Enalaprilによる本態性高血圧症に伴う左室肥大および左心機能に及ぼす影響—X線CT法を用いて

Effect of Enalapril on Left Ventricular Hypertrophy and Left Ventricular Function in Patients with Hypertension

　本態性高血圧症においてACE阻害薬であるenalaprilを長期投与し，左室心筋重量の退縮，左心機能の変化および血漿renin-angiotensin系に与える影響について検討した．本態性高血圧症16例（WHO　Ⅰ期8例，WHO　Ⅱ期8例）を対象とした．平均年齢は49.5±10.5歳．enalapril投与前後で血圧，心拍数，心電図，胸部X線写真，X線CT，心エコーを施行し，かつ血漿PRA,PAC,AT　Ⅱ，ACE活性を測定した．左室心筋重量は，多断面心電図同期心X線CT法より測定し，左心機能は心エコー図法より計測した．血漿renin-angiotensin系には有意な変化を認めなかった．左室心筋重量は，投与前121.4±25.6から投与後104.6±13.7（g／m²）と有意に低下した．左室収縮機能は有意な変化を示さず，左室拡張機能は有意な改善を認めた．enalapril長期投与により血漿renin-angiotensin系は変化しなかったが，左室肥大の退縮，左室拡張機能の改善を認めた．

The aim of this study was to study the effect of enalapril (E) on left ventricular (LV) mass, LV func-tion and blood renin-angiotensin (RA) in patients with hypertension. Sixteen hypertensives were included in this study (WHO Ⅰ 8, WHO Ⅱ 8, 49.5±10.5 yrs). They were examined for blood pressure and heart rate. Chest X-ray film, echocardiography (echo), X-ray computed tomography (CT) and RA before and after about 6 months of E administration were studied. The LV mass was calculated by CT. The LV function was measured by echo. RAS was unchanged during this study.