From mechanocardiography and echocardiography, the systolic time intervals and the ejection phase indices were measured with determination of serum digoxin concentration(SDC) to elucidate the value of oral maintenance digoxin therapy on patients with heart failure in sinus rhythm. The drug interactions of digoxin with quinidine in heart failure, with verapamil in atrial fibrillation, and with aluminium hydroxide gel in healthy volunteers were observed with concomitant changes of SDCs. The results obtained are as follows. 1. After 10 days of treatment with digoxin 0.25 mg/day in 21 patients with heart failure there was a significant decrease in electromechanical systole(QS2), pre-ejection period(PEP) and PEP/left ventricular ejection time(LVET) ratio. There was also and equivocal decrease in LVET and an equivocal increase in mean velociy of circumferential fiber shortening(Vcf). However there was no significant change in ejection fraction(EF) and heart rate. The steadystate SDC was 1.20+/-0.12(S.E.M.)ng/ml. 2. Excellent correlation of the systolic time interval sand ejection phase indices measured from mechanocardiography and those determined from echocardiography was demonstrated. 3. SDCs were measured before and following quinidine therapy in 20 patients receiving maintenance digoxin for heart failure and who require quinidine for suppression of ventricular premature beats. Steady-state SDC following quinidine(Y) could be estimated form steady-state SDC before quinidine(X) as expressed by regression equation, Y=-0.394+2.309 X with correlation coeffcient, r=0.927(p<0.01). 4. In 12 patients with atrial fibrillation receving maintenance digoxin 0.25 mg/day, SDC before and following coadministration fo first 160 mg/day and later 240 mg/day of verapamil for 7days on each occasion was 0.85+/-0.07(S.E.M.) ng/ml, 1.00+/-0.09(S.E.M.)ng/ml and 1.33+/-0.13(S.E.M.)ng/ml, respectively. The difference of SDC between at control and under 240mg/day of verapamil was significant statistically(p<0.05). 5. Digoxin 0.75mg single-dose studies of bioavailability in 11 healthy volunteers showed a statistically significant difference(p<0.05) of the area under the 8-hour SDC curve between the digoxin only group and the digoxin plus aluminium hydroxide gel group. The area under the curve was 680+/-25(S.E.M.) min*ng/ml and 509+/-29(S.E.M.) min*ng/ml, respectively.
Atrial Fibrillation ; Biological Availability ; Cardiac Complexes, Premature ; Digoxin* ; Drug Interactions ; Echocardiography ; Healthy Volunteers ; Heart Failure ; Heart Rate ; Humans ; Quinidine ; Silicon Dioxide ; Systole ; Verapamil

The duration of the phases of left ventricular systole was measured from simultaneous recordings of the electrocardiogram, phonocardiogram and carotid arterial pulse tracing using a multichannel photographic system with paper speed at 100 mm per second. Observations were made in 81 male and 66 female patients with hypertension and 41 healthy males and 38 healthy females who served as controls. All hypertension patients were classified by change in funduscopic finding, EKG and grade of diastolic pressure. STI were measured in each group and analysed. The resutls were as follows: 1. The normal PEP/LVET was 0.293 in male and 0.303 in female. 2. In male & female hypertensive patients, all STI were significantly difference to that of normal control except QA2. 3. In male hypertensive patients, the degree of EKG, funduscopic change and diastolic pressure were positive relation to the increase of PEP/LVET.
Blood Pressure ; Electrocardiography ; Female ; Humans ; Hypertension* ; Male ; Systole*

Direction of blood flow and peak velocity measurement were made in the four cardiac valve and ascending aorta from 87 normal Korean adults (42 men and 45 women, age range 20-63 years) with CW Doppler echocardiography. Measurments of the peak velocities of mitral valve, tricuspid valve and aortic valve (ascending aorta) completed in the apical window using 2.0MHz Pedof transducer. The measurement of pulmonary flow completed in the parasternal view. Also aortic velocity data obtained from suprasternum (70/87), subcostal area (48/87) and right sternal border(41/87). Aortic flow velocity was highest (121+/-11.7 cm/xec), mitral flow velocity was 86.4+/-12.2 cm/sec, pulmonic flow was 85+/-13.3cm/sec, where as tricuspid was lowest (64.8+/-11.2cm/sec). The velocities of aorta obtained from apex (106.9+/-15cm/sec) and suprasternum (113.1+/-18.9cm/sec) were greater than other sites. These normal Doppler data provide a useful information for evaluating flow velocity pattern in patient with various heart disease.
Adult* ; Aorta* ; Aortic Valve ; Echocardiography, Doppler* ; Female ; Heart Diseases ; Heart Valves ; Humans ; Male ; Mitral Valve ; Transducers ; Tricuspid Valve

