Impact of Azelnidipine and Amlodipine on Left Ventricular Mass and Longitudinal Function in Hypertensive Patients with Left Ventricular Hypertrophy

BackgroundThe impact of long-acting calcium channel blocker (CCB) administration on serial changes in left ventricular (LV) function and morphology in hypertensive patients with LV hypertrophy remains unclear. This study attempted to clarify this impact by comparing the effects of administration of azelnidipine with that of amlodipine using conventional and speckle tracking echocardiography. MethodsAn equal number (16) of 32 hypertensive patients was prospectively assigned to a group administered 5mg of amlodipine/day or a group administered 16mg of azelnidipine/day. LV function and morphology was examined by conventional and speckle tracking echocardiography at baseline and at 1, 3, 6, and 12months after treatment initiation. ResultsBoth groups were found to have experienced a significant decrease in systolic blood pressure by 1month after treatment initiation; a significant reduction in septal thickness and LV mass index at 6 and 12months. Transmitral flow E/A ratio and early diastolic mitral annular velocity at lateral wall significantly improved at 12months. On the other hand, a significant improvement of global longitudinal strain was observed earlier than the above indexes at 3, 6, and 12months. Ar-A duration difference was significantly decreased at 3months. The global circumferential strain improved significantly at 3months, but there were no significant changes in mid-/apical circumferential and radial strains throughout the study period. ConclusionAzelnidipine has beneficial effects on LV mass regression, transmitral flow, tissue Doppler, and LV longitudinal strain that are comparable to those of amlodipine on the same parameters.