BACKGROUND: In order to investigate the efficacy and safety of cilazapril, a recently developed angiotensin converting enzyme inhibitor, a clinical study was performed in the patients with mild to moderate essential hypertension. METHODS: The study subject consisted of 31 patients with diastolic blood pressure of 95mmHg~115mmHg (mean age : 56.0+/-8.1 years, 16 males and 15 females). Cilazapril was administered orally in a daily dose of 2.5mg~5.0mg Q.D. for 8 weeks. During cilazapril medication, anti-hypertensive efficacy, side effects and laboratory changes were monitored. RESULTS: Cilazapril decreased blood pressure from baseline value of 162.2+/-4.7/98.4+/-2.8mmHg to 144.6+/-10.0/89.7+/-5.7mmHg after 4weeks of medication (p<0.05) and 138.2+/-4.5/87.8+/-4.0mmHg after 8 weeks of medication (p<0.05). Heart rate change was not significant (72.3+/-4.7/min vs 71.7+/-3.6/min). Body weight change was not significant (66.6+/-9.8 Kg vs 66.8+/-9.9 Kg). There were no significant change in blood chemistry and hematologic examination except mild elevation of alanine transaminase and serum creatinine values but these date were within normal ranges. The side effects were dry cough (4 case, 12.9%), headache (2 case, 6.4%), indigestion (1 case, 3.2%) and dry mouth (1 case, 3.2%). One patient dropped out due to severe dry cough but others were mostly mild in nature. CONCLUSIONS: Cliazapril 2.5mg~5.0mg once daily regimen was effective and well tolerated in patients with mild to moderate essential hypertension.
Alanine Transaminase ; Blood Pressure ; Body Weight Changes ; Chemistry ; Cilazapril* ; Cough ; Creatinine ; Dyspepsia ; Headache ; Heart Rate ; Humans ; Hypertension* ; Male ; Mouth ; Peptidyl-Dipeptidase A ; Reference Values

The effect of ketanserin, serotonin antagonist, among 19 korean patients over 55 years with essential hypertension was assessed in an open clinical trial for three months. patients were given Ketanserin 20mg bid with monthly follow-up visits. Mean values of systolic/diastolic blood pressures fell from 169+/-17/104+/-10mmHg to 155+/-14/94+/-9mmHg at 2 weeks(p<0.01) and to 147+/-10/87+/-6mmHg at end of treatment 12 weeks after(p<0.001). There was no significant change in heart rate. Transient mild side effects were observed in 5 patients. We conclude that Ketanserin is an effective and safe drug for the treatment of elderly hypertensives.
Aged ; Follow-Up Studies ; Heart Rate ; Humans ; Hypertension* ; Ketanserin* ; Middle Aged* ; Serotonin

In single atrial and ventricular cells isolated from the guinea-pig and the rabbit heart, action potentials and membrane currents were recorded by using the whole cell voltage clamp technique. In rabbit atrial cells the repolarization showed two distinctive phases, referred as the early and late phases(early and late plateau phase), but in guinea-pig atrial cells there was a maintained plateau and less distinctive two phases of repolartization. Increasing intracellular sodium or reducing external sodium by replacement with lithium suppressed the late phase of the action potential in rabbit atrial cells and shortened the plateau of action potential in rabbit ventricle and guinea-pig atrial cells. Reducing external sodium decreased Ca-current and late inward current in voltage clamp. Ouabain in the concentration of 10(-5)M shortened the duration of action potential and shifted the holding current level to outward direction, decreased Ca-current and moved late inward current to outward direction. Ryanodine 10(-6)M which is known to be an inhibitor of Ca-release in the intracellular store, suppressed the late phase of action potential in rabbit atrial cells and shortened the plateau of action potential in rabbit ventricular cells. Ryanodine also decreased Ca-current and shifted late inward current to outward direction. It is concluded that an inward current activated by intracellular calcium contributes to the late Phase of the action potential in rabbit atrial cells and to the late plateau in rabbit ventricular cells and in guinea-pig atrial cells. It may be carried by the Na-Ca exchange precess and/or by calcium-activated non-specific channels but preferably Na-Ca exchange machanism.
Action Potentials* ; Calcium ; Heart* ; Lithium ; Membranes* ; Myocytes, Cardiac ; Ouabain ; Ryanodine ; Sodium

