Improvement in left ventricular hypertrophy and left ventricular diastolic function following verapamil therapy in mild to moderate hypertension

Abstract

We evaluated the effect of verapamil therapy on left ventricular hypertrophy and left ventricular diastolic function in 13 patients with mild to moderate hypertension. Left ventricular hypertrophy was determined by M-mode echocardiographic measurements of interventricular septal thickness (IVST), posterior wall thickness (PWT) and left ventricular mass index (LVMI) both before (T0) and after 3 months (T3) of verapamil therapy. Left ventricular diastolic transmitral flow was measured by pulsed Doppler indices of early (E) and atrial (A) velocity, E/A ratio, total area (Ta), A area (Aa), Aa/Ta ratio, E-pressure half-time (E-PHT). A-pressure half-time (A-PHT) and E-PHT/A-PHT ratio both before and after 3 months of verapamil therapy. No significant changes occurred in mean heart rate, systolic function or body weight. We conclude that 3 months' therapy with verapamil resulted in an improvement in left ventricular hypertrophy and left ventricular diastolic function and a normalization of blood pressure, without a corresponding deterioration in left ventricular systolic function.

Hypertension and Left Ventricular Hypertrophy: Is Drug Therapy Beneficial?

“…'72 In another 3-month trial with verapamil, significant reductions in LVMI occurred (p<0.05) with preservation of systolic function. 173 Furthermore, diastolic function improved, as assessed by pulsed Doppler velocity profiles of transmitral flow. Longterm verapamil therapy (12 mo) also was associated with a return of diastolic function to normal.174 In this study, Doppler analysis revealed a significant increase in the ratio of ear1y:late diastolic filling velocities at 6 and 12 months after the initiation of verapamil.…”

“…Other 3-month trials found substantial reductions in LV mass with erap pa mil. '^^, 173 In a 12-month open-label trial, LVMI was reduced 15.3% with a single daily verapamil dose of 240 mg.174 Both PWT and LV SWT were also significantly reduced. These changes in LV mass and structure were associated with improvements in LV diastolic filling values.…”