REVERSAL OF LEFT-VENTRICULAR HYPERTROPHY WITH ISRADIPINE INDUCES DIMINUTION OF CARDIAC-ARRHYTHMIAS

The left ventricular hypertrophy (LVH) of hypertension is often associated with ventricular arrhythmias, which may increase the risk of cardiovascular mortality. Our study was therefore designed to assess whether pharmacological reversal of LVH was associated with the diminution of LV ectopic beats. The antihypertensive agent selected for the study was the dihydropyridine calcium antagonist isradipine (2.5 to 5.0 mg/day orally), which induces rapid regression of LVH. A marked temporal association was observed between regression of LV mass and reductions in the total number of ventricular extrasystoles and in paired beats. Furthermore, there was a diminution of the complexity of the form of ventricular ectopic beats during antihypertensive treatment. No changes in serum electrolytes were documented to account for this control of cardiac arrhythmias. We conclude that the reversal of LVH obtained with isradipine is accompanied by control of the ventricular arrhythmias in hypertensive patients. It is possible that this cardioprotective action may be associated non-specifically with the reduction in LV mass, although a drug- or class-specific action cannot be ruled out.