Cardiovascular Drugs and Therapy

, Volume 4, Supplement 5, pp 957–961 | Cite as

Early regression of left ventricular diastolic abnormalities in hypertensive patients treated with nifedipine

  • I. Sheiban
  • G. Covi
  • C. Zenorini
  • G. Arcaro
  • E. Arosio
  • S. Tonni
  • G. Montresor
  • A. Lechi
Nifedipine in Hypertension


The effects of nifedipine on blood pressure (BP), left ventricular hypertrophy, and diastolic function were evaluated in 14 patients with essential hypertension (EH). All males with a mean age of 44±6 years (range 35–58 years), and in ten normotensive subjects (control group) aged 32–42 years (mean age 36±4). A complete echocardiogram (ECHO) was performed in basal conditions after 1 and 6 months of therapy with nifedipine (20–40 mg/day). Left ventricular echocardiograms (LV ECHO, M-mode, two-dimensional guided) were plotted with a simultaneous ECG tracing by means of a computerized system that allows evaluation of the following parameters: LV end-diastolic and systolic diameters (EDD, ESD); variations in LV diameter and volume during the entire cardiac cycle, and the velocities of such variations; end-diastolic thicknesses of the interventricular septum and posterior wall (ST, PWT); LV mass, mass/volume (M/V) index, end-diastolic diameter/thickness (D/Th) index, and LV ejection fraction (EF). Left ventricular volume curves were obtained and the contributions of rapid filling (RF) and atrial systole (AS) to EDV were evaluated. Filling velocities during RF (vRF) and AS (vAS) were estimated, as well as the isovolumic relaxation period (IR).

No significant changes were observed in the heart rate. After 1 month of therapy, systolic and diastolic BP were significantly decreased (p<0.05). ST and PWT were reduced, with a simultaneous increase in EDD and EDV (p<0.01). LV mass was slightly reduced, as was the M/V index. The D/Th index was increased (p<0.01). The RF contribution to EDV was increased, together with a simultaneous decrease in the AS contribution (p<0.01). The IR period was reduced (p<0.01), while vRF and vAS showed significant increases (p<0.01).

After 6 months of therapy, all the above-mentioned modifications were confirmed.

In conclusion, mild EH induces early modifications in LV geometry, with consequent LV diastolic abnormalities, characterized by prolonged and incomplete diastolic filling. Thus, LV wall thickness may appear increased, with a simultaneous reduction in LV diameter and volume (without any significant changes in LV mass). Antihypertensive treatment with a Ca2+ antagonist (nifedipine) induces early regression of such abnormalities with normalization of LV diastolic function.

Key Words

diastolic function nifedipine hypertension 


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Copyright information

© Kluwer Academic Publishers 1990

Authors and Affiliations

  • I. Sheiban
    • 1
  • G. Covi
    • 1
  • C. Zenorini
    • 1
  • G. Arcaro
    • 1
  • E. Arosio
    • 1
  • S. Tonni
    • 1
  • G. Montresor
    • 1
  • A. Lechi
    • 1
  1. 1.Centro Cardiopneumologico, Instituto di Clinica MedicaUniversità di Verona, Ospedale PoliclinicoVeronaItaly

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