The effect of valsartan on left ventricular myocardial functions in hypertensive patients with left ventricular hypertrophy


Kucukler N., Kurt I. H., Topaloglu C., Gurbuz S., Yalcin F.

Journal of Cardiovascular Medicine, vol.13, no.3, pp.181-186, 2012 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 13 Issue: 3
  • Publication Date: 2012
  • Doi Number: 10.2459/jcm.0b013e3283511f00
  • Journal Name: Journal of Cardiovascular Medicine
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.181-186
  • Keywords: Angiotensin receptor blocker, Hypertension, Left ventricular hypertrophy, Midwall mechanics, Tissue Doppler imaging
  • Akdeniz University Affiliated: No

Abstract

Background It has been shown by various diagnostic methodologies that angiotensin receptor blockage reduces left ventricular mass, improves diastolic function and increases contractility in hypertensive left ventricular hypertrophy (LVH). We planned to detect the effect of angiotensin receptor blockage on midwall mechanics and myocardial dynamics in hypertensive patients with LVH. Methods Angiotensin 2 type 1 receptor blocker (valsartan 80-160 mg) was administered to 38 previously untreated hypertensive patients with LVH for 6 months. Left ventricular midwall mechanics and tissue Doppler velocities were measured at baseline and at the end of the study. Results : Mean blood pressure was reduced from 152W14/ 92W8 to 131±14/83±9mmHg (P < 0.05). Left ventricular mass index was decreased from 135±15 to 114±14g/m2 (P < 0.001). Midwall fractional shortening was increased from 19.0±4 to 22.4±3% (P < 0.05). Circumferential endsystolic wall stress was decreased from 131W44 to 119±37T103 dyn/cm2 (P < 0.05). Left ventricular interventricular septal myocardial tissue peak systolic velocity was increased from 6.7W1 to 8.1±0.9 cm/s (P < 0.001) and lateral wall myocardial tissue peak systolic velocity was increased from 7.5W1 to 9.0W1 cm/s (P < 0.001), and E/Em ratio was significantly decreased (11.0±0.3 to 8.90±0.1, P < 0.05) with 6-month valsartan therapy. Conclusion This study suggests that valsartan exhibits not only blood pressure-lowering qualities but also cardioprotective actions in patients with hypertension because it enhances regression of LVH and improves left ventricular myocardial contractility and relaxation.