To evaluate the efficacy and safety of lovastatin, new hypolipidemic agent of HMG-CoA reductase inhibitor, we administered lovastatin 40mg to 80mg once daily for 12 weeks in 20 patients(7 males, 13 females) with primary hypercholesterolemia, and observed the sequential chamges of the lipid profile every 4 weeks. The results are as follows ; 1) The seurm total cholesterol was reduced significantly by 31% from 321+/-36mg% to 210+/-26mg%(p<0.05). 2) The serum triglycerides was significantly reduced from 321+/-168mg% to 228+/-74mg% by 29%(p<0.05). 3) The low density lipoprotein cholesterol was reduced significantly from 177+/-36mg% to 120+/-22mg% by 32%(p<0.05). 4) The total lipid, high density lipoprotein cholesterol and very low density lipoprotein cholesterol were also reduced significantly. 5) The ratio between total cholesterol and high density lipoprotein cholesterol, low density lipoprotein cholesterol and high density lipoprotein cholesterol did not change after lovastatin therapy. 6) There was no adverse reaction due to lovastatin therapy during 12 weeks of therapy. These results suggested that lovastatin is a effective and safe now hypolipidemic agent and is a convenient HMG-CoA reductase inhibitor for clinical use.
Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Cholesterol, VLDL ; Humans ; Hypercholesterolemia* ; Lovastatin* ; Male ; Oxidoreductases ; Triglycerides

BACKGROUND: Hyperlipidemia is the one of the major risk factors causing the atherosclerosis of coronary arteries. Treatment of hyperlipidemia with drugs has been confirmed the effects of therapy showing a decreased incidence of coronary artery disease. Pravastatin is one of the new HMG-CoA reductase inhibitors and we studied the short-term hypolipidemic effects and safety of pravastatin in patients with hyperlipidemia. METHODS: We studied 31 patients(7 males and 24 females ; range of age, 36-67 years) for 12 weeks whose plasma levels of total cholesterol were higher than 250mg% after one month period of diet therapy. Pravastatin was administered 10mg/day and measured lipid profiles at 4 week interval. RESULTS: Pravastatin reduced the plasma total cholesterol from 286.2mg% to 212.3mg% (25.9%), the LDL-cholesterol from 204.2mg% to 143.6mg% (29.7%), the triglyceride from 226.0mg% to 161.4mg% (28.6%) after 12 weeks treatment. The HDL-cholesterol increased from 25.8mg% to 46.4mg% (20.5%) after pravastatin therapy. These changes were disclosed all statistically significant compared to baseline levels(p<0.01). The clinical and laboratory examinations before and after pravastatin treatment showed no particular abnormal findings. CONCLUSIONS: These results suggested that short-term pravastatin therapy in patients with hyperlipidemia seems to be very effective and safe.
Atherosclerosis ; Cholesterol ; Coronary Artery Disease ; Coronary Vessels ; Diet Therapy ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hyperlipidemias* ; Incidence ; Male ; Plasma ; Pravastatin* ; Risk Factors ; Triglycerides

The antihypertensive effect and side reactions of nicardipine were observed in 30 cases of essential hypertension, and following results were obtained. 1) Nicardipine has very good antihypertensive effect. After medication alone or combined with atenolol, both systolic and diastolic pressure dropped significantly. 2) The overall effectiveness was 86%. 3) Postural hypotension was not observed. 4) The heart rate was not changed after medication of nicardipine. 5) The side efect was observed in 5 cases such as headache, facial flushing, dizziness and anorexia, but 3 cases were tolerable to continue medication.
Anorexia ; Atenolol ; Blood Pressure ; Dizziness ; Flushing ; Headache ; Heart Rate ; Hypertension ; Hypotension, Orthostatic ; Nicardipine*

To evaluate the effect of Perindopril in patients with essential hypertension, we administered Perindopril 4 to 8mg/day once daily to 30 patients(18 males, 12 females) for 12 weeks. Baseline blood pressure after 4 weeks with placebo was 150.4+/-7.5/102.0+/-4.3mmHg. The blood pressures of the patients were declined significantly at 4th(140.6+/-14.9/95.4+/-6.5), 8th(136.7+/-11.4/91.7+/-7.6), and 12th(132.3+/-11.1/87.5+/-6.9) week(p<0.01) without change of heart rate. The blood pressure of the patients was normalized below 140/30mmHg in 24 patients(80%) and declined diastolic blood pressure more than 10mmHg in one patients. Therefore the response rate of perindopril was 83.3%. There were reported 3 patients who revealed mild adverse reactions as follows; cough, indigestion, dizziness in one each. In conclusion, these results indicate that antihypertensive therapy with perindopril single daily dose was effective in patients with mild to moderate essential hypertension and well tolerated.
Blood Pressure ; Cough ; Dizziness ; Dyspepsia ; Heart Rate ; Humans ; Hypertension* ; Male ; Perindopril*

