TO ASSESS THE IMPACT OF SIX-MONTH FIXED COMBINATION THERAPY WITH PERINDOPRIL AND AMLODIPINE ON MYOCARDIAL DEFORMATION PROPERTIES OF THE LEFT VENTRICLE (LV) IN PATIENTS WITH ARTERIA

Objective: To assess the impact of six-month fixed combination therapy with perindopril and amlodipine on myocardial deformation properties of the left ventricle (LV) in patients with arterial hypertension (AH). Design and method: The study included 55 patients of both sexes with I–II grade of AH (ESH/ESC, 2018) who were on outpatient treatment at the Republican Specialized Scientific and Practical Medical Center of Cardiology. The average age of the patients was 52.2 ± 10.94 years, average duration of AH was 7.51 ± 6.77 years. All patients have a fixed-dose combination antihypertensive therapy of perindopril and amlodipine. The average daily dose of perindopril was 4.4 ± 1.2 mg/day, amlodipine was 7.86 ± 2.5 mg/day. Echocardiographic examinations were performed according to the American Society of Echocardiography guidelines in M- and B-modes. Speckle-tracking echocardiography was used to obtain objective and quantitative evaluations of global and regional myocardial function using the “Automated Cardiac Motion Quantification (aCMQ)” technology on the “Affiniti 70G” system. Results were considered statistically significant at p<0.05. Results: The target systolic blood pressure (SBP) was achieved in 98.2% of patients, diastolic blood pressure (DBP) in 96.4%, and mean blood pressure (MBP) in 94.5%. A significant reduction in the left ventricular myocardial mass index (LVMI) was observed, decreasing from 96.40 ± 25.79 g/m2to 82.3±24.5 g/m2(p=0.000), with an overall LVMI reduction of 16.03± 9.9%. The global longitudinal strain (GLS) significantly improved from 15.0 ± 3.2% to 19.09 ± 2.8%, reaching normal values (p<0.001). Additionally, the myocardial strain rate (SR) showed a significant increase from 0.84±0.23 s−1to 1.13±0.23 s−1(p<0.001). Conclusions: Six-month fixed combination AHT with perindopril and amlodipine demonstrated high antihypertensive and cardioprotective efficacy, evidenced by significant regression of left ventricular hypertrophy and improvement in the myocardial deformation properties of the left ventricle.