蒲 卓 吉林医学院(中華人民共和国), 主任
王 書瑞 吉林医学院(中華人民共和国), 講師
徐 麗華 吉林医学院(中華人民共和国), 講師
上原 正巳 滋賀医科大学, 医学部, 教授 (70026871)
越智 幸男 滋賀医科大学, 医学部, 教授 (90079773)
木之下 正彦 滋賀医科大学, 医学部, 教授 (60093168)
UEHARA Masami Professor, Shiga University of Medical Science
XU Li hua Lecturer, Jilin Medical College
KINOSHITA Masahiko Professor, Shiga University of Medical Science
OCHI Yukio Professor, Shiga University of Medical Science
ZHUO Pu Chief, Jilin Medical College
WANG Shu Rui Lecturer, Jilin Medical College
|Budget Amount *help
¥2,000,000 (Direct Cost : ¥2,000,000)
Fiscal Year 1993 : ¥2,000,000 (Direct Cost : ¥2,000,000)
Studies on the effects of various hypotensive drugs on left ventricular myocardial hypertrophy primarily by echocardiography have shown that calcium antagonists, angiotensin-converting enzyme inhibitors, alpha_2-blockers, and central sympatholytic drugs are effective for attenuating the condition, but that the effects of beta-blockers are unpredictable, and diuretics and direct vasodilators have no effects. However, the effects of hypotensive drugs have been suggested to vary among races, and there have been few studies in which the effects of hypotensive drugs on cardiac hypertrophy were compared internationally. Also, MRI has attracted attention as a method for measurement of the left ventricular weight, and comparison of the findings by MRI with those by conventional electrocardiography and echocardiography is interesting. This study is designed to evaluate anti-cardiac hypertrophy effects of various hypotensive drugs in Japanese and Chinese subjects by MRI as well as by echocaardio
graphy and MRI.
Objectives : Using cinemagnetic resonance imaging(MRI)and echocardiography(ECHO), we studied the effects of TCV-116, a specific antagonist for angiotensin II subtype 1 receptors, on hemodynamics and cardiac hypertrophy in patients with essential hypertension.
Subjects and Methods : Twelve patients with essential hypertension received oral TCV-116 after a control period of placebo administration. Cine MRI images were acquired in the axial plane with a gradientecho technique, GRASS, with echo time of 13 msec, repetition time of 66 msec, and flip angle of 20 degrees. Simpson's rule was used forleft ventricular volume and mass measurements by MRI. Left ventricular volumes by ECHO were calculated using Teichholz's formula. Left ventricular mass(LVM)by ECHO was measured using American Society of Echocardiography measurements and the formula by Devereux et al. : LVM=0.8[1.04(IVS+LVID+PWT)^3-LVID^3)]+0.6g. (IVS : interventricularseptal thickness, PWT : posterior wall thickness, LVID : left ventricular internal dimension)
Results : Final daily doses of TCV-116 were 8 mg in 7 patients, 4 mg in 3 patients and 2 mg in 2 patients. After TCV-116 administration, systolic BP decreased from 185*19(mean*SD)to 161*30 mmHg and diastolic BP from 108*10 to 96*13(n=12, p<0.005)while HR remained unchanged from 70*12 to 70*9 bpm(n=12, NS). Both MRI and ECHO revealed a significant decrease in LVM after TCV-116 administration(n=12, p<0.05). MRI revealed a significant decrease in TSR from 1888*473 to 1702*408 dynes-sec-cm^<-5>(n=11, p<0.05). No significant changes were observed in other hemodynamic parameters before and after TCV-116 administration.
Conclusions : Inpatients with essential hypertension, TCV-116 administered orally at doses of 2-8 mg/day for 8-12 weeks reduced blood pressure and led to a regression of cardiac hypertrophy. No deficient changes were observed in other hemodynamic parameters.
The above tests will be carried out and effects will be compared between Japanese and Chinese subjects in further studies. Less