Relationship between decrease in ambulatory blood pressure and heart rate variability due to the effects of taking olmesartan medoxomil.

UNLABELLED: BACKGROUNDS AND METHODS: A higher degree of clinical efficacy with olmesartan compared with other angiotensin receptor blockers, has been reported by several sources. In this study of 31 examples of cases of essential hypertension, Holter electrocardiogram, ambulatory blood pressure monitoring and pulse wave velocity (PWV) measurements were performed before and after substituting olmesartan 20 mg for candesartan 8 mg antihypertensive drug therapy. RESULTS: Following the therapeutic change, daily average systolic and diastolic blood pressures were decreased by 6.7 +/- 9.3 mmHg and 3.6 +/- 8.3 mmHg, respectively, with olmesartan 20 mg; PWV was also significantly decreased. Holter electrocardiogram heart rate variability spectral analysis demonstrated that none of the very low frequency (VLF), high frequency (HF) and low frequency (LF)/HF components were significantly altered. However, a significant correlation was observed between the LF/HF component and blood pressure difference, when blood pressure and heart rate variability components in each individual case were studied. CONCLUSION: This study shows that olmesartan has a stronger antihypertensive effect in comparison to candesartan, and does not generate reflex sympathoexcitatory activity.

Angiographic and clinical characteristics associated with the removable plaque components by means of thrombectomy catheters in patients with myocardial infarction.

BACKGROUND: Previous studies have demonstrated that atheroembolism during percutaneous coronary intervention is associated with myocardial damage. The purpose of this study is to investigate the clinical and angiographic characteristics related to removable plaque elements in patients undergoing thrombectomy for myocardial infarction. METHODS: Eighty consecutive lesions in 80 patients (M/F=58/22, age 65.5+/-11.6 years) with myocardial infarction who underwent thrombectomy (TVAC system, Nipro, Osaka, Japan) prior to mechanical dilatation (balloon angioplasty and/or stent implantation) were investigated. Visible debris was collected and plaque elements (cholesterol clefts and/or foamy cells) were investigated pathologically. Baseline angiographic characteristics [baseline thrombolysis in myocardial infarction (TIMI) grade, culprit lesion, haziness, lesion length, ostium, bifurcation, calcification, eccentricity, thrombus, and multivessel] were analyzed, and predictive angiographic and clinical factors for plaque elements were investigated. RESULTS: There were no complications related to thrombectomy. Final TIMI grade 3 and blush grade 2 or 3 were achieved in 75 (94%) and 66 (83%) patients, respectively. Visible debris specimens were obtained in 49 (61%) patients. Histological plaque elements (cholesterol clefts and/or foamy cells) were observed in 27 out of 49 patients with debris specimens. There was no significant difference in the clinical characteristics between the groups of patients with (group P) and without (group NP) plaque elements. Aspirated plaque elements were more frequently observed in discrete and eccentric lesions (group P vs. group NP: discreteness, 52% vs. 28%, P<.05; eccentricity, 67% vs. 36%, P<.05). CONCLUSIONS: This study demonstrated the clinical characteristics associated with removable plaque components in patients with myocardial infarction undergoing thrombectomy by means of the TVAC system. Discreteness and eccentricity were more frequently observed in lesions with removable plaque elements.

Serial quantitative coronary analyses for the evaluation of one-year change in saphenous vein grafts.

BACKGROUND: A paucity of data exists with respect to changes in whole saphenous vein grafts (SVGs) despite accelerated atherosclerosis within grafted saphenous vein conduits. In the present study, we evaluated the one-year change in SVGs by means of quantitative coronary analysis. METHODS: This study enrolled consecutive 52 patients with 109 SVGs, who underwent coronary artery bypass graft surgery successfully. A follow-up study was performed in 33 patients with 65 SVGs after one year because 16 SVGs were obstructed (baseline, 8; follow-up period, 8), and 15 patients with 28 SVGs dropped out within one year. RESULTS: Both minimal and mean lumen diameters decreased significantly (3.17 +/- 0.64 mm vs 2.41 +/- 0.57 mm, p < 0.001; 3.70 +/- 0.69 mm vs 2.92 +/- 0.70 mm, p < 0.001; respectively). Graft length also decreased significantly (107.1 +/- 25.8 vs 100.6 +/- 25.2 mm, p < 0.001). The graft shortening rate (graft shortening length/baseline graft length x 100) was greater than 5% in 33 vessels (51%) and greater than 10% in 23 vessels (35%). Coronary risk factors (smoking, diabetes mellitus, hypertension, dyslipidemia) did not reveal significant relationship with late loss of minimal and mean lumen diameters. CONCLUSIONS: The present study showed a considerable and uniform lumen loss of SVGs after one year, irrespective of coronary risk factors. Graft length shortening was seen more than elongation.