Effect Of Bisoprolol On Left Ventricular Hypertrophy In Middle-aged And Young Patients With Hypertension

Objective: To observe the reversal effect of biso Prolol-based antihy Pertensive thera Py on left ventricular hy Pertro Phy in middle-aged and young Patients with hy Pertension,and to evaluate left ventricular function and structural changes by 2D-STI technique before and after treatment.Methods: In this single-centered,randomized,Positive drug control,non-inferiority and o Pen design study,sixty four Patients with hy Pertensive left ventricular hy Pertro Phy were randomly divided into two grou Ps: the biso Prolol grou P(biso Prolol±amlodi Pine)and the losartan control grou P(losartan ± amlodi Pine)(P<0.05),each grou P includes 32 cases.Having been followed u P for one year with 2D-STI technique,left ventricular structural and functional outcomes were reflected by left ventricular longitudinal strain(LS),left ventricular radial strain(RS),circumferential strain(CS),left ventricular fractional shortening(FS),E/A ratio,left ventricular ejection fraction(LVEF),interventricular s Petal end-diastolic thickness(IVSTd),left ventricular Posterior wall Thickness end-diastolic thickness(LVPWTd),etc.Analysis and com Parison of differences between two grou Ps before and after treatment were conducted.Results: 1.The systolic blood Pressure of the bisoProlol grouP decreased from 150.3 ± 11.3 mm Hg to 134.7 ± 8.4 mm Hg,clinical diastolic blood Pressure decreased from 104.1 ± 3.7 mm Hg to 82.1 ± 5.8mm Hg,24 h mean systolic blood Pressure 136.9 ± 9.6 mm Hg decreased to 124.3 ± 6.2mm Hg,24 h average diastolic blood Pressure fell from 86.5± 7.6 mm Hg to 74.6 ± 7.6 mm Hg,Blood Pressure difference of this grou P between before and after treatment is of statistical significance(P<0.01);for losartan grou P,clinical systolic blood Pressure decreased from 154.7 ± 13.5 mm Hg to 133.2 ± 6.9 mm Hg,and the diastolic blood Pressure decreased from 104.3 ± 3.6 mm Hg to 82.3 ± 5.2mm Hg;24 hours mean systolic Pressure fell from 136.9 ± 9.6 mm Hg to124.3 ± 6.2 mm Hg,24 hours mean diastolic Pressure 86.5 ± 7.6 mm Hg decreased to 74.6 ± 7.6 mm Hg,which were different from that before treatment and statistically significant(P <0.01).There was no significant difference in blood Pressure between the two grou Ps before and after treatment(P>0.05).2.IVSTd of the biso Prolol grou P decreased from 12.84 ± 1.33 mm to 12.02 ± 1.22 mm,LVM decreased from 301.05 ± 35.71 g to 258.65 ±28.42 g,LVMI decreased from 135 ± 11.98 g / m2 to 110 ± 10.53 g / m2 after treatment;com Pared with these indicators before treatment,the differences were statistically significant(P<0.01).In the losartan grou P,IVSTd decreased 12.76±1.16 mm to 12.07±1.02 mm,LVM decreased from 306.38 ± 34.62 g to 260.05 ± 30.02g;LVMI decreased from 134 ±12.84 g/m2 to 112 ± 11.08 g/m2 after treatment;com Pared with these indicators before treatment,the differences were statistically significant(P<0.01).In the biso Prolol grou P The ratio of E/A increased from 0.82 ±0.29 to 1.07 ± 0.26 after treatment,com Pare with E/A ratio before treatment,the difference was of statistical significance(P <0.01);.the LVEF value increased from 63.54 ± 3.45% to 65.17 ± 2.56%,of which the difference was not significantly different(P>0.05)when com Prared between before and after treatment.The ratio of E/A in losartan grou P increased from 0.79±0.33 to 0.93±0.28;LVEF value increased from63.45±3.24% to 64.74±2.47%,the differences of these indicators before and after treatment were not significantly different(P>0.05).The differences in IVST,LVM,LVMI,E/A ratio and LVEF between the two grou Ps before and after treatment were not significantly different(all P>0.05),where as the difference of E/A ratio was of statistical significance(P<0.01).3.The LS values of the long axis of the two grouPs after treatment were higher than that before treatment,and the differences were of statistical difference(P<0.05).However,difference of left ventricular systolic Phase LS value was of no statistical significance when com Pared between the two grou Ps(P>0.05).4.CS values at systole Phase were higher after treatment in both grou Ps(P<0.05),whereas the difference of CS values between the two grou Ps showed no statistical significance(P>0.05)5.The systolic radial strain(RS)values of the two grou Ps of 3 levels of left ventricular short axis and integral level were higher than those before treatment(P <0.05).There were no statistical differences in RS values when com Pared between the two grou Ps at 3 levels of left ventricular short axis(P> 0.05).Conclusion:Although biso Prolol's effect in reversing left ventricular hy Pertro Py in young and middle-aged Patients with hy Pertension,is equivalent to that of losartan,biso Pro Plol can further im Prove left ventricular diastolic function.