The intake of 100 mL of soda water improves intestinal activity and improves the image quality of the inferior wall.

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Angiotensin II receptor blockers (ARBs) are suggested to be protective against myocardial hypertrophy and fibrosis, although such beneficial effects remain to be elucidated in the human heart. The aim of the present study was to examine the effect of a novel ARB, olmesartan, on myocardial function of the left ventricle in patients with mildto-moderate hypertension. We investigated 10 patients (6 men and 4 women, 62 +/- 7 years of age) who were stable with a single regimen of amlodipine, which was switched to olmesartan. Before and 8 months after changing medications, patients underwent echocardiographic examination and blood sampling, including measurement of the plasma high-sensitivity C-reactive protein (hsCRP) level. Peak velocities at the mitral annulus were determined by tissue Doppler imaging and used as measures of myocardial function. Olmesartan did not significantly alter blood pressure (BP) (systolic BP, 122 +/- 12 to 121 +/- 8 mmHg, P = 0.9; diastolic BP, 79 +/- 6 to 75 +/- 4 mmHg, P = 0.06) or parameters of global left ventricular systolic and diastolic function. Tissue Doppler imaging, however, revealed significant increases in the systolic (8.2 +/- 1.3 to 8.9 +/- 1.1 cm/s, P < 0.01) and early diastolic (6.7 +/- 0.9 to 7.6 +/- 1.0 cm/s, P = 0.02) velocities at the mitral annulus. This was associated with decreases in the left ventricular mass index (83 +/- 15 to 73 +/- 19 g/m2, P = 0.09) and hsCRP (683 +/- 555 to 655 +/- 450 ng/ml, P = 0.07). In conclusion, olmesartan improves myocardial function independent of BP reduction in hypertensive patients. Attenuated inflammatory changes as well as myocardial hypertrophy may play an important role.

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SUMMARYRight ventricular apical pacing (RAP) has been reported to have the potential to lead to left ventricular (LV) dyssynchrony and impaired LV function. The plasma level of Btype natriuretic peptide (BNP) is increased in the state of abnormal ventricular wall stretch. Therefore, the aim of the present study was to examine the effect of LV dyssynchrony on BNP levels in patients with chronic RAP.Thirty-four patients (17 women, age 69 ± 11 years) with preserved LV systolic function on permanent RAP (duration, 7.0 ± 4.7 years) underwent conventional echo-Doppler assessment and tissue Doppler imaging. Twenty-two normal subjects (8 women, age 66 ± 9 years) served as controls. The standard deviation (SD) and dispersion of the time-topeak systolic velocity (TPV) among the 6 basal LV segments were used as the indexes of LV dyssynchrony.Compared with control subjects, RAP patients had prolonged TPVs and heterogeneous LV contraction with greater values of TPV-SD (18 ± 8 ms versus 39 ± 15 ms, P < 0.001) and TPV-dispersion (42 ± 20 ms versus 93 ± 31 ms, P < 0.001). There were significant correlations between BNP levels and the indexes of LV dyssynchrony (r = 0.41, P = 0.017 for TPV-SD; r = 0.46, P = 0.006 for TPV-dispersion).RAP is associated with LV dyssynchrony, which may accelerate BNP secretion. (Int Heart J 2008; 49: 165-173) Key words: B-type natriuretic peptide (BNP), Tissue Doppler, Dyssynchrony, Echocardiography, Pacing RIGHT ventricular apical pacing (RAP) has been reported to have the potential to lead to left ventricular (LV) dysfunction even in the absence of structural heart disease. Underlying mechanisms of impaired LV function during RAP include alterations of cellular structure and ventricular geometry, systolic and diastolic dysfunction, mitral regurgitation, and increased left atrial diameters.1-5) Systolic dyssynchrony may also play a role in deteriorating LV pump function because From the