In this study, efficacy of the angiotensin II type 1 receptor blocker telmisartan given as monotherapy was compared with that of perindopril monotherapy in patients with mild-to-moderate hypertension. After a 2-week, single-blind, placebo run-in period, 60 patients were randomised to double-blind, once-daily treatment with telmisartan 80 mg or perindopril 4 mg for 6 weeks. Clinic and ambulatory blood pressure measurements and clinical laboratory evaluation were performed at the end of the placebo run-in and active treatment phases. Both telmisartan and perindopril significantly (p < 0.0001) reduced clinic systolic blood pressure (SBP) and diastolic blood pressure (DBP) compared with baseline values. Also, both drugs significantly (p < 0.0001) reduced 24-h mean ambulatory SBP and DBP compared with baseline. Comparison of the mean hourly antihypertensive activities showed that the reduction in mean ambulatory DBP for the last 8 h of the dosing interval was significantly greater (p < 0.05) in telmisartan-treated patients. A 24-h mean DBP of <85 mmHg was observed in 66.6% of the telmisartan-treated patients but in only 46.6% of the perindopril-treated patients (p < 0.05). It is concluded that telmisartan and perindopril both produce significant reductions in clinic SBP and DBP, but the mean reduction in ambulatory DBP during the last 8 h of the dosing interval is greater in patients treated with telmisartan.
Background: Two different studies were conducted to evaluate the value of T wave in V 1 taller than T wave in V 6 (TV 1 > TV 6 ) pattern as an indicator of coronary artery disease. Method: In the first study 5,300 resting ECGs were examined and the criterion was found in 283 patients. All of these patients were examined with echocardiography. In the second study, ECG tracings and coronary angiograms of another 500 patients were evaluated. Results: In the first study, in 59 of 283 patients left ventricular hypertrophy was detected and these patients were excluded from the study. There were ST segment‐T wave changes and/or Q wave on ECG suggesting coronary ischemia or myocardial infarction in 160 of the 224 patients. TV 1 , > TV 6 criterion was the sole finding in 64 of the 224 patients. All of the 224 patients underwent coronary angiography and coronary artery disease was detected in 185 patients; 134 of the 160 patients (83.3%) and 51 of 64 patients (80%) had one‐vessel or multivessel disease. There was no significant difference among the groups regarding coronary artery disease. Left anterior descending artery was involved in all of the 185 patients. In the second study, 408 patients were found to have coronary disease involvement and 92 patients showed normal or insignificant coronary disease. Sixty‐six of the 408 patients with coronary disease and four of 92 patients were found to have the TV 1 > TV 6 pattern. Sensitivity of the criterion was 16.1%, specificity was 95.6%, and accuracy was 94.2%. Conclusions: According to these results, it is concluded that TV 1 > TV 6 with or without other ECG findings is a good criterion suggesting coronary artery disease, especially left anterior descending artery involvement in patients without left ventricular hypertrophy. A.N.E. 1999;4(4):397–400
Background: The study was designed to evaluate the severity of mitral regurgitation by cardiac magnetic resonance imaging (MRI). We proposed a new measurement of signal void by MRI and tried to define threshold values for the severity of regurgitation with different sequences. Methods: Twenty‐one patients with mitral regurgitation were evaluated by echocardiography and MRI. We measured the length, width, and the area of jet flow void from long‐axis and four‐chamber views. The regurgitant area was measured with TrueFISP, FLASH sequences, and phase images by tracing the signal‐void area in left atrium parallel to mitral annulus. This new parameter for grading of the severity of mitral regurgitation by cine MRI was called regurgitant area from short axis (RAFSA). Results: All methods (EROA, vena contracta) were correlated for determining the regurgitation severity (P < 0.01). There was a correlation between EROA by echocardiography and RAFSA by MRI with the TrueFISP, FLASH sequences, and phase images (P < 0.01). Stepwise regression analysis revealed that EROA was significantly correlated with RAFSA by phase images (P < 0.001). After regression analysis, threshold values of RAFSA by phase imaging were calculated and found to be 0.27 cm 2 and 0.92 cm 2 between mild, moderate, and severe mitral regurgitations (100% sensitivity, 67% specificity, and 100% sensitivity, 78% specificity, respectively) (P < 0.01, P < 0.05). Conclusions: MRI is an alternative method for evaluating mitral regurgitation. Our study suggests a new parameter, RAFSA by cine MRI, to grade the severity of mitral regurgitation and provides threshold values in order to define mild, moderate, and severe regurgitations. (ECHOCARDIOGRAPHY, Volume **, ***********)
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
