial tension on (NG/CT/EH) 12.8±5.6% (p<0.05)/14.8±4.7%(p<0.01)/10,1±5.9% (p<0.05), pANOVA<0.05. In diastolic function we observed decrease of LV myocardial rigidity on (NG/CT/EH) 12.4±3.6% (p<0.05)/16.9±5.6% (p<0.01)/9.7±5.3% (p<0.05) (pANOVA<0.05) result in decrease of enddiastolic myocardial tension on 15.6±5.7% (p<0.05)/18.9±4.8% (p<0.01)/12.7±8.4% (p<0.05), accordingly, pANOVA<0.05. Renin-angiotensin system block with valsartan (block of angiotensin-1 receptors and activation of angiotensin-2 receptors) in 6-month therapy results in improvement of morpho-functional state of myocardium of LV and promotes to reverse of LV remodeling.