REGRESSION OF LEFT-VENTRICULAR HYPERTROPHY UNDER SPIRAPRIL TREATMENT INVESTIGATED BY NUCLEAR-MAGNETIC-RESONANCE IMAGING

28 hypertensive subjects (6f, 22m, 51.7y) with diastolic blood pressur e >95 mmHg were treated with 12-24 mg spirapril per day over a period of 5 months. To determine the effective the decrease of blood pressure and for reliable and reproducible demonstration of regression of myoc ardial hypertrophy during spirapril treatment we performed parallel me asurements nith magnetic resonance imaging (MRI) and echocardiography. Measurements were carried out before treatment and after 12 and 20 we eks of treatment. MRI slices showed a significant decrease of end-syst olic interventricular septal thickness from 19.4 to 16.1 mm and end-sy stolic thickness of posterior wall decreased from 19.3 mm to 16.5 mm a fter 20 weeks of therapy (p < 0.001). Echocardiography demonstrated a significant reduction of end-diastolic septal thickness from 13.0 to 1 1.5 mm (p < 0.001) and a reduction of posterior wall thickness from 12 .7 mm to 15 mm (p < 0.001),whereas ejection fraction showed no signifi cant change. Quantification of wall thickness nith MRI was performed t hree times at each measuring point and means were calculated. Values w ere obtained with negligible scatter and the changes with spirapril tr eatment were highly significant (p < 0.001). A concomitant decrease of blood pressure was also observed. Antihypertensive treatment with spi rapril resulted in effect the reduction of systolic and diastolic bloo d pressure. In addition to its antihypertensive action, the angiotensi n concverting enzyme (ACE) inhibitor spirapril caused a significant re gression of pathologic left ventricular hypertrophy demonstrated by ma gnetic resonance imaging and echocardiography.