Losartan improves diastolic ventricular filling of hypertensive patients with diastolic dysfunction.

To evaluate the role of losartan on left ventricular (LV) function of hypertensive patients. Hypertensive patients (n = 19) underwent evaluation of systolic and diastolic LV function, using radionuclide ventriculography (RVG), before and at 3 mo into the treatment with the angiotensin II antagonist losartan. All patients underwent a baseline 12 lead ECG and an echocardiogram (ECHO), which was also repeated at 3 mo into treatment. Results are expressed as mean +/- SEM and statistics were performed using paired t-test. A p value < or = 0.05 was considered significant. Treatment with losartan for 3 mo had no effect on LV mass measured by echo (141+/-5 vs. 139+/-6 g/m2). The LV ejection fraction, measured by RVG, was unchanged by treatment when compared to the baseline study (58+/-2% vs. 57+/-2%, respectivelly, p = 0.49). Considering all patients involved in the study (n = 19), the LV "Peak Filling Rate" (PFR), a parameter of diastolic function measured by RVG, was also unchanged by treatment when compared to baseline (2.5+/-0.2 EDV/s vs. 2.5+/-0.3 EDV/s, respectively, p = 0.9). However the analysis of those patients with evidence of diastolic dysfunction (n = 12) on the baseline RVG (PFR < 2.5 EVD/s), demonstrated significant improvement of LV filling after therapy with losartan (PFR = 1.8+/-0.1 EDV/s vs. 2.3 +/-0.2 EDV/s, respectively, p = 0.05). This change was associated with improvement of symptoms. Our results demonstrated that hypertensive patients with diastolic dysfunction on radionuclide ventriculography have significant improvement of ventricular filling at 3 mo into treatment with losartan.

The time-course of contractions induced by acetylcholine and barium in the vas deferens of normal and castrated guinea-pigs.

1. The influence of castration on contraction of the guinea pig vas deferens induced by acetylcholine was investigated regarding facilitation of endogenous neurotransmitter release, changes in post-synaptic events and modification in acetylcholine metabolization. 2. Castration prolonged the duration of the isometric contraction of the vas deferens induced by acetylcholine (3 mM) but not the duration of that induced by barium chloride (10 mM). 3. Reserpinization (0.5 mg/kg) of normal and castrated guinea pigs did not change the time-course of acetylcholine-induced contraction in the vas deferens. 4. 4-Aminopyridine (0.05 mM) prolonged the contraction induced by acetylcholine and barium chloride. This effect was blocked by reserpine pretreatment, indicating that in the presence of 4-AP, both acetylcholine and barium release endogenous noradrenaline. Since there was no difference between the effects of 4-AP on organs from normal and castrated animals, prolongation of the acetylcholine-induced contraction is not related to an increase in neutransmitter release. 5. Total cholinesterase and acetylcholinesterase activities were reduced after castration and the time-course of carbachol contraction was not changed. Thus, this decrease in enzyme activity appears to play a relevant role in the prolongation of acetylcholine-induced contraction.

[Villous adenoma of the Vater's ampulla]. / Adenoma viloso da ampola de Vater.

Benign tumors of the ampulla of Vater are rare. The villous adenoma, the most common benign tumor of this region, has a high tendency to malignant transformation. Postmortem studies showed an incidence of 0.04-0.12% adenomatous lesions of the papilla of Vater. The authors present a case of villous adenoma of the ampulla of Vater and make a review of the literature.