Left Ventricular Diastolic Function Changes In Hypertension Treated With Metoprolol

Objective: Using echocardiography and Doppler technology, the effects of metoprolol on and left ventricular diastolic function in essential hypertensive patients will be evaluated.Methods: Thirty hypertensive patients with impaired left ventricular relaxation assessed by Doppler echocardiography were distributed to metoprolol-treated group. They underwent Doppler echocardiography before and 2 hours after taking 50mg metoprolol orally. The ratio of early to late peak mitral flow and mitral annulus velocity ( E/A, E_m/A_m ), isovolumic relaxation time (IVRT),deceleration time of the E wave(E-DT) and Tei index were measured. In the following days they were given metoprolol 50mg/day for two months. The simultaneous use of other antihypertensive agents except β -blockers were admitted according to the blood pressure level. Other twenty age-matched hypertensive patients were distributed to non-metoprolol-treated group who were given antihypertensive agents except β -blockers to reach normal blood pressure and keep that at least one month. Left ventricular diastolic function indices were also evaluated among them.Results : In metoprolol-treated group there was an significantimprovement in E/A (p<0.001) and Em/Am (p<0.001), and E-DT markedly decreased after 2 hours or 2 months of therapy. However there was no difference in the above indices between the 2 hours and 2 months of therapy. IVRT was longer at 2 hours than that before study but after 2 months of therapy it went back to its beginning level. No changes were found in Tei index during the study. All the patient reached an normal blood pressure at two months and their heart rate slowed clearly after given metoprolol. After 2 months of therapy metoprol-treated group had an increased E/A(0.97±0.19 vs 0.73±0.12, p<0.01) and Em/Am(0.71±0.12 vs 0.60±0.08, p<0.05), a decreased E-DT( 17.64±2.96 vs 23.18±3.27, p<0.01) and a slower heart rate compared with patients treated without metoprolol. However Tei index, IVRT and blood pressure had no difference in two groups.Conclusions: The improvement in indices of diastolic function suggested that metoprolol have the benefits to left ventricular diastolic dysfunction in hypertensive.