Abnormalities of left ventricular long-axis function predict the onset of hypertension independent of blood pressure: a 7-year prospective study.

Increased blood pressure and left ventricular (LV) mass predict the onset of the clinically manifest hypertension, but little is known regarding the possible predictive value of LV function. The present study was designed to evaluate the association between echocardiographic LV long-axis systolic, and diastolic function and hypertension onset. We prospectively followed 244 normotensive adults with a family history of hypertension (HTN), with echocardiography for 7 years. M-mode derived atrioventricular plane displacement of the mitral and tricuspid annuli (MAVPD and TAVPD respectively), and LV circumferential fractional shortening were calculated. Diastolic function of the left and right ventricle were assessed using Doppler indices of the mitral and tricuspid inflow. During follow-up, 79 subjects developed hypertension (H group) and 165 subjects remained normotensive (N group). H group subjects had diminished MAVPD (13.8+/-3.4 vs 15.0+/-3.1 mm; P=0.007), lower mitral E/A ratio, and longer mitral E-wave deceleration time as compared to N group. In multivariate Cox model MAVPD and mitral E/A ratio predicted the onset of hypertension independent of LV mass index, blood pressure, pre-hypertensive status at baseline, age, sex and body mass index. During follow-up, H subjects experienced a significant decline in MAVPD and mitral E/A ratio, whereas the indices of right ventricular function and LV circumferential shortening remained intact. In conclusion, alterations in LV long-axis systolic and diastolic function, as measured by MAVPD and E/A ratio predict the onset of hypertension. These parameters declined during the development of hypertension.

[Endovenous laser treatment (EVLT) for treatment of great saphenous vein insufficiency]. / Tratamentul laser endovenos în insuficienta venei safene interne.

OBJECTIVE: To assess the efficacy and rate of complications of endovenous laser treatment (EVLT) of the great saphenous vein (GSV) insufficiency. METHOD: Between august 2002 and june 2007, 341 of the lower limbs of 322 patients were treated with EVLT using a 980-nm diode laser. Duplex ultrasound and clinical examinations were performed on the day of the procedure, the next day, and 6 to 12 months after the procedure. RESULTS: All procedures were technically successful, and at the 3 months follow-up the Doppler ultrasound indicated the complete obstruction in all cases. 67 of the 70 lower limbs presented a complete obstruction at the 2 year follow-up. Only in two cases (2.85%) the GSV recanalization was observed after 6 months. As side effects reversible paresthesia, transient postoperative pain and ecchymosis were observed. CONCLUSION: EVLT is a safe technique, with low incidence of recanalization and postoperative complications.

[Clinical correlations between the incidence of diabetic retinopathy and diabetic nephropathy]. / Corelatii clinice între incidenta retinopatiei diabetice si nefropatiei diabetice.

In this study we included 651 patients with recently diagnosed diabetes mellitus registered at the Centre for Diabetes Care from Timisoara in 1995. All the patients were from Timisoara and the county of Timis. They had insulin-dependent and noninsulin-dependent diabetes mellitus. We studied the eye lesions ophthalmoscopically, retinophotographically and angiographically and we correlated these informations with the lesions of diabetic nephropathy. We also made an evaluation of the functional implications of the ocular lesions.