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1.
J Phys Chem Lett ; 14(9): 2277-2283, 2023 Mar 09.
Article in English | MEDLINE | ID: mdl-36825819

ABSTRACT

We explore a new platform for realizing excitonic insulators, namely van der Waals (vdW) bilayers comprising two-dimensional Janus materials. In previous studies, type II heterobilayers have been brought to the excitonic insulating regime by tuning the band alignment using external gates. In contrast, the Janus bilayers presented here represent intrinsic excitonic insulators. We first conduct ab initio calculations to obtain the quasiparticle band structures, screened Coulomb interaction, and interlayer exciton binding energies of the bilayers. These ab initio-derived quantities are then used to construct a BCS-like Hamiltonian of the exciton condensate. By solving the mean-field gap equation, we identify 16 vdW Janus bilayers with insulating ground states and superfluid properties. Our calculations expose a new class of advanced materials that are likely to exhibit novel excitonic phases at low temperatures and highlight the subtle competition between interlayer hybridization, spin-orbit coupling, and dielectric screening that governs their properties.

2.
Phys Rev Lett ; 106(18): 187402, 2011 May 06.
Article in English | MEDLINE | ID: mdl-21635125

ABSTRACT

The lowest electronic excitations of benzene and a set of donor-acceptor molecular complexes are calculated for the gas phase and on the Al(111) surface using the many-body Bethe-Salpeter equation. The energy of the charge-transfer excitations obtained for the gas phase complexes are found to be around 10% lower than the experimental values. When the molecules are placed outside the surface, the enhanced screening from the metal reduces the exciton binding energies by several eVs and the transition energies by up to 1 eV depending on the size of the transition-generated dipole. As a striking consequence we find that close to the metal surface the optical gap of benzene can exceed its quasiparticle gap. A classical image charge model for the screened Coulomb interaction can account for all these effects which, on the other hand, are completely missed by standard time-dependent density functional theory.

3.
J Chem Phys ; 135(12): 121101, 2011 Sep 28.
Article in English | MEDLINE | ID: mdl-21974504

ABSTRACT

The band structure and optical absorption spectrum of lithium peroxide (Li(2)O(2)) is calculated from first-principles using the G(0)W(0) approximation and the Bethe-Salpeter equation, respectively. A strongly localized (Frenkel type) exciton corresponding to the π(∗)→σ(∗) transition on the O(2)(-2) peroxide ion gives rise to a narrow absorption peak around 1.2 eV below the calculated bandgap of 4.8 eV. In the excited state, the internal O(2)(-2) bond is significantly weakened due to the population of the σ(∗) orbital. As a consequence, the bond is elongated by almost 0.5 Å leading to an extreme Stokes shift of 2.6 eV. The strong vibronic coupling entails significant broadening of the excitonic absorption peak in good agreement with diffuse reflectance data on Li(2)O(2) which shows a rather featureless spectrum with an absorption onset around 3.0 eV. These results should be important for understanding the origin of the high potential losses and low current densities, which are presently limiting the performance of Li-air batteries.

4.
J Chem Phys ; 135(21): 214704, 2011 Dec 07.
Article in English | MEDLINE | ID: mdl-22149808

ABSTRACT

Non-aqueous Li-air or Li-O(2) cells show considerable promise as a very high energy density battery couple. Such cells, however, show sudden death at capacities far below their theoretical capacity and this, among other problems, limits their practicality. In this paper, we show that this sudden death arises from limited charge transport through the growing Li(2)O(2) film to the Li(2)O(2)-electrolyte interface, and this limitation defines a critical film thickness, above which it is not possible to support electrochemistry at the Li(2)O(2)-electrolyte interface. We report both electrochemical experiments using a reversible internal redox couple and a first principles metal-insulator-metal charge transport model to probe the electrical conductivity through Li(2)O(2) films produced during Li-O(2) discharge. Both experiment and theory show a "sudden death" in charge transport when film thickness is ~5 to 10 nm. The theoretical model shows that this occurs when the tunneling current through the film can no longer support the electrochemical current. Thus, engineering charge transport through Li(2)O(2) is a serious challenge if Li-O(2) batteries are ever to reach their potential.

