[Pulse pressure, arterial compliance and Buckberg index in hypertensive patients treated with nebivolol and nitrates]. / Presiunea pulsului, complianta arterelor de conductanta si irigatia subendocardica la hipertensivii tratati cu nebivolol si nitrati.

OBJECTIVE: To evaluate the effect of nebivolol and nitrate administration on the arterial compliance--an essential factor for left ventricular hypertrophy regression. MATERIAL AND METHOD: The arterial compliance was assessed in 32 hypertensive patients (mean age 52.3 years +/- 11, M/F ratio = 26/6) before drug administration, three hour post oral intake of nebivolol 5 mg and five minutes after sublingual 0.5 mg nitroglycerin. PARAMETERS: mean aortic blood pressure (PAom), pulse pressure (PP), augmentation index (AGIx) and Buckberg index (diastolic pressure-time index/systolic pressure-time index). The statistical significance of the results was determined by means of t-Student test. RESULTS: After nebivolol: PAom decreased from 131.2 +/- 15 mmHg to 118 +/- 15.3 mmHg; PP decreased from 72.5 +/- 12 mmHg to 52.3 +/- 11.3 mmHg; AG decreased from 17 to 10.2 mmHg, AGIx decreased from 26.4% to 22.3%, Buckberg index increased from 145.4 +/- 25% to 161.4 +/- 30%. After nitroglycerin: PAom decreased to 108.5 +/- 12 mmHg; PP decreased to 41.2 +/- 9.3 mmHg; AG decreased to 2.3 mmHg, AGIx decreased to 3.6%, Buckberg index increased to 171.2 +/- 32%. CONCLUSIONS: Nebivolol and nitrates determined a significant lowering of mean aortic pressure and an increase of the arterial compliance suggesting a beneficial effect that could promote the regression of left ventricular hypertrophy.

[Relation between arterial compliance and the prematurity of reflected wave on pulse pressure curve evaluated by tonometric sphygmography]. / Relatia dintre complianta arteriala si precocitatea undei reflectate la nivelul curbei presiunii pulsului evaluata prin sfigmografia tonometrica.

The effect of antihypertensive drugs on the arterial pressure pulse can usually be explained by a change in the timing or intensity of wave reflection or by alteration in the pattern of ventricular ejection. Alteration in timing wave reflection is believed to cause the characteristic changes of pressure wave such: augmentation, augmentation index, "precocity index of second systolic peek" (P2). After calcium channel blockers augmentation decreases from 15 mmHg to 9.4 mmHg, augmentation index P2/P1 (P1 is the first systolic peek) decreases from 132.2 +/- 20% to 129.2 +/- 19.5% and "precocity index of P2" increases from 68.8 +/- 5% ejection duration to 71.8 +/- 4.6% ejection duration.

[The etiological spectrum of pure and isolated chronic mitral insufficiency]. / Spectrul etiologic al insuficientei mitrale cronice pure si izolate.

The 78 patients with mitral insufficiency studied in the present paper were chosen taking into consideration the following: regurgitant apex holosystolic or mesotelesystolic murmur, noise 3 and the dilation of the left atrium and/or left ventricle at Echo-20. The patients were investigated clinically, ECG, phonocardiographically and echographically (2D). The etiology was established in 75 patients; non rheumatic causes were present in 70% of the cases. The echographic study, besides the other methods, is very important in diagnosing the mitral insufficiency, in etiology, severity and the degree of deterioration of the pump function of the left ventricle. The Eco-2D examination, a noninvasive method, allows reaching therapeutic medical and surgical decisions at the best moment and helps in assessing the results.

[An echocardiographic evaluation of pure and isolated mitral stenosis. Comparisons with other noninvasive methods]. / Evaluarea ecocardiografica a stenozei mitrale pure si izolate. Confruntari cu alte metode neinvazive.

In 94/116 (81%) cases of pure and isolated mitral stenosis (MS), ECO-2D permitted the correct determination of the surface of the mitral opening (SMO). The cases were divided in terms of the SMO size into: extended MS (SMO greater than 2 cm2, n = 28), moderate MS (SMO between 1.1 and 2 cm2, n = 54), and narrow MS (SMO less than or equal to 1 cm2, n = 12). The SMO size influenced significantly the values of several noninvasive indices of the MS severity: the Wells index, the 2-C1DM noise interval, the NYHA class, the cardiothoracic index (expressed as an average, the +/- standard deviation for each group), and also the incidence of the atrial fibrillation, AQRS greater than or equal to 70 degrees, of the radiographic aspect of the pulmonary stasis or of the right cardiac failure (given in percent for each group). Anyhow, none of these parameters, taken alone, permitted the correct assessment of the MS severity. The sensibility, specificity and predictive value of the above-mentioned criteria were not sufficient for the detection of the narrow MS (SMO less than or equal to 1 cm2). ECO-2D is the most exact noninvasive method for appreciating the anatomical state of the mitral valvular apparatus in MS and for selecting the patients for the surgical correction.