Abstract

Background: Abnormalities of diastolic function are first signs of cardiac remodeling in hypertension. Despite sufficient long-term antihypertensive treatment, a diastolic dysfunction concerning left ventricular relaxation is observed in many cases. Doppler echocardiography has become well-accepted as reliable, reproducible and a practical noninvasive method for diagnosis and longitudinal follow-up of patients with these diastolic dysfunctions. Since it was shown that dipyridamole treatment increased vasodilatorstimulated phosphoprotein Ser239phosphorylation (VASP), a benefit concerning diastolic dysfunction could be indirectly possible by dipyridamole-induced endothelial resistance reduction. Methods: Prospective observation of 11 long-term successfully pretreated, hypertensive patients with abnormal relaxation in the mitral inflow velocity curve. Patients with coronary artery disease, reduced cardiac ejection fraction, disease of valves or E-F deceleration time lower than 240 ms were excluded. The measurement of the ratio between peak early flow velocity (E) and peak late transmitral flow velocity (A) (E/A ratio) was carried out before and under additional dipyridamole treatment (200 mg sustained release twice daily). There was no change of continual antihypertensive medication during the observation time (12.6 ± 4.7 d). Results: A significant amelioration of the E/A ratio from 0.68 ± 0.11 to 0.81 ± 0.12 was observed (p = 0.017). No relevant change of blood pressure values was registered. Discussion: The additional treatment of sustained release dipyridamole to the continual antihypertensive medication shows a significant improvement of diastolic dysfunction already in a small patient group. This improvement was demonstrated by analysis of Doppler-echographic measurement (E/A ratio). Since there was no affect concerning blood pressure behavior, a greater clinical observation may be justified.

Author Details

Authors

• B. Gremmler¹,⁴
• K. Kisters²
• M. Hausberg³
• M. Kunert¹
• L.J. Ulbricht¹,⁴

Departments

• ¹ Department of Cardiology, Marienhospital Bottrop,
• ² Department of Medicine, St. Anna Hospital Herne,
• ³ AKTE Arbeitskreis Trace Elements and Electrolytes,
• ⁴ University of Witten/Herdecke, Germany

Address

Dr. med. B. Gremmler, PD Dr. med. L.J. Ulbricht
Marienhospital, Josef-Albers-Straße 70, 46236 Bottrop
Email: dr.bernhard.gremmler@ t-online.de

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