Therapeutic efficacy of trimetazidine on angina pectoris

BACKGROUND: Trimetazidine 1(2, 3, 4 trimethoxybenzyl)-piperazine dihydrochloride has shown improved exercise tolerance and delayed ischemic threshold in patients with effort angina. But, unlike other classical antianginal drugs, it netiher reduces oxygen consumption nor increases the blood supply. Its effects could be attributed to protection of the myocardial cell function during ischemia, preventing the fall of ATP, reducing intracellular acidosis and subsequently preventing the accumulation of sodium and calcium in the myocyte. METHODS: We investigated the antianginal efficacy of trimetazidine(Vastinan) in 36 patients(22 males, 14 females, mean age of 56.5 year) who had positive exercise stress test among those with typical effort anginal symptoms from Feb, 1992 to Oct, 1992. These patients received 60mg trimetazidine per day(20mg tid) for 1 month and then exercise stress test, routine hematologic examination and urinalysis were performed at the beginning and at the end of therapeutic examination and urinalysis were performed at the beginning and at the end of therapeutic period. The results were as follows. RESULTS: In exercise parameters, there were 19.2% increase in total work, 30.3% increase in exercise duration and 13% shortening in the normalization time of depressed ST-segment and these were no significant change in hemodynamic parameters(heart rate, blood pressure and maximum Rpp(rate pressure product)(p>0.05). The characters of chest pain were changed in the 19 patients, complete disappearance in 4 patients, reduction of intensity or frequency in 12 patients and aggravation in 3 patients. 2 patients complained of mild epigastric discomfort. There were no significant changes in hematologic findings and urinalysis. CONCLUSIONS: Trimetazidine 60mg per day was efficient in patients with angina and more observations are necessary in assessing the long-term therapeutic efficacy and side effects of this drug.

The study of the left ventricular diastolic function in the patients with dilated cardiomyopathy / 대한내과학회지

No abstract available.

Interobserver Variability in the Assessment of Coronary Arteriogram: Comparison between Visual and Computer based Quantitative Estimation

BACKGROUND: Conventional visual assessment of coronary arteriogram is fraught with large interobserver variance and disagreement with pathologic findings. Thus quantitative coronary angiography had been recently developed to meet the requirement of more reproducible measurement of severity of coronary artery disease. This study was designed to evaluate the interobserver variability of quantitative coronary angiography and its usefulness in clinical application. METHODS: Three independent observers analysed coronary angiogram of 31 consecutive patients by visual assessment and quantitative measurement using computer based algorithm. RESULTS: 1) There was considerable disagreement between 3 observers in the identification of significant coronary stenosis. Complete agreement was achieved in only 29/61 (47%) coronary lesion and agreement of more than 2 observers in 41/61(67%) lesion. 2) In visual assessment, the largest interobserver variance was found in acute marginal artery and distal circumflex artery, whereas the least variance was observed in proximal right coronary artery. 3) The average interobserver variance was 13.1% in visual assessment, 14.9% in geometric analysis, and 10.5% in video densitometric analysis. There was no significant difference between these values. 4) Visual assessment was noted to overestimate the severity of stenotic lesion, by 5.6% compared to geometric analysis and by 11.8% compared to video-densitometric analysis. CONCLUSION: These findings suggest that identifying significant lesion is major source of interobserve variability in both visual and quantitative analysis of coronary arteriogram. In addition, suboptimal image quality was responsible for the inability of quantitative analysis to reduce the variance. These factors seem to be major limitation of quantitative coronary arterirogam.

Hyperbaric Oxygen Therapy in Systemic Scleroderma / 대한피부과학회지

In one case of advanced systemic scleroderma hyperbaric oxygen therapy was performed. The treatrnent were given in an one-man pressure chamber (made in Korea) at a pressure of 2. 5 atmospheres absolute pressure (AT.A). The pressure was increased in 5-7 minutes, kept constant for 1.5 hours and lowered in 5--7 minutes. After 16 weeks of the treatment, regression of the skin contraction was achieved, together with improved mobility of the joints and healing of ulceration.