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Effects of Angiotensin‐Converting Enzyme Inhibition on Left Ventricular Geometric Patterns in Patients with Essential Hypertension
Author(s) -
Castro Stefano,
Pelliccia Francesco,
Cartoni Domenico,
Funaro Stefania,
Melillo Guido,
Beni Sergio,
Magni Giuseppina,
Migliau Giorgio,
Fedele Francesco
Publication year - 1996
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/j.1552-4604.1996.tb04168.x
Subject(s) - essential hypertension , cardiology , angiotensin converting enzyme , medicine , geometric pattern , renin–angiotensin system , blood pressure , geometric shape , mathematics , geometry
Although angiotensin‐converting enzyme inhibitors have been shown to affect left ventricular (LV) remodeling favorably in several conditions, it remains unclear whether they can influence LV geometric pattern in hypertension. To address this issue, 122 patients (71 men and 51 women; mean age = 51 ± 10 years) with mild to moderate hypertension were studied prospectively. All underwent clinical evaluation and Doppler echocardiography at entry and more than 2 years of quinapril therapy (10–40 mg/day). According to either LV mass (normal if <131 g/m 2 for men or <100 glm 2 for women) or the ratio of LV posterior wall thickness to diastolic diameter (RWT; normal if <0.45) at baseline, 58 patients had normal mass and RWT, 18 patients had concentric remodeling (i.e., normal mass but increased RWT), 24 patients had eccentric hypertrophy (i.e., increased mass but normal RWT), and 22 patients had concentric hypertrophy (i.e., increase in both mass and RWT). After 6 months of quinapril therapy, all patients with normal left ventricles showed the maintenance of mass and RWT within normal limits. Patients with concentric remodeling showed no increase in mass but had a significant decrease in RWT. Patients with eccentric hypertrophy exhibited a significant reduction in mass with no substantial change in RWT. Patients with concentric hypertrophy had a significant reduction in both mass and RWT. Changes in LV mass and geometry were maintained during the 2‐year period of treatment and were paralleled by improvements in Doppler indices of LV diastolic function in each group. It is concluded that quinapril, with its well‐known effects on LV hypertrophy, modifies the LV geometric pattern of hypertensive patients favorably, regardless of the presence of an abnormal LV mass or RWT.