Clinical Drug Investigation

, Volume 22, Issue 10, pp 667–675 | Cite as

Impact of a Low-Dose Combination of Isradipine SRO and Spirapril on Left Ventricular Mass and Left Ventricular Performance in Patients with Hypertension and Left Ventricular Hypertrophy

  • David Pittrow
  • Gottfried Weidinger
  • Thomas Stoerk
  • Hermann Eichstaedt
Original Research Article
  • 8 Downloads

Abstract

Objective

This study investigated the effects of a low-dose fixed combination of the ACE inhibitor isradipine SRO (slow-release oral) and the calcium antagonist spirapril on left ventricular hypertrophy (LVH) in patients with mild to moderate hypertension and LVH.

Design

Open, non-randomised preliminary study.

Subjects

20 patients (11 men and nine women, mean age 62 ± 12 years) with arterial hypertension and LVH were included in the study.

Methods

ECG-triggered nuclear magnetic resonance tomography (MRT), echocardiography and radionuclide ventriculography were used to measure parameters of left ventricular function at baseline and after 12 weeks’ treatment with a fixed combination of isradipine SRO 2.5mg and spirapril 3mg once daily.

Results

Diastolic blood pressure was normalised (≤90mm Hg) after 6 weeks in 19 of 20 patients; only one patient required the dosage to be doubled to achieve BP control. Mean blood pressure was reduced from 163/99mm Hg at baseline to 150/84mm Hg at the end of the study (2p < 0.001). Mean end-systolic interventricular septum thickness measured by MRT was reduced from 20.1 to 18.2mm (2p < 0.001) after 12 weeks and end-systolic left ventricular posterior wall thickness from 19.2 to 17.7mm (2p < 0.001). Echocardiographic assessments resulted in similar findings. The left ventricular mass index calculated from echocardiographic data decreased from 195 to 164 g/m2 (2p < 0.001). A marked drop in total peripheral resistance from 1470 to 1233 units (2p < 0.001) was paralleled by a 14% decrease in systolic wall tension and an improvement in peak ventricular filling rate. Although there was a significant reduction in left ventricular mass, parameters of cardiac work did not change significantly, thus indicating a more efficient ventricular performance during treatment.

Conclusion

In this preliminary study, a low-dose combination of isradipine and spirapril induced a significant regression in LVH and an improvement in haemodynamic parameters in patients with mild to moderate hypertension and LVH. This finding needs to be confirmed in larger-scale, controlled studies.

Keywords

Left Ventricular Hypertrophy Leave Ventricular Mass Index Moderate Hypertension Isradipine Peak Filling Rate 

Notes

Acknowledgements

This work was supported by a grant from Novartis Pharma, Nuremberg, Germany. We are indebted to HJ Kaiser, PhD, for his excellent work with the statistical planning and analysis.

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Copyright information

© Adis International Limited 2002

Authors and Affiliations

  • David Pittrow
    • 1
  • Gottfried Weidinger
    • 2
  • Thomas Stoerk
    • 3
  • Hermann Eichstaedt
    • 4
  1. 1.Department of Clinical Pharmacology, Medical FacultyTechnical University of DresdenDresdenGermany
  2. 2.Department of Clinical ResearchNovartis Pharma GmbHNurembergGermany
  3. 3.Department of CardiologyKarl-Olga HospitalStuttgartGermany
  4. 4.Department of Cardiology, Virchow-Clinic of the CharitéHumboldt-University of BerlinBerlinGermany

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