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      Cardiac Structure and Function before and after Acute and Chronic Verapamil Administration in Hypertensive Patients

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          Abstract

          The aim of this study has been to analyze the acute and chronic effects of oral verapamil on diastolic function indices, derived from Doppler echocardiography, and left-ventricular (LV) dimensions and mass, assessed by M-mode echocardiography, in hypertensive patients without LV hypertrophy. 12 patients with essential hypertension were studied in basal conditions and (1) after a single oral administration of verapamil 160 mg and placebo in a double-blind protocol and (2) over chronic treatment (12 months) with verapamil 240 mg/day. At baseline, the ratio between early and atrial-induced transmitral velocities (E/A ratio) was lower in patients than in 12 age-matched normal subjects (1.08 ± 0.2 vs. 1.51 ± 0.3, p < 0.01). Acute verapamil administration significantly decreased arterial blood pressure (162 ± 26/101 ± 8 to 142 ± 12/88 ± 7 mm Hg, p < 0.01 after 2 h) and increased the E/A ratio to 1.26 ± 0.3 (p < 0.05) after 3 h. No change in ventricular dimensions and heart rate was observed. After chronic therapy, we found a further increase in the E/A ratio in 10 responder patients (1.49 ± 0.3, p < 0.01). The LV mass index, that was higher than in normal subjects before the treatment (118 ± 16 vs. 91 ± 11 g/m<sup>2</sup>, p < 0.01), was significantly reduced (100 ± 17 g/m<sup>2</sup>, p < 0.05 vs. basal, nonsignificant vs. normal subjects). Our results demonstrate that acute administration of verapamil only partially improves the abnormal indices of diastolic function in hypertensive patients, whereas chronic treatment, by reducing LV mass indices and blood pressure to normal values, can completely normalize the indices of LV diastolic filling.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          0008-6312
          1421-9751
          1991
          1991
          12 November 2008
          : 79
          : 3
          : 180-187
          Affiliations
          Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano; Centro di Fisiologia Clinica e Ipertensione, Ospedale Maggiore, Milano, Italia
          Article
          174878 Cardiology 1991;79:180–187
          10.1159/000174878
          1837496
          © 1991 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 8
          Categories
          Clinical Pharmacology

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