5.
Sci Adv ; 7(8)2021 Feb.
Article in English | MEDLINE | ID: mdl-33597249

ABSTRACT

Luminescent centers in the two-dimensional material hexagonal boron nitride have the potential to enable quantum applications at room temperature. To be used for applications, it is crucial to generate these centers in a controlled manner and to identify their microscopic nature. Here, we present a method inspired by irradiation engineering with oxygen atoms. We systematically explore the influence of the kinetic energy and the irradiation fluence on the generation of luminescent centers. We find modifications of their density for both parameters, while a fivefold enhancement is observed with increasing fluence. Molecular dynamics simulations clarify the generation mechanism of these centers and their microscopic nature. We infer that VNCB and [Formula: see text] are the most likely centers formed. Ab initio calculations of their optical properties show excellent agreement with our experiments. Our methodology generates quantum emitters in a controlled manner and provides insights into their microscopic nature.

6.
J Chem Phys ; 132(7): 071101, 2010 Feb 21.
Article in English | MEDLINE | ID: mdl-20170208

ABSTRACT

We discuss the electrochemical reactions at the oxygen electrode of an aprotic Li-air battery. Using density functional theory to estimate the free energy of intermediates during the discharge and charge of the battery, we introduce a reaction free energy diagram and identify possible origins of the overpotential for both processes. We also address the question of electron conductivity through the Li(2)O(2) electrode and show that in the presence of Li vacancies Li(2)O(2) becomes a conductor.

7.
J Phys Condens Matter ; 20(37): 374101, 2008 Sep 17.
Article in English | MEDLINE | ID: mdl-21694409

ABSTRACT

The electrical properties of single-molecule junctions, consisting of an organic molecule coupled to metal electrodes, are sensitive to the detailed atomic structure of the molecule-metal contact. This, in turn, is determined by the anchoring group linking the molecule to the metal. With the aim of identifying and comparing the intrinsic properties of two commonly used anchoring groups, namely thiol and amine groups, we have calculated the atomic structure and conductance traces of different Au-S-Au and Au-NH(2)-Au nanojunctions using density functional theory (DFT). Whereas NH(2) shows a strong structural selectivity towards atop-gold configurations, S shows large variability in its bonding geometries. As a result, the conductance of the Au-NH(2)-Au junction is less sensitive to the structure of the gold contacts than the Au-S-Au junction. These findings support recent experiments which show that amine-bonded molecules exhibit more well-defined conductance properties than do thiol-bonded molecules.

8.
Nat Commun ; 8(1): 320, 2017 08 22.
Article in English | MEDLINE | ID: mdl-28831045

ABSTRACT

Compared to artificially structured hyperbolic metamaterials, whose performance is limited by the finite size of the metallic components, the sparse number of naturally hyperbolic materials recently discovered are promising candidates for the next generation of hyperbolic materials. Using first-principles calculations, we extend the number of known naturally hyperbolic materials to the broad class of layered transition metal dichalcogenides (TMDs). The diverse electronic properties of the transition metal dichalcogenides result in a large variation of the hyperbolic frequency regimes ranging from the near-infrared to the ultraviolet. Combined with the emerging field of van der Waals heterostructuring, we demonstrate how the hyperbolic properties can be further controlled by stacking different two-dimensional crystals opening new perspectives for atomic-scale design of photonic metamaterials. As an application, we identify candidates for Purcell factor control of emission from diamond nitrogen-vacancy centers.Natural hyperbolic materials retain the peculiar optical properties of traditional metamaterials whilst not requiring artificial structuring. Here, the authors perform a theoretical screening of a large class of natural materials with hyperbolic dispersion among the family of layered transition metal dichalcogenides.

