Reversal of cardiac hypertrophy and left ventricular function with the calcium antagonist felodipine in hypertensive patients.

Abstract

A study was carried out to evaluate the influence of antihypertensive treatment with a calcium antagonist on left ventricular hypertrophy and to estimate left ventricular performance after reversal of myocardial hypertrophy. Ten essential hypertensives (age 45 +/- 2 years; WHO class II) underwent an M-mode echocardiogram guided by two-dimensional echocardiography, during a wash-out period and after 3, 6 and 12 months of treatment with felodipine ER 10 mg/daily. At month 12 the echocardiogram was also performed during a handgrip test. BP levels during the treatment period decreased significantly, and left ventricular mass index showed a significant reduction from 143 +/- 13 to 112 +/- 9 g/m2 (P less than 0.001). A significant increase occurred in fractional shortening (FS) which was associated with decreases in end-systolic stress (ESS), left ventricular internal diameter (LVIDs) and inotropic state indices. Moreover, after reversal of myocardial hypertrophy left ventricular performance remained unchanged. Linear regression analysis showed a significant correlation of FS with ESS, which remained significant until the end of the study period, both at rest and at peak handgrip test (r = -0.68; P less than 0.05 and r = -0.80, P less than 0.01 respectively). This study demonstrates a significant decrease in left ventricular mass during treatment with a dihydrophyridine calcium antagonist and a good maintenance of left ventricular performance following reversal of myocardial hypertrophy in hypertensives.