Assessment of Effect of Angiotensin Ⅱ Receptor Antagonist Losartan on Aortic Distensibility in Patients With Essential Hypertension by Echocardiography

The effects of angiotensinⅡreceptor antagonist losartan on elastic properties of aorta in patients with mild to moderate essential hypertension were assessed.The ascending aortic distensibility in 26 patients(48±3 years)with mild to moderate essential hypertension before and after 12 weeks of treatment with losartan(50 mg/day)was evaluated by using two-dimensional echocardiography.M-mode measurements of aortic systolic(D_(s))anD_(d)iastolic diameter(D_(d))were taken at a level approximately 3 cm above the aortic valve.Simultaneously,cuff brachial artery systolic(SBP)anD_(d)iastolic(DBP)pressures were measured.Aortic pressure-strain elastic modulus(E p)was calculated as D_(d)×(SBP-DBP)/(D_(s)-D_(d))×1333 and stiffness index beta(β)was defined as D_(d)×Ln(SBP/DBP)/(D_(s)-D_(d)).Blood pressure significantly decreased from 148±13/95±9 mmHg to 138±12/88±8 mmHg(systolic blood pressure,P=0.001;diastolic blood pressure,P=0.003).There was no significant difference in pulse pressure before and after treatment with losartan(53±10 mmHg vs 50±7 mmHg).The distensibility of ascending aorta increaseD_(s)ignificantly as showed by the significant decrease in pressure-strain elastic modulus from 4.42±5.79×10^(6)dynes/cm^(2)to 1.99±1.49×10^(6)dynes/cm^(2)(P=0.02)anD_(s)tiffness index beta from^(2)7.4±32.9 to 13.3±9.9(P=0.02).Although there was a weak correlation between the percent changes in pressure-strain elastic modulus anD_(s)tiffness index beta and that in diastolic blood pressure after losartan treatment(r=0.40,P=0.04 and r=0.55,P=0.004,respectively),no correlation was found between the percent changes in pressure-strain elastic modulus anD_(s)tiffness index beta and that in systolic blood pressure(r=0.04,P=0.8 and r=0.24,P=0.2,respectively).Our study demonstrated that angiotensinⅡreceptor antagonist losartan has a beneficial effect on aortic distensibility in patients with mild to moderate essential hypertension and this effect is partly independent of blood pressure reduction.

Evaluation of cardiovascular risk in patients with Parkinson disease under levodopa treatment

BackgroundLevodopa 是在有 Parkinson 疾病(PD ) 的病人的中间的治疗的不可缺少的选择。因为 L-dopa 治疗被显示增加浆液 homocysteine 层次，为心血管的混乱的一个著名风险因素，有在 L-dopa 治疗下面的 PD 的病人将在为未来的增加的风险心血管的事件。这研究的目的是在 levodopa treatment.MethodsThe 学习下面与 PD 在病人评估心血管的风险人口在 L-dopa 治疗下面与自发的 PD 由 65 个病人组成了。控制组包括了 32 年龄，性匹配没有认知衰落的个人。Echocardiographic 大小，浆液 homocysteine 层次和主动脉的有弹性的参数与 PD 和 controls.ResultsAs 在病人之间被作比较 L-dopa 治疗的一个期望的特征， Parkinson 组有显著地更高的 homocystein 层次(15.1 ±；3.9 µ； mol/L 对 11.5 ±；3.2 µ； mol/L， P = 0.02 ) 。当时，大动脉的膨胀性在有 PD 的病人是显著地更低的与控制相比(4.8 ±；1.5 dyn/cm 2 对 6.2 ±；1.9 dyn/cm 2, P = 0.016 ) 。另外，有 PD 的病人有更高大动脉的紧张和大动脉的僵硬索引(13.4%±；6.4% 对 7.4%±；3.6% ， P <；0.001 和 7.3 ±；1.5 对 4.9 ±；1.9， P <；0.001 分别地) 。而且，浆液 homocysteine 层次被发现断然与大动脉的僵硬索引被相关，在浆液 homocysteine 的大动脉的膨胀性和层次之间有否定关联(r = 0.674， P <；0.001；r =−； 0.602， P <；0.001，分别地) 有在 L-dopa 治疗下面的 PD 的 .ConclusionsThe 病人增加了大动脉的僵硬并且与健康个人相比损害了心脏舒张的功能。提高的浆液 homocysteine 层次可以是可能的 pathophysiological 机制。