9.
J Chem Theory Comput ; 13(12): 6010-6022, 2017 Dec 12.
Article in English | MEDLINE | ID: mdl-29083921

ABSTRACT

A multiscale density functional theory-quantum mechanics/molecular mechanics (DFT-QM/MM) scheme is presented, based on an efficient electrostatic coupling between the electronic density obtained from a grid-based projector augmented wave (GPAW) implementation of density functional theory and a classical potential energy function. The scheme is implemented in a general fashion and can be used with various choices for the descriptions of the QM or MM regions. Tests on H2O clusters, ranging from dimer to decamer show that no systematic energy errors are introduced by the coupling that exceeds the differences in the QM and MM descriptions. Over 1 ns of liquid water, Born-Oppenheimer QM/MM molecular dynamics (MD) are sampled combining 10 parallel simulations, showing consistent liquid water structure over the QM/MM border. The method is applied in extensive parallel MD simulations of an aqueous solution of the diplatinum [Pt2(P2O5H2)4]4- complex (PtPOP), spanning a total time period of roughly half a nanosecond. An average Pt-Pt distance deviating only 0.01 Å from experimental results, and a ground-state Pt-Pt oscillation frequency deviating by <2% from experimental results were obtained. The simulations highlight a remarkable harmonicity of the Pt-Pt oscillation, while also showing clear signs of Pt-H hydrogen bonding and directional coordination of water molecules along the Pt-Pt axis of the complex.

10.
Circulation ; 102(6): 611-6, 2000 Aug 08.
Article in English | MEDLINE | ID: mdl-10931799

ABSTRACT

BACKGROUND: Sudden unexpected death frequently occurs in chronic heart failure. The importance of acute coronary events in triggering sudden death (SD) is unclear. METHODS AND RESULTS: We evaluated at autopsy the prevalence of acute coronary findings (coronary thrombus, ruptured plaque, or myocardial infarction [MI]) and their relation to SD. Autopsy results in 171 patients in the randomized ATLAS trial were reviewed. The prevalence of acute coronary findings was 33%: in 54% of patients with significant coronary artery disease (CAD) who died suddenly, 32% who died of myocardial failure, but in non-CAD patients, they were present in only 5% and 10% respectively. The percentage of patients classified as dying of MI was 28% in the autopsy group versus 4% in the nonautopsied group (P<0.0001). Of the autopsied group with acute MI, 97% (31 of 32 patients) with SD and 40% (6 of 15 patients) with myocardial failure did not have the MI diagnosed during life. When undiagnosed MI was classified as "sudden unexpected" or "myocardial failure" from clinical information only, the distribution of death causes was similar in the autopsy and nonautopsied groups. CONCLUSIONS: Acute coronary findings are frequent and usually not clinically diagnosed in heart failure patients with CAD, particularly in those dying suddenly, suggesting the importance of acute coronary events as a trigger for SD in this setting.


Subject(s)
Cardiac Output, Low/complications , Cardiac Output, Low/pathology , Cardiotonic Agents/therapeutic use , Coronary Disease/pathology , Death, Sudden, Cardiac/etiology , Lisinopril/therapeutic use , Acute Disease , Autopsy , Cardiac Output, Low/drug therapy , Cause of Death , Coronary Disease/epidemiology , Double-Blind Method , Humans , Incidence , Myocardial Infarction/mortality , Prospective Studies , Survival Analysis
11.
J Am Coll Cardiol ; 25(3): 574-81, 1995 Mar 01.
Article in English | MEDLINE | ID: mdl-7860899

ABSTRACT

OBJECTIVES: We sought to determine the incidence and independent prognostic value of increased serum levels of sensitive serologic markers in patients in whom a conventionally diagnosed acute myocardial infarction had been ruled out. BACKGROUND: Increased serum levels of creatine kinase (CK) isoenzyme MB mass and cardiac troponin T in patients with unstable angina pectoris are associated with a poor prognosis. METHODS: We analyzed data from 196 consecutive patients with suspected acute myocardial infarction, which was later ruled out in 124. Increased serum levels of CK-MB mass, troponin T and myosin light chains were compared with clinical findings, ST-T wave abnormalities and presence of arrhythmias. RESULTS: Of the patients in the noninfarction group, 28% had serum CK-MB mass > or = 6 micrograms/liter, 20% had troponin T > or = 0.20 micrograms/liter, and 26% had myosin light chains > or = 0.4 micrograms/liter (discrimination limits). The cardiac event rate (cardiac death, nonfatal acute myocardial infarction) within 28 months was significantly higher in patients in the noninfarction group with elevated marker levels (range 22% to 24%) than in patients with values below these discriminators (range 3% to 5%) but was not significantly different from that in patients with a definite diagnosis of acute myocardial infarction (29%). Further, significant predictors of cardiac events were previous myocardial infarction; myocardial infarction or angina pectoris, or both; previous congestive heart failure; ST-T wave abnormalities on admission; a transient ST-T wave shift on serial electrocardiograms (ECGs); recurrent chest pain; and occurrence of supraventricular or ventricular tachycardia, or both, during the 1st 48 h after admission. It was found that all three biochemical markers, in the main, convey independent prognostic information with respect to clinical findings and presence of arrhythmias but not ST-T wave abnormalities on admission or a transient ST-T wave shift on serial ECGs. CONCLUSIONS: Increased serum levels of CK-MB mass, troponin T and myosin light chains all detect a subgroup of 25% of patients without acute myocardial infarction who have as poor a prognosis as that of patients with a definite diagnosis of acute myocardial infarction. All three biochemical markers provide similar important independent prognostic information with regard to clinical findings and arrhythmias but add no additional prognostic information once ECG ST-T wave changes are considered.


