The antihypertensive effect of Indapamide(Fludex(R)) was studied in 31 patients of essential hypertension and following results were obtained. 1) Daily dosage was 1mg b.i.d. and total duration of medication was weeks. 2) Mean systolic and diastolic blood pressure declined by 23mmHg(14%) and 18mmHg(17%) respectively. 3) Good or fair controls were achieved in 78% of patients. 4) There was no significant change in heart rate during and after treatment. 5) There were no significant changes in fasting blood sugar, serum creatinine, K+, uric acid, ca++, transaminase and cholesterol levels before and after treatment. 6) In 5 patients transient side effects were observed which resolved spontaneously. In view of these results Indapamide appears to be effective agent for the treatment of mild to moderate hypertension and dose not cause significant change in blood chemistry.
Blood Glucose ; Blood Pressure ; Chemistry ; Cholesterol ; Creatinine ; Fasting ; Heart Rate ; Humans ; Hypertension ; Indapamide ; Uric Acid

BACKGROUND: Propafenone is a new class IC antiarrhythmic drug that has been found to be effective in both supraventricular and ventricular tachyarrhythmias. We studied the electrophysiologic and long-term effects of oral propafenone in the patients with paroxysmal supraventricular tachycardia(PSVT). METHODS: The electrophysiologic study was done in 15 patients with PSVT to assess the short-term efficacy of propafenone 450mg daily. For 10 patients with short-term efficacy, follow up study was done to assess the long-term efficacy of propafenone 450mg daily. RESULTS: The electrophysiologic mechanisms of PSVT were AV nodal reentry in 6 patients and AV reentry in 9 patients. During the electrophysiologic study, propafenone prolonged AH, HV and PR intervals significantly(p<0.05), but did not change the corrected SNRT, SACT, and the ERP of atrium, ventricle, AV node and accessory pathway(AP) significantly. The anterograde and retrograde 1:1 conduction capacity of AV node and AP seemed to decrease. Complete block of anterograde conduction over the AP was noted in 2 of 3 patients with manifest WPW syndrome and complete block of retrograde conduction was noted over the AV node in 1 patient with AV nodal reentry and over the AP in 1 patient with AV reentry. Propafenone was effective in 3 of 6 patients with AVNRT and 7 of 9 patients with AVRT. During long term administration for 3 to 11 months in 10 patients with short-term efficacy of propafenone, 7 patients did not report any episode of symptomatic tachycardia and 3 patients reported less frequent palpitation. There were no side effects during short-and long-term follow up except 2 patients with mild indigestion. CONCLUSIONS: Propafenone seems to be a safe, well tolerated and effective drug for short and long-term therapy of patients with PSVT, especially of orthodromic AV reentry.
Atrioventricular Node ; Dyspepsia ; Follow-Up Studies ; Humans ; Propafenone* ; Tachycardia ; Tachycardia, Supraventricular* ; Wolff-Parkinson-White Syndrome

No abstract available.
Echocardiography ; Myocardial Infarction*

We present a case of recurrent left atrial myxoma which occurred 7 years and 10 months after initial operation despite resection of originaltumor and adjacent atrial septum. This is the first case report of recurrence in Korea. Among the possible causes of recurrence, regrowth from pretumorous focus seems to be the most suggesting one in this case. Histopathologic findings of recurrent myxoma showed increased cellularity with active proliferation and nuclear hyperchromasia. These findings, together with the rapidity of regrowth, suggest that recurrent myxoma may have 'wilder' behavior. Prolonged postoperative observation is important, even if ample resection was done at the initial operation including atrial septum.
Atrial Septum ; Korea ; Myxoma* ; Recurrence*

In order to evaluate the effect of cardiac rhythm on hemodynamic changes and pulmonary arterial atrial natriuretic peptide(ANP) levels after percutaneous mitral valvuloplasty(PMV), we measured and analyzed the correlations between hemodynamic parameters and pulmonary arterial ANP levels in 65 patients with mitral stenosis before, 20 minutes, and 24 hours after PMV. The results are as follows: 1) Normal sinus rhythm was present in 49 patients(group1), whereas the other sixteen (group 2) had chronic atrial fibrillation. 2)PMV decreased mean left atrial pressure(LAP) in both groups(p<0.001). Left atrial volume was also reduced after PMV in group 1(p<0.0001), whereas it was not decreased significantly in group 2. 3) Pulmonary arterial ANP levels at 24 hours after PMV decreased significantly in group 1(p<0.001), compared to those prior to PMV. However there was no significantl changes in group 2. 4) In group 1, there was a significant linear relationship between extents of drop in pulmonary arterial ANP levels and LAP, measured 24hours after PMV. These results suggest that ANP secretion might be influenced not only by hemodynamic changes of the left atrium, but also by possible structural changes of left atrial wall induced by chronic atrial fibrillation.
Atrial Fibrillation ; Atrial Natriuretic Factor ; Heart Atria ; Hemodynamics* ; Humans ; Mitral Valve Stenosis

