SummaryBackground and hypothesis: Systemic hypertension is the leading cause of left ventricular (LV) hypertrophy. The present study aimed to investigate the mechanism of left atrial (LA) enlargement in patients with hypertensive heart disease during cardiac catheterization.Methocls: Data were obtained from eight control subjects and seven patients with hypertensive heart disease. Left atrial and LV pressures from catheter-tip micromanometer, and LA and LV volumes from biplane cineangiograms were analyzed during the same cardiac cycle.

Sphingosylphosphorylcholine (SPC) increased intracellular Ca 2+ concentration ([Ca 2+ ]i) and nitric oxide (NO) production in endothelial cells in situ on bovine aortic valves, and induced endothelium-dependent relaxation of bovine coronary arteries precontracted with U-46619. The SPC-induced vasorelaxation was inhibited by N g -monomethyl-L-arginine, an inhibitor of both constitutive and inducible NO synthase (NOS), but not by 1-(2-trifluoromethylphenyl) imidazole, an inhibitor of inducible NOS (iNOS). Immunoblotting revealed that endothelial constitutive NOS, but not iNOS, was present in endothelial cells in situ on the bovine aortic valves. We propose that SPC activates [Ca 2+ ]i levels and NO production of endothelial cells in situ, thereby causing an endotheliumdependent vasorelaxation.z 1999 Federation of European Biochemical Societies.

Digoxin was effective in reducing heart rate at rest, but failed to reduce it during exercise. Propranolol and verapamil reduced heart rate at all levels of exercise as well as at rest. Oxygen uptake during exercise (total exercise capacity) was not reduced with propranolol or verapamil; this was thought to have been accomplished by an increased oxygen pulse.

SUMMARY Left atrial function in patients with hypertensive heart disease was compared with that in control subjects. In patients with hypertensive heart disease, the time constant of left ventricular relaxation was significantly greater than that in controls (54 ± 18 vs 31 ± 16 msec; p<0.01). The ratio of left ventricular filling volume before atrial contraction (left atrial reservoir volume/left atrial emptying volume before atrial contraction, and conduit volume/flow volume from the pulmonary vein into the left ventricle) to left ventricular stroke volume was significantly smaller than that in controls (65 ± 13 vs 76 ± 7%; p<0.05). In patients with hypertensive heart disease, the ratio of reservoir volume to stroke volume was not significantly different from that in controls, while the ratio of conduit volume to stroke volume was significantly smaller than that in controls (43 ± 13 vs57 ± 9%;p<0.05). The latter ratio was inversely correlated with the time constant of left ventricular relaxation (r = -0.05, p<0.05). In patients with hypertensive heart disease, the ratio of left ventricular filling volume during atrial contraction to stroke volume was significantly larger than that in controls (35 ± 13 vs 24 ± 7%; p<0.05). The ratio of left ventricular filling volume during atrial contraction to stroke volume had a significant inverse correlation with the ratio of conduit volume to stroke volume (r = -0.84, p<0.001). In patients with hypertensive heart disease, left atrial work was significantly greater than that in controls (274 ± 101 vs 94 ±42 mm Hg ml; p<0.001). Thus, patients with hypertensive heart disease had impaired left ventricular diastolic filling before atrial contraction, which resulted in the decreased left atrial conduit volume. However, the left ventricular stroke volume was maintained by the increased left atrial emptying volume during atrial contraction. cardiac performance in the diseased heart has been considered previously.'" 10 The left atrium may serve as a conduit for the passage of blood from the pulmonary veins to the left ventricle during early left ventricular filling, as a reservoir for storing blood during left ventricular systole, and as a contractile chamber for augmentation of left ventricular filling. Understanding each of these functions and the contribution of the left atrium to left ventricular function in normal and diseased hearts is important. Electrocardiographic left atrial abnormalities" and the appearance of atrial gallop rhythm on cardiac ausculta- Received August 28, 1985; accepted February 12, 1986. tion 12 have been documented in patients with hypertensive heart disease. Recently, echocardiography has been used to observe left atrial function in hypertensive patients. 13 In these previous studies, the left atrial abnormalities were discussed in association with the abnormal diastolic function of the left ventricle, but further delineation of the significance and pathophysiology of the findings was not pursued.In the present study, the changes in reservoir, condu...

In this longitudinal intervention study, a 6 week health education program consisting of lectures and exercises was implemented for 39 Japanese menopausal women. The effects of the program were assessed by measuring their exercise participation, climacteric symptoms, and quality of life immediately before, 6 weeks after, and 1 year after the program. The Simplified Menopausal Index was used to assess the climacteric symptoms and the Medical Outcomes Study 36-Item Short-Form Health (SF-36) Survey was used to assess the quality of life. Significant improvements were observed in the subscale score for general health perception and the summary score for the physical component summary in the SF-36 Survey. Favorable results also were found for women without a previous exercise habit before the program but who participated in regular exercise 1 year after the program. No improvements were observed in the climacteric symptoms. We concluded that our program was effective for menopausal women in spite of the intervention period being relatively short.