caa a22 4500 477072100 CHVBK 20180405111429.0 cr unu---uuuuu 170330e19960701xx s 000 0 eng 10.1007/BF02627956 doi (NATIONALLICENCE)springer-10.1007/BF02627956 Left ventricular diastolic function during adrenergic stress in essential hypertension: acute and chronic effects of ACE inhibition [Elektronische Daten] [Grazia Covi, Imad Sheiban, Giampaolo Gelmini, Guido Arcaro, Silvia Tonni, Andrea Bolner, Giuseppe Piemonte, Alessandro Lechi] Summary: We studied the changes in left ventricular (LV) diastolic function induced by angiotensin-converting enzyme (ACE) inhibition at rest and during adrenergic stimulation and their relation to blood pressure (BP) variations to determine whether reductions in the renin-angiotensin system may improve diastolic function irrespective of BP reduction. Echocardiographic indices of systolic and diastolic function, plasma catecholamines as estimated by high-pressure liquid chromatography, and BP variations (Dynamap) were determined at rest and during the cold pressor test (CPT) before and 6 hours and 20 days after ACE inhibition (lisinopril), 20 mg/day by mouth in 10 subjects with uncomplicated essential hypertension. Blood Pressure was significantly reduced after both 6 hours and 20 days of therapy. The cold pressor test induced similar increases in BP in both basal conditions and after acute and chronic treatment. Catecholamine levels were unchanged by the therapy. Systolic function, evaluated by fractional shortening, ejection fraction, and systolic dV/ dt, was normal and unchanged during CPT and after treatment. Diastolic function, assessed by volume curve analysis, showed a reduced percentage contribution of rapid filling to total diastolic filling, an increase in the contribution of the atrial systole, and an increase in the isovolumetric relaxation time. During CPT these parameters deteriorated further in response to increased afterload. Lisinopril therapy induced significant increases in end-diastolic volume (p<0.005) with a progressive increase in the rapid filling dV/dt (p<0.005 at rest; p<0.001 during CPT) and a reduction in isovolumetric relaxation (p<0.001 at rest and p<0.01 during CPT). The correlation between systolic BP (afterload) and the rapid filling dV/dt, both at rest and during CPT, was modified by treatment with the ACE inhibitor, with significantly higher rapid filling dV/dt values, and with the pressure loads equal treduction of the slope and rightward shift of the correlation line). The improvement in diastolic function achieved by ACE inhibition at rest and during CPT appears unrelated to plasma catecholamines and only partly ascribable to the reduced pressure load. The tissue angiotensin II reduction might by itself improve the myocardial response to the pressure load and adrenergic stimulation. Kluwer Academic Publishers, 1996 diastolic function nationallicence essential hypertension nationallicence ACE inhibition nationallicence angiotensin II nationallicence Covi Grazia Cattedra di Medicina Interna, Istituto di Clinica Medica, Verona, Italy aut Sheiban Imad aut Gelmini Giampaolo Cattedra di Medicina Interna, Istituto di Clinica Medica, Verona, Italy aut Arcaro Guido Cattedra di Medicina Interna, Istituto di Clinica Medica, Verona, Italy aut Tonni Silvia Cattedra di Medicina Interna, Istituto di Clinica Medica, Verona, Italy aut Bolner Andrea Laboratori Universitari di Ricerca Medica, Università di Verona, Policlinico di Borgo Roma, Verona, Italy aut Piemonte Giuseppe Laboratori Universitari di Ricerca Medica, Università di Verona, Policlinico di Borgo Roma, Verona, Italy aut Lechi Alessandro Cattedra di Medicina Interna, Istituto di Clinica Medica, Verona, Italy aut Cardiovascular Drugs and Therapy Kluwer Academic Publishers 10/3(1996-07-01), 321-329 0920-3206 10:3<321 1996 10 10557 https://doi.org/10.1007/BF02627956 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF02627956 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Covi Grazia Cattedra di Medicina Interna, Istituto di Clinica Medica, Verona, Italy aut NATIONALLICENCE 700 1- Sheiban Imad aut NATIONALLICENCE 700 1- Gelmini Giampaolo Cattedra di Medicina Interna, Istituto di Clinica Medica, Verona, Italy aut NATIONALLICENCE 700 1- Arcaro Guido Cattedra di Medicina Interna, Istituto di Clinica Medica, Verona, Italy aut NATIONALLICENCE 700 1- Tonni Silvia Cattedra di Medicina Interna, Istituto di Clinica Medica, Verona, Italy aut NATIONALLICENCE 700 1- Bolner Andrea Laboratori Universitari di Ricerca Medica, Università di Verona, Policlinico di Borgo Roma, Verona, Italy aut NATIONALLICENCE 700 1- Piemonte Giuseppe Laboratori Universitari di Ricerca Medica, Università di Verona, Policlinico di Borgo Roma, Verona, Italy aut NATIONALLICENCE 700 1- Lechi Alessandro Cattedra di Medicina Interna, Istituto di Clinica Medica, Verona, Italy aut NATIONALLICENCE 773 0- Cardiovascular Drugs and Therapy Kluwer Academic Publishers 10/3(1996-07-01), 321-329 0920-3206 10:3<321 1996 10 10557 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer