Long-term Effects of a Selective .ALPHA.1-adrenergic Inhibitor on Right and Left Ventricular Masses in Patients with Chronic Pulmonary Disease.

DOI PubMed 18 References
  • Nakamoto Takaaki
    The First Department of Internal Medicine, Dokkyo University School of Medicine
  • Harasawa Hiroshi
    The First Department of Internal Medicine, Dokkyo University School of Medicine
  • Momoki Shigeru
    The First Department of Internal Medicine, Dokkyo University School of Medicine
  • Suzuki Hidehiko
    The First Department of Internal Medicine, Dokkyo University School of Medicine
  • Hone Yasuhito
    The First Department of Internal Medicine, Dokkyo University School of Medicine
  • Ohnuma Noboru
    The First Department of Internal Medicine, Dokkyo University School of Medicine
  • Ohno Kunihiko
    The First Department of Internal Medicine, Dokkyo University School of Medicine
  • Kato Shiro
    The First Department of Internal Medicine, Dokkyo University School of Medicine
  • Okuda Masaaki
    The First Department of Internal Medicine, Dokkyo University School of Medicine
  • Iizuka Masahiko
    The First Department of Internal Medicine, Dokkyo University School of Medicine

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  • 慢性肺疾患患者におけるα１遮断薬長期投与による右室重量および左室重量に及ぼす影響

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Abstract

We examined the effect of one year of treatment with the selective α1-adrenergic inhibitor doxazosin on right ventricular mass (RV mass), left ventricular mass (LV mass), and arterial blood gases. The subjects were 24 outpatients (18 men and 6 women, mean age 68.3±9.4 years) with chronic pulmonary disease complicated by hypertension who were clinically stable. One year of drug therapy was associated with significant decreases both in systolic pressure (159±15.2 vs 125.8±14.1mmHg, p<0.05, n=24), and in LV mass index (101.0±13.4 vs 97.6±11.8gm-2, p<0.05, n=24). We obtained the RV mass index by multiplying the thallium score RV/LV count and the LV mass index obtained by echocardiography. One year of drug therepy was associated with a significant increase in RV mass index (42.9±31.2 vs 53.6±30.5gm-2, p<0.05, n=8). Vital capacity decreased (2.18±1.95 vs 1.95±0.57l p<0.05, n=24), but PaO2 improved (77.3±17.2 vs 82.2±2.4mmHg, p<0.05, n=24). These data indicate that doxazosin can decrease blood pressure and can depress the left ventricle with no adverse effect on oxygenation in patients with chronic pulmonary disease complicated by hypertension. The worsening of RV hypertrophy may have been caused by a mechanism different from the one that caused LV hypertrophy, and by an increase in the work load on the right ventricles secondary to lung deterioration.

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