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Blockage of Angiotensin 2 Receptor-1 Effects Not Only on Stress-induced Myocardial Dynamics but on Circulating Cathecolamins in Hypertensive Patients

Abstract

Nurettin Yeral* and Fatih Yalcin

We aimed to investigate alterations at plasma norepinephrine (NE) levels during rest and exercise and to evaluate tissue Doppler imaging (TDI) parameters in patients with essential hypertension after 6 months from treatment with olmesartan 20 mg. Fourty patients were included in the study. Rest and exercise plasma NE levels were evaluated before and after olmesartan 20 mg treatment. Plasma NE levels were studied by HPLC (high performance liquid chromatography) device. Nevertheless, we examined whether there was a relationship between TDI parameters and plasma NE levels. After 6 months from treatment with olmesartan, rest plasma NE levels (p<0.05) and exercise plasma NE levels (p<0.001) were significantly decreased. Left ventricular mass index (LVMI) and septal myocardial performance index (MPI) were significantly decreased. Systolic septal myocardial velocity (Sm) and early diastolic septal myocardial velocity (Em) were significantly increased. In addition, E/Em ratio, and isovolumetric relaxation time (IVRT) were significantly decreased. Plasma NE levels were seen increased as synchronous with increasing of LVMI. In addition, we observed that plasma NE levels are in relation with LVMI, Sm, Em and E/Em ratio. Consequently, olmesartan treatment, reduces the levels of plasma NE. It also effects on stress-induced systolic and diastolic myocardial functions. These findings support the argument that improvement in myocardial dynamics in patients with HT is related to circulating cathecolamins under stress after angiotensin II receptor subtype 1 blocker therapy.