41 patients with hyperlipidemia(Serum cholesterol > or =260mg% or triglyceride> or =200mg%) were treated for 12 weeks each with either Bezafibrate(200mg t.i.d.)(n=23) or placebo(n=18) in a randomized trial. Compared with placebo, Bezafibrate was more effective in lowing total cholesterol(287+/-63 to 244+/-32 mg%, P<0.01), LDL-cholesterol(183+/-39 to 153 +/-25mg%, P<0.01) and the LDL/HDL ratio(4.7+/-2.9 to 3.4+/-1.3, P<0.05). There was also a marked reduction in serum triglyceride(307+/-295 to 218+/-167mg%, P<0.05) as well as a significant increase in HDL-cholesterol(43+/-12 to 48+/-12mg%, P<0.05). Compliance or tolerance to both Bezafibrate and placebo was good. No significant side effects except one case, who complained of mild indigestion, were observed. Therefore, Bezafibrate seemed to be effective in lowing serum total cholesterol, LDL-cholestrol, triglyceride and in increasing in HDL-cholesterol without significant side effect.
Bezafibrate ; Cholesterol ; Compliance ; Dyspepsia ; Humans ; Hyperlipidemias* ; Triglycerides

BACKGROUND: Second degree AV block is occasionally induced during AV nodal reentrant tachycardia by programmed electrical stimulation. This study was performed to determine the incidence, the block site, and the mechanism of AV block during AV nodal reentrant tachycardia. METHODS AND RESULTS: The study population was 67 consecutive patients with AV nodal reentrant tachycardia studied by programmed electrical stimulation. Among these patients, common types(slow pathway for anterograde and fast pathway for retrograde conduction) were 64 patients and uncommon types(fast pathway for anterograde and slow pathway for retrograde conduction) were 3 patients. Among 67 patients with AV nodal reentrant tachycardia 10 patients developed 2:1 AV block during tachycardia. The block site of AV block was infrai bundle in 9 patients and supraHis bundle in patient. There were intermittent aberrancies of RBBB and/or LBBB form during tachycardia in 5 patients with infraHis AV block. CONCLUSION: The occurrence of AV block during AV nodal reentrant tachycardia is not rare and might be related to the prematurity of atrial extrastimulation. The block sites of AV block were infraHis bundle in most cases and this finding suggests that distal common pathway of the reentry circuit is present in the AV node.
Atrioventricular Block* ; Atrioventricular Node ; Electric Stimulation ; Humans ; Incidence ; Tachycardia ; Tachycardia, Atrioventricular Nodal Reentry*

BACKGROUND: Since reperfusion early after acute myocardial infarction has been demonstrated to reduce the infarct size and mortality, many drugs and interventions to reduce the reperfusion injury have been tried with limited success. Adenosine, a potent coronary vasodilator, has been reported to counteract a few mechanisms implicated with reperfusion injury, however, its effects and exact mechanisms to reduce the reperfusion injury have not been clearly elucidated. METHODS AND RESULTS: Effects of adenosine upon infarct size reduction and upon postulated mechanisms involved in the reperfusion injury such as no reflow phenomenon and neutrophil infiltration were evaluated in anesthetized open chest dog model where acute myocardial infarction was induced by 90 minute left anterior descending coronary artery occlusion followed by 240 minute reperfusion. Adenosine(3.75 mg/min) was administered intravenously for total 90 minutes from 30 minutes before reperfusion. Compared to control group(n=6), infarct area/risk area ratio was significantly lower in adenosine group(n=6)(34+12% vs. 22+/-11, p=0.04), although risk area/total left ventricular area ratio were similar in both groups. Myocardial blood flows(MBF), measured by radiolabelled microspheres, of the infarcted regions during coronary occlusion were similar in both groups, however, both subepicardial MBF(0.63+/-0.15ml/min/g vs. 0.95+/-0.31, p=0.02) and subendocardial MBF(0.45+/-0.08 ml/min/g vs. 0.69+/-0.27, p=0.02) were higher in daenosine group. Neutrophil infiltration, semiquantitatively measured under light microscope, were less severe in daenosine group,compared to control group. CONCLUSION: Intravenous adenosine administered before coronary reperfusion appears to reduce infarct size by limiting reperfusion injury through improving no reflow phenomenon and preventing neutrophil infiltration to the ischemic myocardium during reperfusion.
Adenosine* ; Animals ; Coronary Occlusion ; Coronary Vessels ; Dogs* ; Microspheres ; Mortality ; Myocardial Infarction* ; Myocardial Reperfusion ; Myocardium ; Neutrophil Infiltration ; No-Reflow Phenomenon ; Reperfusion Injury* ; Reperfusion* ; Thorax*

