Regression of left ventricular hypertrophy in treated hypertensive patients with dilevalol and metoprolol--a double blind randomized study.

Academic Article

Abstract

  • This study was designed to evaluate the effects of a new beta-adrenergic blocking agent with beta 2 agonist activity (dilevalol, an R-R' isomer of labetalol) on left ventricular hypertrophy regression as seen by M-mode echocardiography. The study design was a 2:1 double blind randomization of dilevalol versus metoprolol. There was an equal blood pressure reduction in the two groups (supine diastolic blood pressure fell from 101 +/- 4.5 mm Hg to 87 +/- 13.7 mm Hg, P less than .001 in the dilevalol group, and 101 +/- 4.3 mm Hg to 87 +/- 8.6 mm Hg, P less than .01, in the metoprolol group). At the end of 2 months, there was an overall 7.5% decrease in left ventricular mass index in the 16 dilevalol treated patients (this was due to a 4.4% decrease in posterior wall thickness, end diastolic dimension increased by only 1%). Of the seven patients with an increased left ventricular mass index, all demonstrated hypertrophy regression (mean 17.14%). In contrast, no significant change in left ventricular mass was seen in the metoprolol treated group. Echocardiographic left ventricular mass index and electrocardiographic evidence of left ventricular hypertrophy (using the Sokolow-Lyons criteria and Romhilt-Estes point score) had poor correlation (r = .30 and r = .38, respectively). Resting ejection fraction increased by 5% and velocity of circumferential fiber shortening by 14% in the dilevalol treatment group (not significant).(ABSTRACT TRUNCATED AT 250 WORDS)
  • Published In

    Keywords

  • Adrenergic beta-Antagonists, Adult, Aged, Cardiomegaly, Double-Blind Method, Echocardiography, Electrocardiography, Female, Humans, Hypertension, Labetalol, Male, Metoprolol, Middle Aged, Randomized Controlled Trials as Topic
  • Author List

  • Glasser SP; Koehn DK; Powell R
  • Start Page

  • 791
  • End Page

  • 797
  • Volume

  • 29
  • Issue

  • 9