G.V. Dzyak, M.Yu. Kolesnyk.Influence of perindopril and amlodipinе fixed combination on left ventricular myocardial deformation in men with arterial hypertension

The aim – to assess the impact of fixed combination of angiotensin-converting enzyme perindopril and calcium antagonist amlodipine on left ventricular (LV) myocardial deformation in men with arterial hypertension (AH).

Material and methods. The study included 78 males with AH, age 52 (48–59) years. All the patients underwent ambulatory blood pressure monitoring, transthoracic echocardiography, speckle-tracking echocardiography at baseline and at the end of treatment. Patients were treated with a fixed dose combination of perindopril 5 mg and amlodipine 5 mg. Dose adjustments were performed on the first and third months of therapy. The observation period was 6 months.

Results. Treatment with perindopril and amlodipine was effective and well tolerated. Target blood pressure level was achieved in 70 % of patients. The significant decrease of LV mass index from 137 (104–163) to 123 (105–149) g/m2 (Р=0.008) and increase of LV ejection fraction from 68.7±7.3 to 70.9±7.1 % (Р=0.012) was found. The increase of the early diastolic velocity of medial and lateral sides of the mitral ring according to the tissue Doppler imaging was shown. The improvement of basal circular LV strain from –18.60±3.98 to –19.70±4.65 % (Р=0.026) and strain rate from 1.26 (1.13–1.47) to 1.35 (1.17–1.61) s–1 (Р=0.049) was noted after 6 months of the treatment. Significant changes of the longitudinal and radial deformation were absent.

Conclusions. Treatment with fixed combination of perindopril and amlodipine for 6 months leads to significant increase of basal left ventricle strain and strain rate without significant changes of longitudinal and radial deformation. Improvement of the circular contractility is associated with significant decrease of the left ventricular myocardial mass index, increased ejection fraction and improved parameters of the diastolic function.

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