Subject(s)
Creatine Kinase/blood , Myocardial Infarction/blood , Myosin Light Chains , Myosins/blood , Troponin/blood , Adult , Aged , Aged, 80 and over , Arrhythmias, Cardiac/blood , Biomarkers , Female , Follow-Up Studies , Humans , Isoenzymes , Male , Middle Aged , Myocardial Infarction/enzymology , Prognosis , Troponin T
12.
J Am Coll Cardiol ; 36(3): 959-69, 2000 Sep.
Article in English | MEDLINE | ID: mdl-10987628

ABSTRACT

Definition of MI. Criteria for acute, evolving or recent MI. Either one of the following criteria satisfies the diagnosis for an acute, evolving or recent MI: 1) Typical rise and gradual fall (troponin) or more rapid rise and fall (CK-MB) of biochemical markers of myocardial necrosis with at least one of the following: a) ischemic symptoms; b) development of pathologic Qwaves on the ECG; c) ECG changes indicative of ischemia (ST segment elevation or depression); or d) coronary artery intervention (e.g., coronary angioplasty). 2) Pathologic findings of an acute MI. Criteria for established MI. Any one of the following criteria satisfies the diagnosis for established MI: 1) Development of new pathologic Q waves on serial ECGs. The patient may or may not remember previous symptoms. Biochemical markers of myocardial necrosis may have normalized, depending on the length of time that has passed since the infarct developed. 2) Pathologic findings of a healed or healing MI.


Subject(s)
International Cooperation , Myocardial Infarction/diagnosis , Biomarkers/analysis , Humans , Myocardial Infarction/pathology , Myocardial Infarction/physiopathology
13.
J Am Coll Cardiol ; 33(6): 1519-27, 1999 May.
Article in English | MEDLINE | ID: mdl-10334417

ABSTRACT

OBJECTIVES: We investigated whether the addition of 24 h of continuous vectorcardiography ST segment monitoring (cVST) for an early (within 24 h of the latest episode of angina) determination of cardiac troponin T (cTnT) could provide additional prognostic information in patients with unstable coronary artery disease (UCAD), i.e., unstable angina and non-Q wave myocardial infarction. BACKGROUND: Determination of cTnT at admission and cVST are individually reported to be valuable techniques for the risk assessment of patients with UCAD. METHODS: Two hundred and thirty-two patients suspected of UCAD were studied. Patients were followed for 30 days, and the occurrence of cardiac death or acute myocardial infarction (AMI) were registered. RESULTS: One ST segment episode or more (relative risk [RR] 7.43, p = 0.012), a cTnT level > or = 0.20 microg/liter (RR 3.85, p = 0.036) or prestudy medication with calcium antagonists (RR 3.31, p = 0.041) were found to carry independent prognostic information after multivariate analysis of potential risk variables. By combining a cTnT determination and subsequent cVST for 24 h, subgroups of patients at high (25.8%) (n = 31), intermediate (3.1%) (n = 65) and low risk (1.7%) (n = 117) of death or AMI could be identified. CONCLUSIONS: Twenty-four hours of cVST provides additional prognostic information to that of an early cTnT determination in patients suspected of having UCAD. The combination of biochemical and electrocardiographic methods provides powerful and accurate risk stratification in UCAD.


