EFFECT OF SUBLINGUAL NIFEDIPINE ON LEFT-VENTRICULAR DIASTOLIC DYSFUNCTION IN HYPERTENSIVES - ECHO-DOPPLER STUDY AT REST AND DURING HANDGRIP

Using digitized M-mode echocardiography, we evaluated the acute effect of nifedipine on left ventricular (LV) diastolic dysfunction in 30 un treated hypertensives, evaluated at rest and during handgrip, both bef ore and 30' after nifedipine (20 mg sublingually). Ar rest after nifed ipine blood pressure and end-systolic wall stress significantly decrea sed and peak lengthening rate of LV diameter, peak thinning rate of LV posterior wall and Doppler E/A ratio increased. Before and after nife dipine handgrip induced significant increases of blood pressure, heart rate and end-systolic wall stress; diastolic parameters significantly decreased during basal handgrip and did not change during handgrip af ter nifedipine. Nifedipine induced an acute improvement of LV diastoli c dysfunction, that persisted when afterload increased during handgrip . Therefore nifedipine seems to improve LV diastolic function not only by reducing afterload, but also through a direct action on the myocar dium. Besides, these results demonstrate that LV diastolic abnormaliti es in hypertension are partly dynamic and reversible.