AIM:To evaluate efficacy and tolerability of the combination valsartan plus hydrochlorothiazide(160 mg and 25 mg daily,respectively) in young-middle aged males with high-normal blood pressure(BP) or firstdegree arteri...AIM:To evaluate efficacy and tolerability of the combination valsartan plus hydrochlorothiazide(160 mg and 25 mg daily,respectively) in young-middle aged males with high-normal blood pressure(BP) or firstdegree arterial hypertension with evidence of target organ damage.METHODS:Twenty males with high-normal BP or first-degree hypertension associated with left ventricular concentric remodeling and/or increased aortic stiffness were enrolled.BP at rest and during exercise,and echocardiographic parameters of the left ventricle(LV),were evaluated at baseline and after 3 mo of treatment.The effects of treatment on aortic stiffness,metabolic parameters,renal and erectile function were also assessed.RESULTS:BP was significantly reduced by treatment both at rest(P < 0.001) and during exercise(P < 0.001),and 85% of patients achieved BP normalization(< 130/85 mmHg).Doppler echocardiography showed a significant reduction of LV mass(P < 0.005).LV hypertrophy was identified in 70% of subjects at baseline and in 5% after 3 mo of treatment.The ratio of early(E) to late(A) trans-mitral diastolic flow velocity increased,(P < 0.05),the relative wall thickness decreased(P < 0.05) and the left ventricular relaxation time shortened(P < 0.005).The left atrial diameter(P < 0.05) and the aortic diameter(P < 0.05) and stiffness(P < 0.005) also decreased.CONCLUSION:The full-dose combination of valsartan plus hydrochlorothiazide produced optimal BP control with regression of target organ damage,already after 3 mo,without relevant side effects.展开更多
目的:探讨升主动脉弹性与早发冠心病患者冠状动脉狭窄程度之间的相互关系。方法:对临床拟诊为早发冠心病的63例患者行冠状动脉造影(CAG)术,造影阳性患者为早发冠心病组,阴性患者为对照组,并进行冠状动脉狭窄评分(CAS),两组患者在行CAG前...目的:探讨升主动脉弹性与早发冠心病患者冠状动脉狭窄程度之间的相互关系。方法:对临床拟诊为早发冠心病的63例患者行冠状动脉造影(CAG)术,造影阳性患者为早发冠心病组,阴性患者为对照组,并进行冠状动脉狭窄评分(CAS),两组患者在行CAG前后1周内行超声心动图检查,用M-型内径法测量主动脉瓣上3 cm处升主动脉相同处收缩期与舒张期内径(D s,Dd),用公式计算出升主动脉僵硬度和膨胀性。结果:(1)早发冠心病组与对照组比较,升主动脉僵硬度(2.93±0.34 vs 2.45±0.58,P<0.05)与膨胀性[(2.32±0.48)10-6cm2/dyn(1dyn=10-5N)vs(2.76±0.52)10-6cm2/dyn,P<0.05]均有统计学意义;(2)经偏相关分析研究发现,升主动脉僵硬度与冠状动脉狭窄程度密切相关,且独立于其他早发冠心病易患因素。结论:升主动脉弹性与早发冠心病程度密切相关,是早发冠心病重要的预测因子。展开更多
Background： In the early stages of atrial remodeling, aortic stiffness might be an indication of an atrial myopathy, in particular, atrial fibrosis. This study aimed to investigate the association between left atrial...Background： In the early stages of atrial remodeling, aortic stiffness might be an indication of an atrial myopathy, in particular, atrial fibrosis. This study aimed to investigate the association between left atrial （LA） mechanical function, assessed by two-dimensional speckle tracking echocardiography, and aortic stiffness in middle-aged patients with tile first episode of nonvalvular atrial fibrillation （AF）. Methods： This prospective study included 34 consecutive patients with the first episode of AF, who were admitted to Kartal Kos.;uyolu Research and Training Hospital between May 2013 and October 2015, and 31 age- and gender-matched healthy controls. During the 1^st month （mostly in the first 2 weeks） following their first admission, 34 patients underwent the first pulse wave measurements. Then, 21 patients were recalled for their second pulse wave measurement at 11.8 ± 6.0 months following their initial admission. Echocardiographic and pulse wave findings were compared between these 34 patients and 31 healthy controls. We also compared the pulse wave and echocardiographic findings between the first and second measurements in 21 patients. Results： Pulse wave analysis showed no significant differences between tile AF patients and healthy controls with respect to PWV （ 10.2 ± 2.5 m/s vs. 9.7 ± 2.1 m/s： P = 0.370）, augmentation pressure （9.6 ± 7.4 mmHg vs. 9. 1± 5.7 mmHg; P = 0.740）, and aortic pulse pressure （AoPP; 40.4 ± 14.0 mmHg vs. 42. 1 ±7.6 mmHg, P = 0.550）. The first LA positive peak of strain was inversely related to the augmentation pressure （r 0.30; P = 0.02） and aortic systolic pressure （r - 0.26, P - 0.04）. Comparison between the two consecutive pulse wave measurements in 21 patients showed similar results, except for AoPP. In 21 patients, the AoPP at the second measurement （45.1± 14.1 mmHg） showed a significant increase compared with AoPP at the first measurement （39.0 ±10.6 mmHg, P = 0.028）, which was also higher than that of healthy contr展开更多
