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Effect of the Single-Pill Amlodipine/Valsartan Combination on Hypertrophy and Myocardial Deformation Characteristics in Middle-Aged Patients with Essential Arterial Hypertension

https://doi.org/10.20996/1819-6446-2019-15-3-305-314

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Abstract

Aim. To investigate the impact of amlodipine/valsartan single-pill combination (A/V SPC) on left ventricular hypertrophy (LVH) and left ventricular (LV) myocardial strain and stiffness parameters in naїve middle-aged patients with stage II grade 1-2 essential arterial hypertension (EAH).
Material and methods. A group of patients with stage II grade 1-2 EAH who had not previously received regular antihypertensive treatment (AHT) [n=38; mean age 49.7±7.0 years] was retrospectively formed. All the patients were treated with A/V SPC and all of them achieved target office blood pressure (BP) (less than 140/90 mm Hg). And after 12 weeks follow-up (since the time of reaching the target BP) the AHT effectiveness assessment, its impact on LVH and LV myocardial strain and stiffness parameters (general clinical data, ambulatory blood pressure monitoring, conventional and 2D-speckle tracking echocardiography) were performed in all included patients.
Results. The number of patients with LVH significantly (p=0.039) decreased from 25 individuals (65.8%) at baseline to 15 patients (39.5%) at the end of follow-up. Among patients with LVH at baseline after the treatment with A/V SPC significantly decreased (p<0.001 for all) interventricular septum thickness (from 1.36±0.19 to 1.28±0.18 cm), LV posterior wall thickness (from 1.08±0.09 to 0.97±0.11 cm) and the LV myocardial mass index (from 123.3±19.3 to 110.8±20.8 g/m2). At the end of follow-up end-systolic elastance significantly (p<0.001) decreased from 4.01±1.12 to 3.46±0.88 mm Hg/ml. In the subgroup of patients with reduced (in absolute value) LV longitudinal 2D-strain (n=27) at baseline, there was a significantly (p=0.005) increasing in this parameter at the end of the study (from -16.14±2.21% to -17.30±2.13%, Δ%=8.45±13.35).
Conclusion. In naive patients 40-65 years old with stage II grade 1-2 EAH AHT with A/V SPC provides effective 24 hours BP control, significantly reduced LVH and improves LV strain parameters, which indicates decreasing of LV myocardial stiffness.

About the Authors

A. I. Kochetkov
Pirogov Russian National Research Medical University
Russian Federation

MD, PhD, Researcher, Laboratory of Clinical Pharmacology and Pharmacotherapy, Russian Gerontology Clinical Research Center; Assistant, Chair of Aging Diseases

Ostrovitianova ul. 1, Moscow, 117997 Russia



E. V. Borisova
E.O. Mukhin Municipal Clinical Hospital
Russian Federation

MD, Cardiologist, Cardiology Department No1

Federativnii prospect, 17, Moscow, 111399 Russia



O. D. Ostroumova
Pirogov Russian National Research Medical University I.M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

MD, PhD, Head of Laboratory of Clinical Pharmacology and Pharmacotherapy, Russian Gerontology Clinical Research Center; Professor, Chair of Clinical Pharmacology and Propaedeutics of Internal Medicine

Ostrovitianova ul. 1, Moscow, 117997 Russia

Trubetskaya ul. 8-2, Moscow, 119991 Russia



M. V. Lopukhina
E.O. Mukhin Municipal Clinical Hospital
Russian Federation

MD, PhD, Cardiologist, Head of Functional Diagnostics Department

Federativnii prospect, 17, Moscow, 111399 Russia



G. V. Piksina
E.O. Mukhin Municipal Clinical Hospital
Russian Federation

MD, PhD, Cardiologist, Head of Cardiology Department No1

Federativnii prospect, 17, Moscow, 111399 Russia



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For citation:


Kochetkov A.I., Borisova E.V., Ostroumova O.D., Lopukhina M.V., Piksina G.V. Effect of the Single-Pill Amlodipine/Valsartan Combination on Hypertrophy and Myocardial Deformation Characteristics in Middle-Aged Patients with Essential Arterial Hypertension. Rational Pharmacotherapy in Cardiology. 2019;15(3):305-314. (In Russ.) https://doi.org/10.20996/1819-6446-2019-15-3-305-314

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