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依贝沙坦和阿替洛尔可改善高血压伴左心室肥大患者的舒张功能
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作者 müller-brunotte r. Edner m. +2 位作者 malmqvist K. Kahan T. 孟欣 《世界核心医学期刊文摘(心脏病学分册)》 2005年第11期53-54,共2页
Objectives and design: An abnormal diastolic filling is common in hypertensive left ventricular(LV) hypertrophy, a condition that may lead to heart failure and death. The renin-angiotensin-aldosterone system has been ... Objectives and design: An abnormal diastolic filling is common in hypertensive left ventricular(LV) hypertrophy, a condition that may lead to heart failure and death. The renin-angiotensin-aldosterone system has been implicated in the development of LV hypertrophy. This study examines the effects of 48 weeks of double-blind treatment with the AT1 receptor blocker irbesartan and the beta-blocker atenolol on diastolic function. Methods: Diastolic function was evaluated in 115 hypertensive patients with LV hypertrophy by Doppler echocardiography mitral in-flow velocities calculated from the peak of early(E) and peak of late(A) diastolic velocities(E/A ratio), the E-wave deceleration time, the isovolumic relaxation time, the pulmonary venous flow velocity, and by the atrioventricular valve plane displacement method. Results: By similar reductions in blood pressure both groups progressively reduced the LV mass index, with a greater reduction in the irbesartan group(P=0.024). Diastolic function was improved similarly by irbesartan and atenolol; for example, the E/A ratio by 12 and 14%(P=0.022 and P< 0.001), and the pulmonary venous flow velocity by 10 and 7%(P=0.036 and P=0.001), respectively. The isovolumic relaxation time was improved by irbesartan(P=0.040) only, and was related to changes in LV geometry(P< 0.001). For atenolol, improvement in diastolic function was associated only with the reduction in blood pressure(P=0.048). An improvement in diastolic function appeared greater in concentric LV hypertrophy than in eccentric LV hypertrophy. Conclusions: Treatment based on atenolol or irbesartan improves diastolic function in patients with hypertensive LV hypertrophy to the same degree, but through different mechanisms. 展开更多
关键词 阿替洛尔 依贝沙坦 左心室肥大 质量指数 受体阻断剂 等容舒张时间 同等程度 舒张期 房室瓣 向心性
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