Subject(s)
Angina, Unstable/diagnosis , Coronary Disease/diagnosis , Myocardial Infarction/diagnosis , Troponin T/blood , Adult , Aged , Aged, 80 and over , Angina, Unstable/blood , Angina, Unstable/drug therapy , Angina, Unstable/mortality , Antithrombins/adverse effects , Antithrombins/therapeutic use , Coronary Disease/blood , Coronary Disease/drug therapy , Coronary Disease/mortality , Death, Sudden, Cardiac/epidemiology , Death, Sudden, Cardiac/prevention & control , Dose-Response Relationship, Drug , Double-Blind Method , Drug Administration Schedule , Electrocardiography, Ambulatory/drug effects , Female , Glycine/adverse effects , Glycine/analogs & derivatives , Glycine/therapeutic use , Humans , Male , Middle Aged , Myocardial Infarction/blood , Myocardial Infarction/drug therapy , Myocardial Infarction/mortality , Patient Admission , Piperidines/adverse effects , Piperidines/therapeutic use , Prognosis , Prospective Studies , Risk Assessment , Vectorcardiography/drug effects
15.
Hypertension ; 7(6 Pt 2): II14-7, 1985.
Article in English | MEDLINE | ID: mdl-4077232

ABSTRACT

Seventy-nine of 673 patients attending a hypertensive outpatient clinic were classified as diabetics at the first examination. These patients were age- and sex-matched to two control groups: nondiabetic hypertensives and the background population. Nondiabetic hypertensive patients had a significantly poorer survival than expected during a 10-year observation period; the survival of diabetic hypertensives was even poorer, although not significantly. No sex difference was observed in the survival rates of hypertensive diabetics, neither was a difference seen between insulin-dependent and non-insulin-dependent patients. Acute myocardial infarction was the most frequent cause of death in both diabetic (40%) and nondiabetic (42%) hypertensive persons.


Subject(s)
Diabetes Mellitus, Type 1/mortality , Diabetes Mellitus, Type 2/mortality , Hypertension/mortality , Adult , Aged , Antihypertensive Agents/therapeutic use , Denmark , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 2/complications , Diet, Diabetic , Female , Humans , Hypertension/drug therapy , Hypertension/etiology , Hypoglycemic Agents/therapeutic use , Male , Middle Aged
16.
Thromb Haemost ; 75(6): 939-44, 1996 Jun.
Article in English | MEDLINE | ID: mdl-8822590

ABSTRACT

Magnesium (Mg) has shown the ability to inhibit arterial thrombus formation in some experimental animal studies. This effect may be due to an inhibition of platelet reactivity as in vitro studies have demonstrated that Mg inhibits platelet aggregation. In order to evaluate the in vivo effect of Mg in humans measurements of platelet activity, fibrinolytic activity, as well as measurements of prostacyclin (PGI2), and nitric oxide (NO) release were performed after infusion of magnesium sulphate (MgSO4) in healthy volunteers. In a placebo controlled, cross-over study in 14 healthy male subjects, 8 mmol MgSO4 was given as an intravenous bolus over 15 min followed by 3 mmol MgSO4/h. The mean S-Mg concentration increased from 0.85 to 1.50 mM during the Mg infusion period. A transient decrease in blood pressure was observed during the initial bolus infusion of Mg. Haemodynamic parameters were otherwise unstable. The bleeding time increased by 48% during the Mg infusion (p < 0.005), and in accordance with this, ex vivo platelet aggregation in platelet rich plasma was significantly inhibited, both following collagen (p = 0.02) and ADP (p = 0.04) stimulation. There were no significant changes in plasma beta-thromboglobulin concentration or the excretion of 2,3-dinor-thromboxane B2 in the urine. Neither tissue plasminogen activator (t-PA)activity, tissue plasminogen activator (t-PA)antigen nor plasminogen activator inhibitor (PAI)antigen changed during the Mg infusion period. There was no sign of increased release of PGI2 from the vessel wall as judged by urinary concentration of 2,3-dinor-6-keto-prostaglandin F1 alpha. Nor was there any sustained increase in the release of NO, measured as nitrate concentration in urine. However, a transient increase in NO release was observed during one sample period. In conclusion a reduced platelet activity and increased bleeding time, was found during Mg infusion in healthy volunteers. Fibrinolytic activity showed no changes. An anti-platelet effect may in part be responsible for the beneficial effect of Mg, described in patients with acute myocardial infarction (MI) and preeclampsia.


