Background: We report the reduction of QT and QTc dispersion in patients treated for 7 years with enalapril for systemic hypertension with left ventricular (LV) hypertrophy. We assess the correlation ...between QT dispersion and LV mass during this period and at the end of an 8‐week period of suspension of enalapril treatment after 5 years.
Methods: Twenty‐four previously untreated patients with this condition took enalapril (20 mg twice daily) for 7 years, except during an 8‐week period following 5‐year follow‐up. Cardiovascular parameters were determined by two‐dimensional guided M‐mode echocardiography, and QT interval was measured, in a pretreatment placebo phase, 8 weeks and 1, 3, 5, and 7 years after the start of the therapy, at the end of the 8‐week suspension effected after 5 years, and 8 weeks after the end of the suspension.
Results: Therapy rapidly reduced blood pressure (BP) from 156/105 mmHg to normal values: 134/84 mmHg after 8 weeks’ treatment, 130–84 mmHg at 7‐year follow‐up (P < 0.001 with respect to the placebo phase). LV mass index decreased progressively until at 5‐year follow‐up the reduction had reached 39% (P < 0.001), after which neither LV mass nor any other structural parameter underwent any further significant change. During this time, QT dispersion (ΔQT) and the dispersion of “corrected” QT (ΔQTc) decreased significantly: ΔQT (from 61 ± 21 to 37 ± 13 ms) and ΔQTc (from 67 ± 27 to 41 ± 16 ms). After suspension of treatment for 8 weeks following 5‐year follow‐up, ΔQT was 40 ± 14 ms and ΔQTc was 44 ± 17 ms; there were no significant changes either in ΔQT and ΔQTc or LV hypertrophy although BP had returned to pretreatment values (BP: 150 ± 16; 101 ± 10 mmHg).
Conclusions: Long‐term enalapril treatment of hypertensive patients with LV hypertrophy induces marked regression of LV mass and improvement of QT dispersion. These improvements occur on a longer timescale than improvement in BP, and are not affected by transient changes in BP values.
Parkinson's disease (PD) is a chronic and progressive disorder. It produces a significant burden not only for patients, but also for their family and caregivers, with a major socio-economic impact on ...society. Current knowledge on PD is characterized by scarce information about the evolutionary course of: 1) the non-motor PD features; 2) impact of non-motor PD features on disability and health related quality of life (HRQL) impairment; 3) factors related to disability and HRQL determinants; 4) factors that speed or slow the progression of PD; 5) differential long-term effect of available PD therapeutic schedules and their relationships with disability, complications, and HRQL; and 6) impact of the disease on patients' caregivers. In addition, heterogeneity in the metric quality of the applied measures and selection bias are frequently found.
Due to the aforementioned limitations and from a multidimensional perspective, a new longitudinal study in PD is deemed necessary. The longitudinal study of PD patients (ELEP) includes a long-term follow-up of never before systematically assessed aspects, will allow to increase the global knowledge about PD.
Tooth wear in gastroesophageal diflux disease (GERD) Munoz, Jose V.; Mora, Francisco; Minguez, Miguel ...
Gastroenterology (New York, N.Y. 1943),
April 2001, 2001-04-00, Letnik:
120, Številka:
5
Journal Article
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