LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN CORONARY HEART DISEASE: ASSESSMENT OF TELMISARTAN AND ENALAPRIL EFFECTIVENESS

Abstract

Aim: To assess enalapril and telmisartan effects on hemodynamic parameters and left ventricular (LV) diastolic dysfunction (DD) in patients with coronary heart disease (CHD) and arterial hypertension (AH). Material and methods: In total, 51 men with stable CHD (mean age 57,3+3,4 years) were examined. The methods included general clinical and laboratory examination, 24-hour blood pressure monitoring, Holter ECG monitoring, and echocardiography. Results: In patients with CHD and abnormal relaxation LVDD, telmisartan therapy improved transmitral diastolic blood flow parameters: IVRT increased to 25%, DT – to 13,4%, E/A ratio – to 23%. Diastolic function improvement was associated with decreased LV myocardial mass index (5,6%), reduced circadian duration of myocardial ischemia, increased LV ejection fraction (9,6%), and increased fraction of systolic LV antero-posterior shortening (17,2%). The beneficial effects of telmisartan could be explained by optimised LV relaxation and early and late diastolic filling.

Keywords

• coronary heart disease
• left ventricular diastolic dysfunction
• angiotensin receptor antagonists