Failure of antihypertensive therapy with diuretic, beta-blocking and calcium channel-blocking drugs to consistently reverse left ventricular diastolic filling abnormalities.
Failure of antihypertensive therapy with diuretic, beta-blocking and calcium channel-blocking drugs to consistently reverse left ventricular diastolic filling abnormalities.
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使用利尿剂、β-阻滞剂和钙通道阻滞剂的抗高血压治疗未能持续逆转左心室舒张期充盈异常。
DOI：
10.1016/0002-9149(84)90583-6
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发表时间：
1984
期刊：
影响因子：
--
通讯作者：
Tubau,JF
中科院分区：
文献类型：
--
作者：
Inouye,IK;Massie,BM;Loge,D;Simpson,P;Tubau,JF
本方案旨在确定使用氢氯噻嗪、普萘洛尔或地尔硫卓（3种作用机制不同且对心肌功能的潜在影响不同的药物）进行降压治疗是否可逆转左心室充盈异常。12例原发性高血压患者，没有相关的心血管疾病的证据，无论是临床或非侵入性测试，进行了评估，而不采取任何药物治疗和2个月后，这些代理商。所有3种药物对血压（BP）的控制效果相当，坐位收缩压平均降低20至24 mm Hg，舒张压平均降低14至16 mm Hg。除1例受试者（从LV舒张充盈分析中排除）外，所有受试者的LV射血分数和舒张末期容积均正常，且未因药物治疗而改变。高血压患者的左室峰值充盈率和第一-第三充盈分数降低，但这些指标和峰值充盈率时间均未显著改善。10例用地尔硫卓控制血压的患者中有9例的第1 - 3充盈分数增加，但这种变化没有达到统计学意义。我们的研究结果表明，左室舒张期充盈异常并不总是受到短期治疗的慢性，以前治疗过的全身性高血压患者。
The present protocol was designed to determine whether antihypertensive therapy with hydrochlorothiazide, propranolol or diltiazem, 3 agents with different mechanisms of action and potentially different effects on myocardial function, reverses left ventricular filling abnormalities. Twelve patients with essential hypertension and no evidence of associated cardiovascular disease, either clinically or with noninvasive testing, were evaluated while taking no medication and after 2 months of treatment with these agents. All 3 drugs produced equivalent control of blood pressure (BP), reducing sitting systolic BP by a mean of 20 to 24 mm Hg and diastolic BP by 14 to 16 mm Hg. LV ejection fraction and end-diastolic volume were normal in all but 1 subject (who was excluded from the analyses of LV diastolic filling) and were not altered by drug therapy. The peak LV filling rate and the first-third filling fraction were reduced in the patients with hypertension, but neither of these indexes nor the time to peak filling rate were significantly improved for the group as a whole by any of these medications. Nine of 10 patients whose BP was controlled by diltiazem had increases in their first-third filling fraction, but this change did not reach statistical significance. Our findings suggest that abnormalities of LV diastolic filling are not consistently affected by short-term therapy in patients with chronic, previously treated systemic hypertension.