Freehand three-dimensional echocardiographic evaluation of the effect of telmisartan compared with hydrochlorothiazide on left ventricular mass in hypertensive patients with mild-to-moderate hypertension: a multicentre study.

Antihypertensive efficacy, effects on left ventricular mass index (LVMI) and tolerability of telmisartan, an angiotensin II receptor blocker, were compared with those of hydrochlorothiazide (HCTZ). Adult patients with mild-to-moderate hypertension and an optimal acoustic window by two-dimensional echocardiography were randomised at baseline to 12 months' double-blind, once-daily treatment with telmisartan 80 mg or HCTZ 25 mg. Two-dimensional echocardiography and freehand precordial three-dimensional echocardiography and 24-h ambulatory blood pressure monitoring were performed at baseline and after treatment. Of the 41 telmisartan group patients and 28 HCTZ group patients, 40 and 25, respectively, completed the study. Following treatment, 24-h mean SBP (telmisartan 157 +/- 11 vs 133 +/- 7 mmHg, P<0.001; HCTZ 154 +/- 10 vs 144 +/- 11 mmHg, P<0.003) and DBP (telmisartan 96 +/- 6 vs 83 +/- 5 mmHg, P<0.001; HCTZ 95 +/- 7 vs 87 +/- 8 mmHg, P<0.003) were significantly reduced. Telmisartan produced significantly greater 24-h mean SBP and DBP reductions than HCTZ (P<0.001). LVMI was significantly reduced by telmisartan (141 +/- 16 vs 125 +/- 19 g/m2, P<0.001), but not by HCTZ (139 +/- 20 vs 135 +/- 22 g/m(2)). Incidences of adverse events in both the treatment groups were low; two cases of hypokalaemia occurred with HCTZ. In conclusion, telmisartan 80 mg was well tolerated and significantly reduced SBP, DBP and LVMI after 12 months' treatment compared with HCTZ.

[Prognostic value of the exertion test in patients treated with thrombolytic therapy for acute myocardial infarct]. / Il valore prognostico del test da sforzo in pazienti trombolisati per infarto acuto del miocardio.

Prognostic value of exercise testing after thrombolytic therapy in patients with acute myocardial infarction. Few studies have evaluated the prognostic value of exercise testing in patients suffering from acute myocardial infarction (AMI) and thrombolysis. For this reason the authors studies 398 patients divided into two groups: 189 thrombolysed patients (T) and 209 non-thrombolysed patients (NT), matched for age, sex, AMI site and treatment received. Thrombolysis was performed within 6 hours of the onset of symptoms using rt-PA in an accelerated regime (90 degrees) preceded by sodium heparin infusion 5000 UI i.v. in bolus, and followed by sodium heparin for 5 days, maintaining a PTT value 2-3 times the basal level. The efficacy of thrombolytic treatment was confirmed by the presence pf at least two of the following markers: CK peak time, rapid reduction of ST overunlevelling, reperfusion arrhythmia. All patients underwent exercise testing using the cycloergometer after suspending treatment at 3 weeks and 6 months after AMI, and a echocardiographic examination on the first day and after 6 months. These data show that thrombolytic treatment reduces the myocardial damage during the course of AMI, enabling the patient to exercise longer and causes improved myocardial contractility with a lower asynergic index compared to non-reperfused patients. Moreover, significantly fewer ergometric tests that were positive for residual ischemia were observed in T compared to NT. The incidence of mortality one year after AMI was low in both groups, albeit lower in T. This confirms the important prognostic role of ergometric tests also in this population.

[The effect of dilazep on circulating platelet aggregation in diabetics]. / Studio dell'azione del dilazep sugli aggregati piastrinici circolanti in diabetici.

The aim of the present paper was to evaluate the effect of the 1,4 bis [3-(3,4,5-trimethoxybenzoyl-oxy) propyl] perhydro-1,4 diazepina (dilazep) on reduction of circulating platelet aggregates in 18 patients with type 2 diabetes, 13 female and 5 male, aged 25-65 years. Dilazep was orally given at 100 mg X 3/day for 8 weeks. The platelet activity has valued before and after the treatment trough the evaluation of circulating platelet aggregates with the method of Wu and Hoak. The results confirmed that the dilazep decreased statistically significant after 8 weeks the circulating aggregates.

[Changes in platelet production of malondialdehyde in diabetics treated with dilazep]. / Variazione della produzione piastrinica di MDA in diabetici trattati con dilazep.

We have investigated the effect of dilazep on the prostaglandin synthesis determined as indicator malondialdehyde (MDA) formation. Twenty patients with type 2 diabetes, aged 25-65 years were orally given dilazep at 100 mg X 3/day for 56 daily. The platelet activity has valued before and after the treatment with the production of the MDA. We conclude that the dilazep inhibited statistically significant biosynthesis of prostaglandin endoperoxides from arachidonic acid.

Cortical control of neurally-mediated arrhythmogenic properties of desacetyl lanatoside C: the role of the posterior hypothalamus.

Functional ablation of the cerebral cortex by cortical spreading depression (CSD) significantly increased the dose of desacetyl lanatoside C required to induce A-V block and ventricular fibrillation. To examine the role of the posterior hypothalamus in the increased resistance of decorticated rats to arrhythmia induced by toxic doses of desacetyl lanatoside C, four groups of animals were injected with this drug: group 1 rats had a craniotomy; group 2 rats had a craniotomy and functional decortication; group 3 rats had a craniotomy and a hypothalamic lesion; and group 4 rats had a craniotomy, hypothalamic lesion and functional decortication. The dose of drug required to induce A-V block and ventricular fibrillation was significantly less in group 1, than in groups 2,3 and 4, and there was no statistically significant difference between these last three groups. These results are consistent with the hypothesis that the increased resistance to arrhythmia induced by desacetyl lanatoside C in decorticated rats is mediated by the posterior hypothalamus.

[Effect of calcitonin on human gastric function]. / Effetto della calcitonina sulla funzione gastrica nell'uomo.

The effects of calcitonin on the gastric secretion have been investigated. Five subjects (age 34 and approximately 70 kg on average) have been injected by 0,25 microgram/kg s.c. a decrease of gastric secretion has been detected. The inhibition of pepsin secretion is much larger than the effect on MAO and PAO. This supports the hypothesis that calcitonin inhibits protein synthesis of the gastric mucous.

[Cimetidine in experimental gastric ulcers induced by pyloric ligation]. / La cimetidina nelle ulcere gastriche sperimentali da legatura pilorica.

Male albino rats of the Wistar strain, without food from 48 h, have been operated with pylorus ligature and treated with cimetidine, at the dose of 30 mg/kg i.m., just after the operation and 12 h later. Cimetidine reduced the size and the number of gastric ulcers induced by pylorus ligature, showing a significant protective effect. This action, due to the inhibition of gastric secretion induced by cimetidine, supports the hypothesis that the staunching of gastric juice (by pylorus ligature) plays a basic role in the pathogenesis of these experimental gastric ulcers.

[Cimetidine and the hypothalamo-hypophysial-suprarenal axis]. / Cimetidina ed asse ipotalamo-ipofiso-corticosurrenalico.

The effects of cimetidine on experimental stress, induced by a long time fast and pylorus ligature, in male albino rats were investigated. The drug at the dose of 30 mg/kg was administered i.m. just after the operation and 12 h later. To evaluate the interference of cimetidine on the hypothalamo-hypophyseal-adrenal axis were dosed, in the rat, the level of adrenal ascorbic acid and cholesterol as well as corticosterone plasma levels. The results seem to suggest that cimetidine, in this experiment, is unable to modify stress induced changes.