Echocardiographic Assessment of Left Ventricular Hypertrophy in Patients with Essential Hypertension

Left ventricular hypertrophy(LVH) is one of common cardiovascular complications in hypertensive patients and it is well known that hypertensive cardiac disease accompained by LVH is still common cause of congestive heart failure in spite of treatment of hypertension. The authors assessed the prevalence of anatomical and functional abnormalities of left ventricle by EKG, chest X-ray and echocardiography in 45 essential hypertensive patients and also in 20 normal controls. Average values of left ventricular posterior wall thickness(LVPWd), interventricular septal thickness(IVSd), left ventricular mass(LVM), and left ventricular mass index(LVM/BSA) by echocardiography in hypertensive groups with LVH by EKG or chest X-ray were significantly higher than those of hypertensive groups without LVH by EKG or chest X-ray(P<0.005). Among 27 hypertensive patients with LVH by EKG and chest X-ray increased LVPWd was found in 24 patients(18%) and increased LVH in 26 patients(19%). Increased LVPWd and LVM were found in 3 patients(23%) among 13 hypertensives without LVH by EKG and chest X-ray. Hypertensive patients with increased LVH showed LVH by EKG and chest X-ray more frequently than those with increased LVPWd. Also, hypertensive patients without increased LVM showed MVH by EKG and chest X-ray less frequently than those without increased LVPWd. Therefore, echocardiography appears to be superior to routine chest X-ray and EKG for defecting LVH in hypertensive patients, especially without LVH by these tests. In conclusion, even though estimation of LVM by echocardiography seems to be a better method than single measurement of LVPWd, it seems thant estimation of LVM together with LVPWd will be more valuable in diagnosis of LVH in hypertensive patients.

Electrocardiographic Findings and Left Ventricular Function According to the Amount of Pericardial Effusion Measured by Echocardiography

Clinical findings, electrocardiographic voltage and left ventricular function were evaluated in 104 patients with percardial effusion. Patients were classified into three groups by the amounts of pericardial effusion measured by two-dimensional echocardiography. 49 patients had small pericardial effusion, 31 moderate effusion and 24 large effusion. In 47 patients the effusions were clinically unsuspected prior to echocardiographic examination. Pericardial friction rub was noted in 14 patients, two-thirds of whom had moderate to large effusions. There was no relationship between the size of effusion and the presence of friction rub. Total QRS amplitudes were lower in patients with moderate to large effusions than those in control group. Maximum diastolic endocardial velocity(DEVM) and E-F slope of the anterior mitral leaflet were decreased significantly in patients with moderate to large effusions as compared with those with small effusions. As a result, authors concluded that reduction in the QRS voltages in serial ECGs may suggest the presence and the amount of pericardial effusion and also DEVM and E-F slope of the anterior mitral leaflet can be sensitive measures of left ventricular relaxation in patients with pericardial effusion.

Clinical Trial on the Hypotensive Effect of Buterazine

The hypotensive effect and side reactions of Buterazine were evaluated in 21 patients with essential hypertension. The results were as follows; 1) Before medication and after 2 and 4 weeks of medication, the over all average systolic and diastolic pressure were 188+/-23/112+/-7, 168+/-13/101+/-17, and 158+/-12/95+/-8mmHg, respectively. After 2 and 4 weeks of medication, the over all average systolic pressure decreased by 20 and 30mmHg(P<0.005, P<0.001), and the over all average diastolic pressure decreased by 11 and 17mmHg(P<0.025, P<0.001), respectively. In 69% of all cases, marked or moderate degree of hypotensive effect was observed. 2) There was no significant changes in heart rates before and after treatment. 3) In 84% of all cases, improvement of symptoms were observed. 4) There was no side effects which required discontinuing the treatment, except 2 cases which discontinued the medication.