Losartan improves diastolic ventricular filling of hypertensive patients with diastolic dysfunction

To evaluate the role of losartan on left ventricular (LV) function of hyper tensive patients. Hypertensive patients (n = 19) underwent evaluation of sy stolic and diastolic LV function, using radionuclide ventriculography (RVG) , before and at 3 mo into the treatment with the angiotensin ZI antagonist losartan. All patients underwent a baseline 12 lead ECG and an echocardiogr am (ECHO), which was also repeated at 3 mo into treatment. Results are expr essed as mean +/- SEM and statistics were performed using paired t-test. A p value less than or equal to 0.05 was considered significant. Treatment wi th losartan for 3 mo had no effect on LV mass measured by echo (141 +/- 5 v s. 139 +/- 6 g/m(2)). The LV ejection fraction, measured by RVG, was unchan ged by treatment when compared to the baseline study (58 +/- 2% vs. 57 +/- 2%, respectively, p = 0.49). Considering all patients involved in the study (n = 19), the LV "Peak Filling Rate" (PFR), a parameter of diastolic funct ion measured by RVG, was also unchanged by treatment when compared to basel ine (2.5 +/- 0.2 EDV/s vs. 2.5 +/- 0.3 EDV/s, respectively, p = 0.9). Howev er the analysis of those patients with evidence of diastolic dysfunction (n = 12) on the baseline RVG (PFR < 2.5 EVD/s), demonstrated significant impr ovement of LV filling after therapy with losartan (PFR = 1.8 +/- 0.1 EDV/s vs. 2.3 +/- 0.2 EDV/s, respectively, p = 0.05). This change was associated with improvement of symptoms. Our results demonstrated that hypertensive pa tients with diastolic dysfunction on radionuclide ventriculography have sig nificant improvement of ventricular filling at 3 mo into treatment with los artan.