The Effect Of Two Therapeutic Regimens On The Left Ventricular Diastolic Function In Patients With Anti-hypertension Therapy

Objective:We aimed to explore whether the hypertensives benefits from anti-hypertension therapy in left ventricular diastolic function by Echocardiography and the relationship between the improvement of left ventricular diastolic function and medication of anti-hypertensive drugs.Methods:121patients with essential hypertension and51healthy controls were enrolled in this study. All of them were detected by conventional echocardiography for left atrial diameter(LAd), left atrial volume(LAV), the early and late diastolic peak velocity of mitral inflow (E,A), and the early and late diastolic peak velocity of mitral annulus myocardium(Em,Am) in PW-TDI. The parameters of LADI, LAVI, E/A, and Em/Am were calculated. The eligible patients were randomly assigned to group A or group B. Group A was treated with Levoamlodipine and Irbesartan. Group B was treated with Levoamlodipine and Arottnolol. The blood pressure and Echocardiographic examination were detected at baseline(0-week treatment),4-weeks and8-weeks treatment. Result:1. Compared to the control group(group N), LADI,LAVI and LVMI raised, while E/A, Em and Em/Am decreased in the hypertensive group(group A+B). The difference between the groups was significant (P<0.05).2. Compared to the baseline, Em/Am and Em increased in group A and group B, after4-weeks and8-weeks treatment (P<0.05).3. LAVI had no change in group A and group B after4-weeks treatment (P>0.05). After8-weeks treatment,compared to the baseline, LAVI decreased in group B and group A(P<0.05). Compared to group A,LAVI decreased in group B after8-weeks treatment(P<0.05).4. The stepwise regression analysis were showed:LAVIC=-3.596Xthe period of treatment+0.037XPPc+3.582(F=18.774, P<0.05).Em/AmC:=-0.006XPPc+0.138Xthe period of treatment+0.076Xtherapeutic regimen-0.139(F=21.170, P<0.05).EmC=-0.026XPPc+0.726Xthe period of treatment+0.104(F=6.630, P<0.05).Conclusion:1.Both Levoamlodipine combined with Irbesartan and Levoamlodipine combined with Arottnolol could improve the diastolic function of left ventricle after4-weeks treatment.2.Compared to LAVI, Em and Em/Am were more sensitive to reflect the improvement of left ventricular diastolic function after anti-hypertension therapy.3.Compared with Irbesartan, Arottnolol may be more effective on the earlier improvement of LAVI in left ventricular diastolic function.4.The change of PP, the period of treatment and therapeutic regimen were important independent impact factors of the improvement of LAVI, Em and Em/Am in left ventricular diastolic function.