PREVALENCE OF ECTOPIC VENTRICULAR ACTIVITY AFTER LEFT-VENTRICULAR MASS REGRESSION

被引：31
作者：
GONZALEZFERNANDEZ, RA
RIVERA, M
RODRIGUEZ, PJ
FERNANDEZMARTINEZ, J
SOLTERO, LH
DIAZ, LM
LUGO, JE
机构：
[1] Department of Medicine, University School of Medicine, Rio Piedras Puerto Rico
[2] Department of Medicine, TX, 76127-5000, Carswell AFB
来源：
AMERICAN JOURNAL OF HYPERTENSION | 1993年 / 6卷 / 04期
关键词：
CAPTOPRIL; HIGH BLOOD PRESSURE; LEFT VENTRICULAR HYPERTROPHY; VENTRICULAR ARRHYTHMIAS;
D O I：
10.1093/ajh/6.4.308
中图分类号：
R6 [外科学];
学科分类号：
1002 ; 100210 ;
摘要：
To assess the effects of left ventricular mass reduction on the prevalence of ventricular ectopic activity, we conducted a double-blind, placebo-controlled trial measuring ambulatory 48 h premature ventricular depolarizations in 27 patients with mild-to-moderate hypertension and an increased left ventricular mass index. Data was obtained at baseline and 6 +/- 2 months after randomization to either 25 mg captopril or placebo twice a day. Patients on captopril attained reduction in blood pressure from 167 +/- 11/103 +/- 6 to 136 +/- 10/85 +/- 5 mm Hg W = .001), left ventricular mass index regression from 149 +/- 17 to 96 +/- 23 g/m2 (P = .001), and ventricular ectopic activity reduction from 413 +/- 172 to 77 +/- 27 ventricular extrasystoles/day (P = .001). Patients on placebo had no significant change in blood pressure (from 162 +/- 11/101 +/- 6 at baseline to 160 +/- 8/100 +/- 8 mm Hg after 6 months; P = NS). In the placebo group left ventricular mass index increased from 155 +/- 40 to 182 +/- 51 g/m2 (p = .01), and ventricular ectopic activity decreased from 634 +/- 293 to 562 +/- 260 ventricular extrasystoles/day (P = NS). Eight out of 14 patients on captopril (57%) and 1 out of 13 patients on placebo (8%) achieved reduction > 85% in ventricular ectopic activity per day (P = .004). Using multivariate logistic regression analysis, left ventricular mass index regression and reduction in systolic blood pressure were the most important correlates for this effect. It is concluded that in mild to moderate hypertensives with left ventricular hypertrophy, regression in left ventricular mass index results in significant decrease in the prevalence of ventricular ectopic activity.
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页码：308 / 313
页数：6
相关论文
共 46 条
[1]  
Kannel W.B., Gordon T., Castelli W.P., Margolis J.R., Electrocardiographic left ventricular hypertrophy and risk of coronary heart disease: The Framingham study, Ann Intern Med, 72, pp. 813-822, (1970)
[2]  
Koren M.J., Devereux R.B., Casale P.N., Et al., Relation of left ventricular mass and geometry to morbidity and mortality in uncomplicated essential hypertension, Ann Intern Med, 114, pp. 345-352, (1986)
[3]  
Messerli F.H., Ventura H.O., Elizardi D.J., Et al., Hypertension and sudden death, increased ventricular ectopic activity in left ventricular hypertrophy, Am J Med, 77, pp. 18-22, (1984)
[4]  
Koyanagi S., Easthman C., Marcus M.L., Effects of chronic hypertension and left ventricular hypertrophy on the incidence of sudden cardiac death after coronary artery occlusion in conscious dogs, Circulation, 65, (1982)
[5]  
McLenachan J.M., Henderson E., Kl M., Dargie H.J., Ventricular hypertrophy and ventricular arrhythmias in essential hypertension, N Engl J Med, 317, (1987)
[6]  
Aronow W.S., Epstein S., Schwartz K.S., Koenigsberg M., Correlation of complex ventricular arrhythmias detected by ambulatory electrocardiographic monitoring with échocardiographie left ventricular hypertrophy in per-sons older than 62 years in a long-term health care facility, Am J Cardiol, 60, pp. 730-735, (1987)
[7]  
Levy D., Erson K.M., Savage D.D., Risk of ventricular arrhythmias in left ventricular hypertrophy: The Framingham Heart Study, Am J Cardi, 60, (1987)
[8]  
Smith V.E., Schulman P., Karimeddini M.K., Rapid ventricular filling in left ventricular hypertrophy: II, Pathologic Hypertrophy. J am Coll Cardiol, 5, (1985)
[9]  
Amodeo C., Kobrin I., Ventura H.O., Et al., Immediate and short-term hemodynamic effects of diltiazem in patients with hypertension, Circulation, 73, pp. 108-113, (1986)
[10]  
Devereux R.B., Savage R., Sachs I., Laragh J., Relation of hemodynamic load to left ventricular hypertrophy and performance in hypertension, Am J Cardiol, 51-55, pp. 171-176, (1983)
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