RESUMEN
BACKGROUND AND PURPOSE: Left ventricular hypertrophy (LVH) and increased common carotid artery intimamedia thickness (IMT) are known target organ damages of hypertension. However, the relation between LVH and carotid artery IMT is not well defined in Korea. Thus, the purpose of this study is to evaluate the association of common carotid artery IMT and luminal diameter (LD) with LVH (LV mass) in patients with hypertension. METHOD: LV mass was measured by echocardiography and IMT and LD of right and left common carotid artery were measured by high resolution ultrasound in non-hypertensive subjects (n=24), patients with known hypertension without LVH (n=22) and hypertension with LVH (n=22). Data obtained were adjusted statistically for age. RESULTS: Mean IMT (in mm) were 0.51+/-0.12 in non-hypertension group, 0.61+/-0.09 in hypertension without LVH group and 0.73+/-0.13 in hypertension with LVH group (age adjusted p<0.0001 by ANCOVA). Mean systolic and diastolic IMT/LD ratios were 0.077+/-0.015 and 0.089+/-0.018 in non-hypertensive group, 0.052+/-0.015 and 0.09+/-0.014 in hypertension without LVH group, and 0.085+/-0.015 and 0.104+/-0.022 in hypertension with LVH group (p=0.063 for systolic ratio and 0.137 for diastolic ratio). CONCLUSION: These findings suggest that there is a significant correlation between carotid artery intima-media thickness and LVH in hypertensio.
Asunto(s)
Humanos , Arterias Carótidas , Arteria Carótida Común , Grosor Intima-Media Carotídeo , Ecocardiografía , Hipertensión , Hipertrofia Ventricular Izquierda , Corea (Geográfico) , Fenobarbital , UltrasonografíaRESUMEN
BACKGROUND AND OBJECTIVES: Various intravenous (IV) antiarrhythmic drugs in patients with atrial fibrillation (AF) refractory to electrical cardiooversion have been attempted. We assessed the efficacy of IV propafenone in patients with AF who failed to achieve normal sinus rhythm using standard external direct current (DC) cardioversion. SUBJECTS AND METHODS: Of the 77 AF patients who underwent a DC cardioversion, 18, who were refractory for up to a maximal 360 joules of external DC cardioversion, were included in this study. Propafenone was infused for 10 minutes at doses of 2 mg/kg (n=3), 2.5 mg/kg (n=8), and 3 mg/kg (n=7) followed by repeated DC cardioversion. RESULTS: The mean age of the patients receiving propafenone was 55+/-14 years and 21% were women. The mean ejection fraction and the average diameter of the left atrium were 56+/-5% and 42+/-7 mm, respectively. The AF cycle length increased following propafenone infusion form 160+/-23 ms to 278+/-62 ms (p<0.05). The AF converted to a normal sinus rhythm following propafenone infusion in three patients. Thirteen patients were successfully cardioverted following IV propafenone infusion, with a mean accumulated energy of 410+/-216 joules (689+/-373 joules prior to propafenone infusion, p<0.05). Cardioversion failed in 2 patients;therefore, the success rate of the cardioversion in patients who received IV propafenone was 88.9% (16/18). No significant adverse effects were observed. CONCLUSION: IV propafenone can be safely used to enhance the efficacy of cardioversion in patients with AF refractory to transthoracic DC cardioversion.