Studies on the difference in the circumstances and the diseases between Japanese and Chinese

主要通过超声心动图研究各种降压药物对左室心肌肥厚的影响表明，钙拮抗剂、血管紧张素转换酶抑制剂、α _2受体阻滞剂和中枢交感神经抑制剂对减轻病情有效，但β受体阻滞剂的作用是不可预测的，利尿剂和直接血管扩张剂没有作用。然而，降压药的作用被认为在不同种族之间存在差异，并且在国际上比较降压药对心脏肥厚的作用的研究很少。此外，MRI作为一种测量左心室重量的方法也引起了人们的关注，将MRI的结果与常规心电图和超声心动图的结果进行比较是有趣的。本研究通过MRI、超声心动图和MRI对不同降压药对日本和中国受试者的抗心肌肥厚作用进行评价。目的：利用磁共振成像（MRI）和超声心动图（ECHO）技术，研究血管紧张素II亚型1受体特异性拮抗剂TCV-116对原发性高血压患者血流动力学和心脏肥厚的影响。研究对象和方法：12例原发性高血压患者在给予安慰剂对照期后口服TCV-116。采用梯度回波技术（GRASS）获取轴向平面的MRI图像，回波时间为13 msec，重复时间为66 msec，翻转角度为20度。MRI测量左心室容积和质量采用辛普森规则。采用Teichholz公式计算超声左室容积。回声左心室质量（LVM）采用美国超声心动图学会测量方法，Devereux等计算公式：LVM=0.8[1.04(IVS+LVID+PWT)^3-LVID^3]+0.6g。（IVS：室间隔厚度，PWT：后壁厚度，LVID：左心室内径）结果：TCV-116最终日剂量为8mg 7例，4mg 3例，2mg 2例。给药后，收缩压由185*19（mean*SD）降至161*30 mmHg，舒张压由108*10降至96*13(n=12, p<0.005)，心率由70*12降至70*9 bpm（n=12， NS）。MRI和ECHO均显示TCV-116给药后LVM明显降低（n=12, p<0.05）。MRI显示TSR由1888*473下降至1702*408 dyns -sec-cm^<-5>(n=11, p<0.05)。TCV-116给药前后其他血流动力学参数无明显变化。结论：住院原发性高血压患者，TCV-116口服剂量为2- 8mg /天，持续8-12周，可降低血压，并导致心脏肥厚的消退。其他血流动力学参数未见缺陷改变。在进一步的研究中，将对日语和汉语受试者进行上述测试和效果比较。少

Studies on the effects of various hypotensive drugs on left ventricular myocardial hypertrophy primarily by echocardiography have shown that calcium antagonists, angiotensin-converting enzyme inhibitors, alpha_2-blockers, and central sympatholytic drugs are effective for attenuating the condition, but that the effects of beta-blockers are unpredictable, and diuretics and direct vasodilators have no effects. However, the effects of hypotensive drugs have been suggested to vary among races, and there have been few studies in which the effects of hypotensive drugs on cardiac hypertrophy were compared internationally. Also, MRI has attracted attention as a method for measurement of the left ventricular weight, and comparison of the findings by MRI with those by conventional electrocardiography and echocardiography is interesting. This study is designed to evaluate anti-cardiac hypertrophy effects of various hypotensive drugs in Japanese and Chinese subjects by MRI as well as by echocaardio … More graphy and MRI.Objectives : Using cinemagnetic resonance imaging(MRI)and echocardiography(ECHO), we studied the effects of TCV-116, a specific antagonist for angiotensin II subtype 1 receptors, on hemodynamics and cardiac hypertrophy in patients with essential hypertension.Subjects and Methods : Twelve patients with essential hypertension received oral TCV-116 after a control period of placebo administration. Cine MRI images were acquired in the axial plane with a gradientecho technique, GRASS, with echo time of 13 msec, repetition time of 66 msec, and flip angle of 20 degrees. Simpson's rule was used forleft ventricular volume and mass measurements by MRI. Left ventricular volumes by ECHO were calculated using Teichholz's formula. Left ventricular mass(LVM)by ECHO was measured using American Society of Echocardiography measurements and the formula by Devereux et al. : LVM=0.8[1.04(IVS+LVID+PWT)^3-LVID^3)]+0.6g. (IVS : interventricularseptal thickness, PWT : posterior wall thickness, LVID : left ventricular internal dimension)Results : Final daily doses of TCV-116 were 8 mg in 7 patients, 4 mg in 3 patients and 2 mg in 2 patients. After TCV-116 administration, systolic BP decreased from 185*19(mean*SD)to 161*30 mmHg and diastolic BP from 108*10 to 96*13(n=12, p<0.005)while HR remained unchanged from 70*12 to 70*9 bpm(n=12, NS). Both MRI and ECHO revealed a significant decrease in LVM after TCV-116 administration(n=12, p<0.05). MRI revealed a significant decrease in TSR from 1888*473 to 1702*408 dynes-sec-cm^<-5>(n=11, p<0.05). No significant changes were observed in other hemodynamic parameters before and after TCV-116 administration.Conclusions : Inpatients with essential hypertension, TCV-116 administered orally at doses of 2-8 mg/day for 8-12 weeks reduced blood pressure and led to a regression of cardiac hypertrophy. No deficient changes were observed in other hemodynamic parameters.The above tests will be carried out and effects will be compared between Japanese and Chinese subjects in further studies. Less