Left ventricular false tendon, also called moderator bands, anomalous cords, accessory bands or false chordae tendinae, has been known as simple anatomical without clinical importance. But the possible relationship with Still's type murmur and ventricular arrhythmia were reported recently. The incidence of false tendon was known as 0.5-6.1% variably. In Korea, there are no reports about left ventricular false tendon till now. The authors examined 2,052 patients' echocaediograms and clinical manifestations retrospectively to find the incidence and potent clinical significance of false tendons. The incidence in present study was 1.02% and there was no specific relationship between false tendon and cardiovascular diseases. The authors observed Still's type musical murmur in 5 patients out of 21 and ventricular premature beats in 2 patients out of 10 without other cardiovascular diseases. One of them showed nonsustained ventricular tachycaedia during Holter ECG monitoring. The most frequent echocardiographic site of attachment was from basal inter-ventricular septum to lelft ventricular free wall and false tendon attached to papillary muscle was least frequently observed.
Arrhythmias, Cardiac ; Cardiac Complexes, Premature ; Cardiovascular Diseases ; Echocardiography ; Electrocardiography ; Humans ; Incidence ; Korea ; Music ; Papillary Muscles ; Retrospective Studies ; Tendons*

Thizide diuretics which are widely used nowadays, are considered to be drugs of first choice of antihypertensive agents, due to their slow and useful diuretic effects in hypertensive patients. But their adverse effects have been noted as hypokalemia and hyperuricemia. A newly developed non-thiazide diuretic agent, Sulfamoyl benzamide has been known as slow effective and safe diuretics as thiazides through several previous studies. And all the studies showed no serious hypokalemia or hyperuricemia. Authors administrated Sulfamoyl benzamide to 20 patients of essential hypertension for 4 weeks, who visited the Department of Internal Medicine of han Yang University Hospital from Nov.82' to May 83', and observed its hypotensive effect and its adverse effect as follows. 1) Before Sufamoyl benzamide administeration, mean arterial systolic pressure and mean arterial diastolic pressure of 20 patients of essential hypertension were 165.5+/-7.23 mmHg and 99.8+/-4.93 mmHg, respectively. The Mean Arterial Pressure(MAP) was 121.7+/-4.48 mmHg. After 4 weeks of treatment, the mean arterial systolic pressure, mean arterial diastolic pressure, and MAP were decreased to 148.3+/-10.64 mmHg(p<0.01), 94.3+/-6.40 mmHg(p<0.01), and 112.1+/-6.66 mmHg(p<0.01), respectively. 2) After 4 weeks of treatment, the hypotensive effect on each of 20 hypotensive patients was evaluated using our arbitrary scoring system which is decided by the degree of reduction of arterial systolic pressure and diastolic pressure. In all patients, useful hypotensive effect was noted. Out of 20 patients, 11 patients(55%) were 'Mild effective', 6 patients(30%) were 'Moderate effective', and 3 patients(15%) were 'Mild effective'. By MAP, the meaningful hypotensive effect was observed in 12 patients(60%), and there were a 'Mild effect' in 6 of 12 patients, a 'Moderate effect' in 4 of 12 patients, and a 'Marked effect' in 2 of 12 patients. 3) There was no adverse side effect except mild dizziness in only 1 patient, which was improved spontaneously after reduction of dosage of Sulfamoyl benzamide from 30 mg to 15mg whitout any specific treatment.
Antihypertensive Agents ; Blood Pressure ; Diuretics* ; Dizziness ; Humans ; Hypertension ; Hyperuricemia ; Hypokalemia ; Internal Medicine ; Thiazides

The authors accessed the effects of heart rate and age to echocardiographic right ventricular systolic time intervals in 27 cases with normal pulmonary artery pressure and correlation of pulmonary hemodynamic parameters with echocardiographic right ventricular systolic time intervals in 76 cases with congenital and acquired valvular heart diseases. The results were as follows; 1) As heart rate increased there was a diminution of the length of right ventricular ejection time(RVET)(r=0.642), but no significant changes in the length of right ventricular pre-ejection period(RVPEP) and the ratio of RVPEP/RVET were found. 2) As age increased there was an increase in the ratio of RVPEP/RVET(r=0.46), but no significant changes in the length of RVPEP and RVEF were found. 3) In patients with the RVPEP/RVET of 0.3 or more this ratio can predict that pulmonary artery systolic pressure is >30mmHg(sensitivity : 83%, specificity : 96%, accuracy 88%), pulmonary artery mean pressure >20mmHg(sensitivity : 87%, specificity : 96%, accuracy 90%), and pulmonary artery diastolic pressure >15mmHg(sensitivity : 86%, specificity : 90%, accuracy : 88%). 4) In patients with the RVPEP/RVET of 0.4 or more this ratio can predict that pulmonary artery systolic pressure is >50 mmHg(sensitivity : 75%, specificity : 98%, accuracy : 92%), pulmonary artery mean pressure >40mmhg(sensitivity : 93%, specificity : 96%, accuracy : 96%), pulmonary artery diastolic pressure >25mmHg(sensitivity : 75%, specificity : 98%, accuracy : 92%), pulmonary vascular resistance >6 units(sensitivity : 70%, specificity : 96%, accuracy : 89%), and Rp/Rs >0.25(sensitivity : 86%, specificity : 95%, accuracy : 93%). In conclusion, pulmonary hypertension, increased pulmonary vascular resistance and pulmonary arteriolar obstructive disease can be predicted by echocardiographic measurement of RVPEP/RVET.
Blood Pressure ; Echocardiography* ; Heart Rate ; Heart Valve Diseases ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Pulmonary Artery* ; Sensitivity and Specificity ; Systole ; Vascular Resistance*