Subject(s)
Magnesium/administration & dosage , Platelet Activation/drug effects , Adult , Bleeding Time , Cross-Over Studies , Double-Blind Method , Hemodynamics/drug effects , Humans , Infusions, Intravenous , Male
17.
Am J Cardiol ; 70(2): 156-60, 1992 Jul 15.
Article in English | MEDLINE | ID: mdl-1626500

ABSTRACT

The left ventricle progressively dilates in some patients after acute myocardial infarction (AMI). Both systolic and diastolic left ventricular (LV) dysfunction can be of significance in the development of heart failure. Captopril has been shown to prevent dilatation, but the effect on LV diastolic function is unknown. In a placebo-controlled double-blind parallel study, 58 AMI patients with heart failure or low ejection fraction, or both, were consecutively randomized at day 7 to either placebo or captopril (25 mg twice daily). No differences were present between the groups at baseline. Fifty-three patients completed the 6-month study period. Both LV diastolic and systolic volume indexes increased significantly in the placebo group (17 and 14%, respectively); in the captopril group there was no change in LV diastolic volume index, but a 13% reduction in LV systolic volume index. Ejection fraction increased significantly in the captopril group. The peak flow velocities of the early and atrial filling phases were measured, and the ratio between the velocities was calculated. A significant reduction was observed during the study period in early peak flow velocity (65 to 52 cm/s) and in the ratio between early and atrial peak flow velocity (1.3 to 0.8) in the placebo group (p less than 0.05), but no significant changes occurred in the captopril group. No correlation was found between dilatation of the left ventricle and reduction in early peak flow velocity or the ratio between early and atrial peak flow velocity. In conclusion, captopril prevented LV dilatation, improved ejection fraction and prevented LV diastolic dysfunction in AMI patients with early signs of LV systolic dysfunction.


Subject(s)
Captopril/pharmacology , Myocardial Infarction/drug therapy , Ventricular Function, Left/drug effects , Aged , Captopril/administration & dosage , Chi-Square Distribution , Diastole/drug effects , Drug Evaluation , Echocardiography , Hemodynamics/drug effects , Humans , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/epidemiology , Myocardial Infarction/physiopathology , Systole/drug effects , Time Factors
18.
Am J Cardiol ; 65(3): 173-8, 1990 Jan 15.
Article in English | MEDLINE | ID: mdl-1967510

ABSTRACT

The effects of glutamate on exercise tolerance, ischemic threshold and venous substrate concentrations were studied in 20 patients with stable angina pectoris and positive stress tests. Each patient underwent 4 upright bicycle exercise tests on consecutive days. The first and fourth tests were performed without medication while the second and third tests were preceded by a low and high bolus dose of monosodium glutamate, either 0.8 and 1.5 mg/kg body weight intravenously (10 patients) or 40 and 80 mg/kg orally (10 patients). Comparison of the first and fourth tests revealed good reproducibility of electrocardiographic, hemodynamic and metabolic data. Glutamate increased exercise duration (p less than 0.05) in a dose-related way when given intravenously (59 +/- 14 and 153 +/- 14 seconds) and when given orally (53 +/- 21 and 90 +/- 23 seconds; all data are mean +/- standard error of the mean). It also delayed the onset of ST-segment depression (p less than 0.05) by 73 +/- 19, 120 +/- 23, 62 +/- 27 and 80 +/- 30 seconds, respectively. Hemodynamics were not changed by glutamate at rest or at comparable workloads, but at onset of ST-segment depression the heart rate-blood pressure product was increased (p less than 0.05). Glutamate administration induced dose-related 1.5- to 10-fold elevations in plasma glutamate, 15 to 50% decreases in plasma free fatty acids (p less than 0.05) and 5 to 30% increases in plasma alanine contents. Circulating levels of glucose, lactate, citrate and albumin were not modified by glutamate.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Angina Pectoris/physiopathology , Glutamates/pharmacology , Physical Endurance/drug effects , Alanine/blood , Angina Pectoris/blood , Blood Chemical Analysis , Citrates/blood , Citric Acid , Electrocardiography , Exercise Test , Female , Glutamic Acid , Hemodynamics/drug effects , Humans , Lactates/blood , Lactic Acid , Male , Middle Aged , Rest , Time Factors
19.
Am J Cardiol ; 76(15): 38E-40E, 1995 Nov 24.
Article in English | MEDLINE | ID: mdl-7484887