Arterial stiffness and wave reflections are widely used in observational studies to analyse the determinants of haemodynamic changes observed in various clinical conditions and to understand the pathogenesis of their ...Arterial stiffness and wave reflections are widely used in observational studies to analyse the determinants of haemodynamic changes observed in various clinical conditions and to understand the pathogenesis of their cardiovascular complications. A large number of publications and several reviews documented the changes in arterial stiffness and wave reflections after various interventions, either non-pharmacological or pharmacological.展开更多
文摘AIM:To evaluate efficacy and tolerability of the combination valsartan plus hydrochlorothiazide(160 mg and 25 mg daily,respectively) in young-middle aged males with high-normal blood pressure(BP) or firstdegree arterial hypertension with evidence of target organ damage.METHODS:Twenty males with high-normal BP or first-degree hypertension associated with left ventricular concentric remodeling and/or increased aortic stiffness were enrolled.BP at rest and during exercise,and echocardiographic parameters of the left ventricle(LV),were evaluated at baseline and after 3 mo of treatment.The effects of treatment on aortic stiffness,metabolic parameters,renal and erectile function were also assessed.RESULTS:BP was significantly reduced by treatment both at rest(P < 0.001) and during exercise(P < 0.001),and 85% of patients achieved BP normalization(< 130/85 mmHg).Doppler echocardiography showed a significant reduction of LV mass(P < 0.005).LV hypertrophy was identified in 70% of subjects at baseline and in 5% after 3 mo of treatment.The ratio of early(E) to late(A) trans-mitral diastolic flow velocity increased,(P < 0.05),the relative wall thickness decreased(P < 0.05) and the left ventricular relaxation time shortened(P < 0.005).The left atrial diameter(P < 0.05) and the aortic diameter(P < 0.05) and stiffness(P < 0.005) also decreased.CONCLUSION:The full-dose combination of valsartan plus hydrochlorothiazide produced optimal BP control with regression of target organ damage,already after 3 mo,without relevant side effects.
文摘目的:探讨升主动脉弹性与早发冠心病患者冠状动脉狭窄程度之间的相互关系。方法:对临床拟诊为早发冠心病的63例患者行冠状动脉造影(CAG)术,造影阳性患者为早发冠心病组,阴性患者为对照组,并进行冠状动脉狭窄评分(CAS),两组患者在行CAG前后1周内行超声心动图检查,用M-型内径法测量主动脉瓣上3 cm处升主动脉相同处收缩期与舒张期内径(D s,Dd),用公式计算出升主动脉僵硬度和膨胀性。结果:(1)早发冠心病组与对照组比较,升主动脉僵硬度(2.93±0.34 vs 2.45±0.58,P<0.05)与膨胀性[(2.32±0.48)10-6cm2/dyn(1dyn=10-5N)vs(2.76±0.52)10-6cm2/dyn,P<0.05]均有统计学意义;(2)经偏相关分析研究发现,升主动脉僵硬度与冠状动脉狭窄程度密切相关,且独立于其他早发冠心病易患因素。结论:升主动脉弹性与早发冠心病程度密切相关,是早发冠心病重要的预测因子。
文摘Background： In the early stages of atrial remodeling, aortic stiffness might be an indication of an atrial myopathy, in particular, atrial fibrosis. This study aimed to investigate the association between left atrial （LA） mechanical function, assessed by two-dimensional speckle tracking echocardiography, and aortic stiffness in middle-aged patients with tile first episode of nonvalvular atrial fibrillation （AF）. Methods： This prospective study included 34 consecutive patients with the first episode of AF, who were admitted to Kartal Kos.;uyolu Research and Training Hospital between May 2013 and October 2015, and 31 age- and gender-matched healthy controls. During the 1^st month （mostly in the first 2 weeks） following their first admission, 34 patients underwent the first pulse wave measurements. Then, 21 patients were recalled for their second pulse wave measurement at 11.8 ± 6.0 months following their initial admission. Echocardiographic and pulse wave findings were compared between these 34 patients and 31 healthy controls. We also compared the pulse wave and echocardiographic findings between the first and second measurements in 21 patients. Results： Pulse wave analysis showed no significant differences between tile AF patients and healthy controls with respect to PWV （ 10.2 ± 2.5 m/s vs. 9.7 ± 2.1 m/s： P = 0.370）, augmentation pressure （9.6 ± 7.4 mmHg vs. 9. 1± 5.7 mmHg; P = 0.740）, and aortic pulse pressure （AoPP; 40.4 ± 14.0 mmHg vs. 42. 1 ±7.6 mmHg, P = 0.550）. The first LA positive peak of strain was inversely related to the augmentation pressure （r 0.30; P = 0.02） and aortic systolic pressure （r - 0.26, P - 0.04）. Comparison between the two consecutive pulse wave measurements in 21 patients showed similar results, except for AoPP. In 21 patients, the AoPP at the second measurement （45.1± 14.1 mmHg） showed a significant increase compared with AoPP at the first measurement （39.0 ±10.6 mmHg, P = 0.028）, which was also higher than that of healthy contr
文摘Arterial stiffness and wave reflections are widely used in observational studies to analyse the determinants of haemodynamic changes observed in various clinical conditions and to understand the pathogenesis of their cardiovascular complications. A large number of publications and several reviews documented the changes in arterial stiffness and wave reflections after various interventions, either non-pharmacological or pharmacological.