The P wave during orthodromic atrioventricular reentry tachycardial were analysed in 19 patients to evaluate the usefulness in identifying the location of accessory pathways. The results were as follows; 1) Definitely inverted and upright P waves in lead I represented the left-sided and right-sided pathways respectively, but the converse is not necessarily true. 2) Dome and Dart appearance in lead VI(4 cases), upright P wave in inferior leads(3 cases), and negative P wave in aVL(3 cases) suggested the left-sided pathway and deeply inverted P waves in inferior leads suggested the posteroseptal or right-sided one. 3) In 17 cases(79%), inverted P wave appeared on more than one lead among the inferior leads, which were helpful to identify the position on P wave and mechanism of supraventricular tachycardia. Although the number of cases especially with right-sided pathway was small to conclude, P wave was useful for determining the location of accessory pathway noninvasively.
Humans ; Tachycardia* ; Tachycardia, Supraventricular

Seventeen cases of apical hypertrophic cardiomyopthy were reviewed to clarify whether there is any racial difference in phenotypic expression of apical hypertrophic cardiomopathy and to study whether there is any clinical or morphological difference between apical hypertrophic cardiomyopathy of Japanese type (J-APH) and apical hypertrophic cardiomyophthy of non-Japanese type (NJ-APH). The diagnosis was made by cardiac catheterization, left ventriculography and echocardiography. Seventeen patients were divided into 9 (53%) patients with J-APH and 8 (47%) patients with NJ-APH. Mean ages of patients with J-APH and NJ-APH were 55 years and 57 years, respectively. The most common clinical symptoms were chest pain(100%), dyspnea(59%) and palpitation(35%). Mean values of S1+R5 and T wave depth were 58+/-16mm and 16+/-6mm in J-APH and 42+/-11mm and 7+/-3mm in NJ-APH(p<0.05, respectively). Seven patients experienced transient or permanent atrial fibrillation without significant symptoms. Seven patients showed progression or regression of T wave depth greater than 5mm during the period of follow-ups. On echocardiography IVS/LVPW thickness(mm) at the base were 11+/-2/10+/-2 in J-APH and 17+/-7/11+/-2 in NJ-APH, and IVS/LVPW thickness(mm) at the apex were 25+/-7/24+/-5 in J-APH and 26+/-3/26+/-2 in NJ-APH. Three patients with NJ-APH showed asymmetrical septal hypertrophy, cardiac catheterization disclosed elevated left ventricular end diastolic pressure in 11 out of 19 patients. Dye entrapment at the apex during systole was noted in 5 out of 18 patients. In conclusion, our study showed high prevalence rate expression of J-APH in contrast to the Western countries, there may be racial difference in phenotype of apical hypertrophic cardiomyopathy. Considering progression or regression of T-wave depth, NJ-APH may be a forme fruste or regressed form of J-APH.
Asian Continental Ancestry Group ; Atrial Fibrillation ; Blood Pressure ; Cardiac Catheterization ; Cardiac Catheters ; Cardiomyopathy, Hypertrophic ; Classification* ; Diagnosis ; Echocardiography ; Echocardiography, Doppler* ; Follow-Up Studies ; Heart Septal Defects, Ventricular* ; Humans ; Hypertrophy ; Phenotype ; Prevalence ; Systole ; Thorax