Doxorubicin(Adriamycin(R)) is effective in the treatment of various solid tumors and hematologic malignancies. Because of dose-related cardiotoxicity, however, early inappropriate discontinuation of doxorubicin therapy may minimize its therapeutic efficacy in many patients. Consequently, clinically sensitive tests are needed to select patients in whom treatment must be stopped early. Various techniques have been used for early detection of subclinical doxorubicin-induced cardiotoxicity, including electrocardiography, systolic time intervals, echocardiography, radionuclide angiography and endomyocardial biopsies. Most studies of doxorubicin cardiotoxicity have dealt with systolic function of the left ventricle and effects on diastolic function have not been reported. In order to determine whether impaired diastolic function may be an early sign of doxorubicin cardiotoxicity, a retrospective study was performed in 12 patients who had undergone serial radioangiography and were found to have left ventricular ejection fractions(LVEF)> or =55% prior to doxorubicin treatment and during follow-up. Average rapid filling velocity(RFV) and slow filling velocity(SFV) were both significantly reduced after doxorubicin treatment. RFV fell from 5.17+/-1.52 units/second to 4.18+/-0.96(P<0.01) and SFV fell from 2.20+/-1.32 units/second to 1.42+/-0.62(P<0.05). There were no significant changes in filling volume ratio, total diastolic time and diastolic time ratio. Since a change in left ventricular diastolic function can occur before ejection fraction falls to subnormal levels, diastolic function as well as systolic function should be examined in the early detection of doxorubicin cardiotoxicity.
Biopsy ; Doxorubicin* ; Echocardiography ; Electrocardiography ; Follow-Up Studies ; Heart Ventricles ; Hematologic Neoplasms ; Humans ; Radionuclide Angiography ; Retrospective Studies ; Systole

Left ventricular hypertrophy is a compensatory response to hemodynamic overload secondary to an increased systemic resistance. This increase, however, is not the only cause of hypertrophy, and there are other factors which can have a significant effect on its incidence. To determine whether chronic antihypertensive therapy by enalapril modifies the cellular and subcellular changes of left ventricular hypertrophy observed in spontaneously hypertensive rats(SHR), 20-weeks-old SHR were treated for 22 weeks with enalapril(2mg/kg) and compared with normotensive Wister-Kyoto rats and not-treated SHR. Systolic blood pressure in enalapril-treated SHR was significantly lowered after 22 weeks compared with that of untreated control SHR group. Myocytes were reduced in size and fibrination seen in cardiac muscle fibers of control SHR was decreased in treated SHR group. Myofibrils appeared to be irregular in shape and myofilaments are decreased in control SHR but in enalapril-treated SHR the diameter and length of the myofilament became turned to regular forms. These results suggest that, enalapril, angiotensin converting enzyme inhibitor, may regress hypertrophy and some subcellular changes may be modified by enalapril.
Animals ; Blood Pressure ; Enalapril* ; Fibrin ; Hemodynamics ; Hypertrophy ; Hypertrophy, Left Ventricular* ; Incidence ; Muscle Cells ; Myocardium ; Myofibrils ; Peptidyl-Dipeptidase A ; Rats ; Rats, Inbred SHR*

Identification of patients with combined valvular prolapse has important clinical imlications, because such patients appear to be early surgical candidates. Detection of combined valvular prolapse became more feasible with development of 2-dimentional echocardiography and the incidence of combained mitral and valve prolapse is reported to be variable from 3% to 24%. The authors found a case of combined mitral and aortic valve prolapse detected by 2-dimensional echocardiography. This 30-years-old male patient who admitted because of peptic ulcer bleeding revealed a prolapse of anterior mitral leaflet with regurgitation and also a prolapse of the right coronary cusp into the left ventricular outflow tract but without evidence of aortic regurgutation by Doppler echocardiogram. he discharged without surgical intervention and needs further observation.
Aortic Valve Prolapse* ; Aortic Valve* ; Echocardiography ; Hemorrhage ; Humans ; Incidence ; Male ; Mitral Valve ; Peptic Ulcer ; Prolapse

No abstract available.
Cardiomyopathy, Dilated* ; Carnitine* ; Estrogens, Conjugated (USP)*