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D Aquino

Publications and source records attributed to D Aquino.

6 recordsLinked to original sources

Effects of losartan on hypertension and left ventricular mass: a long-term study.

This study evaluated the anti-hypertensive efficacy, tolerability and effects on left ventricular mass of losartan, a selective angiotensin II receptor antagonist, after 22 months in patients with essential hypertension. The study included 77 hypertensive patients who were randomised at baseline to 22 months double-blind once-daily treatment with losartan 50 mg (L group n = 44 patients, mean age 54+/-9 years) or hydrochlorothiazide 25 mg (HCTZ group, n = 33 patients, mean age 56+/-7 years). Routine haematology, blood chemistry, standard electrocardiography, echocardiography and ambulatory non-invasive 24-h blood pressure (BP) monitoring were performed at baseline and after 10 and 22 months. The results showed good tolerability and a significant mean systolic and diastolic BP reduction in all groups (L group: 22 mm Hg and 11 mm Hg; HCTZ group: 11 mm Hg and 7 mm Hg, respectively for systolic and diastolic mean BP). Moreover, a remarkable reduction in left ventricular mass index was reached after 10 and 22 months only in the L group (L group: delta = -11 g/m2, P<0.02; HCTZ group: delta = -5 g/m2, P= 0.38). In conclusion, losartan was well tolerated and produced a significant reduction in BP and left ventricular mass in hypertensive patients

Adult↗

[The effectiveness and tolerability of losartan and effect on left ventricular mass in patients with essential hypertension].

The purpose of our study was to evaluate the antihypertensive efficacy, tolerability and effects on left ventricular mass of losartan over 10 months in patients with essential hypertension. Losartan is a selective angiotensin II receptor-antagonist. The whole study comprised 89 hypertensive patients who were randomized, at baseline, to 10 months of double-blind once daily treatment with losartan 50 mg (L Group, n = 49, mean age 55 +/- 13 years) or hydrochlorothiazide 25 mg (HCTZ Group, n = 40, mean age 56 +/- 10 years). Routine hematology, blood chemistry and urinalysis were performed before and after 5 and 10 months; standard electrocardiography, ambulatory non invasive 24-hours blood pressure monitoring, M-mode echocardiography, psychometric test and quality of life evaluation were obtained from all the patients before and after 10 months. In patients non responding after 4 weeks, hydrochlorothiazide 25 mg or losartan 50 mg was added in the L Group and in the HCTZ Group, respectively (L-HCTZ Group). The results showed good tolerability and a significant mean systolic and diastolic blood pressure reduction in all groups (L Group from 157/96 +/- 9/7 to 137/85 +/- 9/5 mmHg, p < 0.001; HCTZ Group from 158/97 +/- 11/8 to 150/91 +/- 9/7 mmHg, p < 0.003; L-HCTZ Group from 159/98 +/- 9/5 to 141/88 +/- 6/4 mmHg, p < 0.001), although L and L-HCTZ treatment were more effective during 24 hours than HCTZ. Moreover, a remarkable reduction in left ventricular mass index was obtained after 10 months only in the L Group (from 138.4 +/- 26.2 to 127.2 +/- 23.1 g/m2, p < 0.04) and in the L-HCTZ Group (from 140 +/- 20.3 to 125.5 +/- 20.1 g/m2, p = 0.126). Finally, in patients treated with losartan the results of psychometric test significantly improved (L Group: p < 0.05; L-HCTZ Group: p < 0.05) and a positive remarkable change in the quality of life was observed (L Group: p < 0.05; L-HCTZ Group: p = 0.083). In conclusion, losartan in monotherapy or in association with hydrochlorothiazide, was well tolerated, respected the quality of life, and produced a significant and remarkable reduction in blood pressure and left ventricular mass in hypertensive patients.

Adult↗

[ST elevation during ergometric test: correlation with coronary angiography].

BACKGROUND: ST elevation during ergometric stress test (EST) is relatively rare. Its prevalence depends upon the tested population but occurs more frequently in patients who have had myocardial infarction or variant angina. This phenomenon is very rare in patients with typical exertional angina and its pathogenesis is still unclear. MATERIAL AND METHODS: We studied a group of 75 consecutive patients with exertional angina who underwent EST and coronary angiography. A symptom limited EST was performed in the upright position on a cycloergometer with load increases of 25 watts every 3 minutes and 12 leads were monitored during all test. Coronary angiography was performed according to Judkins technique. From these patients, according to Froelicher's criteria, a group of 49 patients (age 32-68, mean 51.6 years), without myocardial infarction and/or left ventricular asynergy, was selected. RESULTS: All patients had a coronary artery disease (16 patients with 3 vessels, 11 patients with 2 vessels and 22 patients with 1 vessel disease). The EST was positive for ST depression in 31 patients (63.3%) and for ST elevation in 5 patients (10.1%), while 13 patients (26.6%) had a non diagnostic EST. The ST elevation occurs in V1-V2 and it was associated in all cases with a stenosis in the left anterior descending (LAD) artery. Therefore we divided the 19 patients with LAD stenosis into two subgroups: subgroups A (9 patients, mean age 49.6 years) with LAD stenosis > or = 90% and subgroups B with LAD stenosis between 70% and 90%. ST elevation occurs in 5 patients (55.5%) of subgroup A and in no patient of the subgroup B. Moreover, in the subgroup A ST elevation seems to be related to the anatomic localization of the stenosis: in fact it appears in 83.3% of patients with LAD stenosis located before the onset of the first diagonal branch. CONCLUSIONS: From these data it can be desumed that ST elevation in V1-V2 that occurs in patients with exertional angina and without myocardial infarction or variant angina is strongly predictive of a very important LAD stenosis.

Adult↗

[Myocardial infarct without Q wave in the elderly: diagnostic evaluation using vectorcardiography].

The diagnosis of previous non-Q wave myocardial infarction by standard electrocardiographic investigation is uncertain, particularly in elderly patients because of concomitant disease. We have studied 31 elderly patients (aged 63-72 years) with a diagnosis of non-Q wave myocardial infarction between 1-6 months after this acute event. The patients underwent clinical-anamnestic examination, standard electrocardiography, vectorcardiography according to the Frank system and M-mode and 2-D echo-cardiography with continuous and pulsated Doppler. The ECG showed ST-T anomalies in 12 patients (38.7%) whereas the VCG showed anomalies of QRS-loop normal convexity in 27 patients (87%) and 16 of these (51.6%) showed bites criteria (duration > or = 10 msec, voltage > or = 0.1 mV, present at least on two planes). By echocardiography, regional hypo-akinesia was observed in 19 patients (61.3%). Although bites are not only present in myocardial infarction, they indicate an interruption of myocardial gradual electric activation, compatible with fibrous areas, and should be evaluated as a part of the clinical-anamnestic, laboratory and instrumental data.

Age Factors↗