ABSTRACT

A total of 25 patients with newly diagnosed or poorly controlled essential hypertension were randomly selected from a larger group referred to hospital. Treatment was initiated with perindopril (4-8 mg orally). If normotension was not achieved, isradipine (5-10 mg orally) was added and, if necessary, hydralazine was added. Before treatment and at the end of a 9-month period of normotension (diastolic blood pressure < or = 90 mm Hg), 24-hour blood pressure and echocardiographic measurements were performed and resistance artery structure was determined. A total of 20 age- and sex-matched normotensives were used as controls. During antihypertensive treatment, mean blood pressure was reduced from 128 +/- 11 to 103 +/- 6 mm Hg. Left ventricular mass was reduced from 300 +/- 76 to 198 +/- 54 g. The media:lumen ratio of the resistance arteries decreased from 9.8 +/- 2.6% to 7.8 +/- 1.9%; control subjects exhibited a media:lumen ratio of the same magnitude (7.9 +/- 2.0%). Results indicate that a perindopril-based regimen is extremely efficient in normalizing resistance artery and cardiac ventricular structures within one year of treatment. The impact of these findings on the excess cardiovascular morbidity and mortality in arterial hypertension still remains to be demonstrated.


Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Hypertension/drug therapy , Hypertrophy, Left Ventricular/drug therapy , Skin/blood supply , Analysis of Variance , Antihypertensive Agents/therapeutic use , Arteries/drug effects , Arteries/pathology , Blood Pressure/drug effects , Heart Ventricles/drug effects , Humans , Hypertension/pathology , Hypertension/physiopathology , Indoles/therapeutic use , Perindopril , Tunica Media/drug effects , Tunica Media/pathology
20.
Am J Hypertens ; 9(3): 207-15, 1996 Mar.
Article in English | MEDLINE | ID: mdl-8695018

ABSTRACT

In essential hypertension, cardiovascular structure is believed to be influenced by hormonal and by hemodynamic factors. The objective of the present study was, in essential hypertensives, to investigate the relationship between blood pressure (BP) level as well as circulating hormones on the one hand and cardiovascular structure on the other. Seventy-nine untreated essential hypertensives were examined by 24-h ambulatory BP monitoring, echocardiography, microscopy of subcutaneous resistance vessels and analyzes of plasma for angiotensin II (P-Ang II), aldosterone, atrial natriuretic factor and 24-h urinary excretion of catecholamines. Multiple regression analysis showed a statistically significant correlation between P-Ang II and the end diastolic interventricular septal diameter (IVSDd) (R = 0.32, P = .005) and a weak correlation between P-Ang II and the left ventricular posterior wall diameter (R = 0.22, P = .049). These correlations were closer in the subgroup of patients (N = 54) who had never received antihypertensive treatment (R = 0.42/0.32, respectively). A weak, though statistically significant, correlation was found between the catecholamine excretion and systolic BP (R = 0.26, P = .03). A statistically negative correlation existed between catecholamines and end-diastolic left ventricular internal diameter index (R = -0.36, P = .001). No significant relationship was found between hormonal levels and the tunica media structure of the resistance arteries. In conclusion, P-Ang II was in this study significantly correlated to IVSDd, but not to resistance artery structure. In essential hypertension a complex relationship exists between humoral and hemodynamic factors and cardiovascular remodeling.


Subject(s)
Aldosterone/blood , Angiotensin II/blood , Atrial Natriuretic Factor/blood , Catecholamines/blood , Hypertension/blood , Hypertrophy, Left Ventricular/blood , Adult , Blood Pressure , Blood Pressure Monitoring, Ambulatory , Echocardiography , Female , Hemodynamics , Humans , Hypertension/physiopathology , Hypertrophy, Left Ventricular/diagnostic imaging , Hypertrophy, Left Ventricular/physiopathology , Male , Middle Aged , Radioimmunoassay
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