Valsartan Versus Amlodipine Effect on Left Ventricular Multidirectional Deformation and Adipocytokines Levels in Hyperte
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ORIGINAL ARTICLE
Valsartan Versus Amlodipine Effect on Left Ventricular Multidirectional Deformation and Adipocytokines Levels in Hypertensive Patients: Speckle Tracking Echocardiography Ibtsam Khairat1 · Lamiaa Khedr1 · Rehab Werida2 Received: 14 January 2020 / Accepted: 27 June 2020 © Italian Society of Hypertension 2020
Abstract Introduction Structural and functional properties of the left ventricle (LV) wall have been reported to be altered in hypertension, even at early stages of the disease. Abnormal adipokine levels affect blood pressure regulation. Hypo-adiponectinaemia and hyper-leptinaemia were reported in hypertension. Aim To evaluate the effects of valsartan versus amlodipine on LV deformation also, on plasma adiponectin and leptin levels in hypertensive individuals. Methods LV strain was measured by two-dimensional speckle tracking echocardiography, plasma levels of adiponectin and leptin was determined in 30 healthy individuals served as control group and in 200 hypertensive patients before and after treatment for 6 months with either valsartan 160 mg or amlodipine 10 mg. Results Compared to control group longitudinal strain was significantly affected in hypertensive patients, adiponectin was significantly lower while TNF-α, hs-CRP and leptin levels were significantly higher in hypertensive group. A significant improvement in LV functions, along with a decrease in leptin and increase in adiponectin levels in valsartan group compared to amlodipine group. Conclusions Our results indicate that valsartan is superior to amlodipine when it comes to affecting the hormonal function of human adipose tissue. Valsartan has a beneficial effect on LV deformation and function presented in GLS. Keywords Two-dimensional strain · Hypertension · GLS · Valsartan · Amlodipine
1 Introduction Hypertension is considered one of the major risk factors leading to cardiovascular diseases and is one of the contributors to heart failure [1]. When a clear left ventricle (LV) systolic dysfunction is obvious, conventional echocardiographic parameters can detect LV systolic function abnormalities in the progressive stages of hypertensive patients [2–4]. Prompt detection of sub-clinical LV-systolic dysfunction can be achieved by detection of LV strain deterioration by the new echocardiographic modalities (2D strain) as it * Rehab Werida [email protected] 1
Department of Cardiology, Faculty of Medicine, Tanta University, El‑Gharbia, Egypt
Department of Clinical Pharmacy, Faculty of Pharmacy, Damanhour University, El‑Behaira 22511, Egypt
2
can provide new systematic perception about systolic dysfunction even in patients whom has no structural cardiac alterations [5]. Adipocytes secrete Adipokines that involved in various pathological pathways, comprising cardiovascular and inflammatory complications in hypertension [6]. Hypertensive patients have shown imbalanced levels of adipocytokines levels as adiponectin and leptin, which are hormones, produced by adipocytes compared to normotensive subjects [7]. A de
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