For many years, interest in cardiac function has primarily centered around the systolic pump performance of the left ventricle. it is now recognized, however, that diastolic abnormalities may be just as important in the pathophysiology of certain cardiac disease states. To examine the left ventricular abnormalities (especially diastolic events) in hypertension, diastolic and systolic time intervals were measured from simultaneous high-speed recordings of a phonocardiogram, ECGs, apexcardiogram, echocardiogram and external carotid pulse in 35 hypertensive patients and were compared with those in 15 normal subjects. The hypertensive patients showed significantly prolonged preejection period (PEP) and shortened ejection time (ET), compared to those in normal control subjects (p<0.005, p<0.05 respectively). The PEP/ET ratio too was different from the control subjects in hypertensive patients (0.335+/-0.050 vs 0.422+/-0.666; p<0.005). The isovolumic relaxation time (IVRT) was increased to 81.3+/-15.0 msec, which was significantly longer (p<0.005) than in normal subjects (56.7+/-10.7 msec), in patients with hypertension. The active filling period (AFP) was also prolonged. In patients with hypertension there was no significant difference in rapid filling period and slow filling period compared with those in normal subjects. It is likely that in hypertensive patients the alterations of diastolic time intervals, reflecting disorders in elasticity and compliance, may occur in conjunction with abnormal systolic events.
Compliance ; Elasticity ; Electrocardiography ; Heart Diseases ; Heart Ventricles ; Humans ; Hypertension ; Relaxation ; Systole*

Abnormal left ventricular diastolic properties have been reported in dilated cardiomyopathy (DC). Characteristics of transmitral flow were analysed in 37 patients with DC and 29 age matched normal subjects by pulsed Doppler echocardiography. Peak flow velocity of early diastole(PFVE, E), atrial systole (PFVA, A), E/A and deceleration rate of early diastolic flow (DEF) were measured from mitral Doppler spectrum. The extent of mitral regurgitation (MR) was determined by mapping method in the left atrium. Significant mitral regurgitation was founded in 27 out of 37 patients. Three distinct transmitral flow velocity patterns were demonstrated. Ten Patients without significant MR(27%, group 1), PFVE(58+/-17 cm/s), PFVA(73+/-17 cm/s) and E/A (0.94+/-0.4) were significant different from normal subjects (73+/-11 cm/s, 61+/-11 cm/s, 1.22+/-0.26, P<0.025, P<0.005, P<0.05, respectively). In contrast 17 patients with significant MR(46%, group 2) showed higher E (89+/-24 cm/s), lower A(52+/-19 cm/s), higher E/A (1.83+/-0.6) and DEF (596+/-149 cm/s2) than group 1 patients. Remained 10 cases (27%, group 3) had higher single peak flow (104+/-25 cm/s) with higher DEF and significant MR. In conclusion, abnormalities of left ventricular filling are detected in dilated cardiomyopathy without MR but not in DC with MR by Doppler echocardiography. The presence of MR, which augments early diastolic filling, may mask abnormal diastolic filling properties of DC.
Cardiomyopathy, Dilated* ; Deceleration ; Echocardiography* ; Echocardiography, Doppler ; Echocardiography, Doppler, Pulsed ; Heart Atria ; Humans ; Masks ; Mitral Valve Insufficiency ; Systole

Acute stroke has been associated with a variety of cardiac abnormalities. Data derived from EGC monitoring have suggested that cardiac arrhythmia may be more common in stroke patient. Acute stroke such as cerebral infarction has been reported to increase serum cardiac enzyme and histologic changes, focal myocardial myocytolysis. Also, plasma norepinephrine was significantly elevated in a group of stroke patients compared with non-stroke control. These observations led to the hypothesis that acute stroke may increase sympathetic activity with resultant electrocardiographic abnormalities and myocardial cell necrosis. In order to test this hypothesis, we evaluated 24 acute stroke patients for several cardiac parameter including arrythmias defected by 24 hour Holter monitoring, serum cardiac enzymes such as CK, LDH, SGOT and plasma catecholamine values. Similar studies were also performed in 15 control subjects matched with stroke patients for age. The result were as follows; 1) Arrhythmias such as VPB, SVPB in the acute stroke group were more common than in the non-stroke group. VPB(209+/-61/24hr, P<0.005) SVPB(232+/-54/24hr, P<0.005). 2) Plasma norepinephrine, epinephrine and CK was significantly elevated in a group of stroke patients compared with non-stroke controls. norepinephrine(715.3+/-93.8 pg/ml, P<0.005) epinephrine(346.1+/-63.1 pg/ml, P<0.005). 3) Stroke patients with abnormal serum CK values(above 80 IU/L) had a higher(P<0.05) mean norepinephrine concentration(776.6+/-142.0 pg/ml) than remaining stroke patients(406.3+/-101.7 pg/ml). 4) Stroke patients with high plasma norepinephrine did not exhibit an increase in cardiac arrhythmias.
Arrhythmias, Cardiac* ; Aspartate Aminotransferases ; Cerebral Infarction ; Electrocardiography ; Electrocardiography, Ambulatory ; Epinephrine ; Humans ; Necrosis ; Norepinephrine ; Plasma* ; Stroke*