Regression of left ventricular hypertrophy under spirapril treatment investigated by nuclear magnetic resonance imaging

28 hypertensive subjects (6f, 22m, 51.7y) with diastolic blood pressure >95 mmHg were treated with 12-24 mg spirapril per day over a period of 5 months. To determine the effective the decrease of blood pressure and for reliable and reproducible demonstration of regression of myocardial hypertrophy during spirapril treatment we performed parallel measurements nith magnetic resonance imaging (MRI) and echocardiography. Measurements were carried out before treatment and after 12 and 20 weeks of treatment. MRI slices showed a significant decrease of end-systolic interventricular septal thickness from 19.4 to 16.1 mm and end-systolic thickness of posterior wall decreased from 19.3 mm to 16.5 mm after 20 weeks of therapy (p < 0.001). Echocardiography demonstrated a significant reduction of end-diastolic septal thickness from 13.0 to 11.5 mm (p < 0.001) and a reduction of posterior wall thickness from 12.7 mm to 15 mm (p < 0.001),whereas ejection fraction showed no significant change. Quantification of wall thickness nith MRI was performed three times at each measuring point and means were calculated. Values were obtained with negligible scatter and the changes with spirapril treatment were highly significant (p < 0.001). A concomitant decrease of blood pressure was also observed. Antihypertensive treatment with spirapril resulted in effect the reduction of systolic and diastolic blood pressure. In addition to its antihypertensive action, the angiotensin concverting enzyme (ACE) inhibitor spirapril caused a significant regression of pathologic left ventricular hypertrophy demonstrated by magnetic resonance imaging and echocardiography.