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PubMed1989

Diltiazem as monotherapy in treatment of mild to moderate essential hypertension.

The effectiveness and safety of diltiazem monotherapy was evaluated in 29 patients with mild to moderate essential hypertension (diastolic pressure between 95 and 115 mmHg). There were 16 men and 13 women, ages ranged from 29 to 58 years (mean 43). After a 2-week placebo period, each patient was given a 60 mg diltiazem tablet three times a day for 8 weeks. Blood pressure and heart rate were determined at weekly clinic visits. Three patients were withdrawn from the study because of a skin rash, palpitation and a frequent loose stool, respectively. In the remaining 26 patients, the mean systolic and diastolic blood pressures were reduced significantly in 2 weeks of therapy and thereafter. At the end of the 8-week treatment the mean supine blood pressure decreased from 158/103 at baseline to 139/94 mmHg, the mean sitting blood pressure from 156/104 to 136/93 mmHg, and the mean standing blood pressure from 151/104 to 134/96 mmHg. The heart rate did not change significantly before or during diltiazem treatment. In 16 (61.5%) of the 26 patients, diltiazem consistently reduced the diastolic blood pressure more than 5 mmHg throughout 2 to 8 weeks of treatment. The left ventricular mass and ejection fraction assessed with M-mode echocardiograms were normal before diltiazem treatment, and remained unchanged 8 weeks after the treatment. By using treadmill exercise tests, there was a significant increase in exercise duration and a significant reduction in the peak heart rate at 8 weeks after the treatment. The peak systolic blood pressure did not change significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Postoperative echocardiographic study of patients with symptomatic chronic aortic regurgitation.

Aortic valve replacement was performed in 31 patients with symptomatic chronic aortic regurgitation. The patients ranged in age from 13 to 66 (mean = 39) years and included 29 men and 2 women. They were followed up for a mean of 47 months. Perioperatively, 2 patients (6.5%) died, and 2 (6.5%) received a permanent pacemaker for complete heart block. Thirty patients received an M-mode echocardiographic examination both before, and 6 to 11 days after, the operation. In this early postoperative period, the end-diastolic dimension (EDD) and left ventricular end-diastolic radius/posterior wall thickness ratio (R/Th) decreased in all patients. This decrease in EDD could be predicted by preoperative ejection fraction (EF), but not by end-systolic dimension (ESD) or R/Th ratio. The ESD regressed only in patients with preoperative EF greater than 50%, or ESD less than 55mm, or R/Th less than 3.8. During the long-term follow-up, one each had mild tissue valve degeneration, stroke, infective endocarditis, and severe myocardial failure, but none died. Eighteen patients had repeated M-mode echocardiographic studies. There was no further regression of EDD and R/Th, while ESD showed significant decrease. The EF and fractional shortening (FS) did not change. Clinically, the patients who survived the operation improved or remained unchanged postoperatively in a functional status. However, those who had preoperative EF greater than 50% or ESD less than 55mm had a better postoperative functional class (1.2 +/- 0.4 vs 1.9 +/- 1.0, p less than 0.05, 1.2 +/- 0.4 vs 2.0 +/- 1.1, p less than 0.05, respectively). Thus, patients with symptomatic chronic aortic regurgitation can often benefit from valve replacement.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