The effects of benazepril, a new angiotensin-converting enzyme inhibitor, in mild to moderate essential hypertension: a multicenter study.

Benazepril hydrochloride is a new angiotensin-converting enzyme inhibitor. In a multicenter study, 206 patients with mild to moderate hypertension were randomized to receive benazepril at a dose of 2, 5, 10, or 20 mg, hydrochlorothiazide, 25 mg, or placebo once daily for 4 weeks. The 20 mg dosage of benazepril lowered blood pressure to a degree equal to that of 25 mg hydrochlorothiazide: -12.

Entropy and the contractile state.

Entropy production must accompany the utilization of free energy in any cellular process and is a measure of the degree of randomness or molecular disorder within a system. A highly entropized system approaches equilibrium, is incapable of performing work, and never unrandomizes spontaneously. Therefore, chemical reactions are reversible only if the entropy of the system can be reduced through the expenditure of free energy and at the expense of an increase in the entropy of the surroundings.

Perioperative myocardial infarction associated with coronary artery bypass graft surgery: improved sensitivity in the diagnosis within 6 hours after operation with 99mTc-glucoheptonate myocardial imaging and myocardial-specific isoenzymes.

The present study was performed to evaluate scintigraphic imaging with technetium 99m-labeled glucoheptonate and serum enzyme levels of creatine phosphokinase isoenzyme (MB-CPK) in the early diagnosis of perioperative acute myocardial infarction associated with saphenous vein bypass graft operations. Myocardial imaging was done in 27 patients (50% of whom were considered high-risk) before operation and again 5 hours after operation. Four of these patients (15%) had both electrocardiographic and serum MB-CPK evidence of acute myocardial infarction, and all 4 had developed positive postoperative scintigrams.

[Thermodynamics and electrophysiology of the nervous system].

This study expresses a theory designed to associate the fundamental thermodynamic concepts to the electrophysiology of the nervous system. An analogy is drawn between the thermodynamic and electrical events of the myocardial cell during its mechanical phases with those thermodynamic and electrical events of the nerve cell during conduction. Although the myocardial and nerve cells are designed to perform different functions, their processes of membrane potential activation and corresponding directions of thermodynamic and entropy changes are basically the same.

A model of graded ischemia in the isolated perfused rat heart.

Insertion of a flow pump into the Langendorff retrograde perfusion apparatus has permitted the production of stable, graded ischemia in hearts whose hemodynamic and metabolic response may be evaluated. Ventricular pressures were monitored with a modified balloon and catheter-tip manometer system, and oxygen consumption , lactate and glucose metabolism, and tissue high-energy phosphate stores measured. A 15-min stabilization period in 56 paced hearts was followed by 15 min of either full, 40, 30, 20, or 10% coronary flow, after which the ventricular tissue was freeze-clamped for tissue assay.

Metabolic evaluation of agents designed to protect the ischemic myocardium and to reduce infarct size.

There is as yet no adequate animal mode for human myocardial ischemia. The commonly utilized technique of coronary arterial ligation in large animals may induce regional ischemia but introduces variables that make it difficult to compare studies in different laboratories. A model of global ischemia in an isolated perfused rat heart that offers a rapid, inexpensive means for producing graded, controlled, stable state and reproducible ischemia is described.

Characterization of the ischemic process by regional metabolism.

The myocardial cell requires energy for contractile activity and for the work of internal maintenance. With the onset of ischemia mechanical performance is compromised. If the ischemia is severe and persistent, the energy necessary to maintain the internal millieu proves inadequate and cell death ensues.

Effects of mannitol on cardiac ultrastructure and microcirculation following anoxia.

Electron microscopic and microcirculatory effects of hyperosmolal mannitol were evaluated in the isolated perfused isovolumic rat heart. Specimens for ultrastructural examination were obtained in 26 experiemnts after 15 min of sequential aerobic, anoxic, and reoxygenated perfusion using an isosmolal perfusate of Krebs-Ringer-Henseleit bicarbonate buffer (KRB) (osmolality equals 290 mosmol/kg) vs. a hyperosmolal solution of KRB + mannitol (equals 350 mosmol/kg).

Metabolic and hemodynamic consequences of mannitol following myocardial anoxia.

The mechanism of action of hyperosmolal mannitol was evaluated by hemodynamic and metabolic studies in 79 isovolumic nonrecirculating paced perfused rat hearts during sequential 15-min periods of aerobic, anoxic, and reoxygenated perfusion. Hyperosmolality induced by addition of mannitol significantly decreased myocardial water content (wet/dry wt ratio). It improved recovery of hemodynamic function during reoxygenation.

The effects of hyperosmolal coronary perfusion on the haemodynamic, metabolic and ultrastructural changes of myocardial anoxia.

Recovery from anoxia has been evaluated in the isovolumic non-recirculating paced perfused rat heart. Seventy studies were performed consisting of 15 min of aerobic perfusion (AP); AP+15 min anoxic perfusion; and AP+15 min anoxic perfusion+15 min reoxygenation (recovery). Krebs-Ringer-bicarbonate+5 mmol glucose (KRB) (290 mmol) was compared to KRB+mannitol (350 mmol).

Hemodynamic, metabolic, and ultrastructural consequences of hyperosmolal mannitol after myocardial anoxia.

Recovery from anoxia has been evaluated in the isovolumic nonrecirculating paced perfused rat heart. Seventy studies were performed consisting of 1) 15 min of aerobic perfusion (AP), 2) AP + 15 min of anoxic perfusion, 3) AP + 15 min of anoxic perfusion + 15 min of reoxygenation. Krebs-Ringer-bicarbonate + 5 mM glucose (KRB) was compared with KRB + mannitol (osmolality, +60 mOsm).

Protective role of increased myocardial glycogen stores induced by propranolol.

Glycogen is an essential substrate during myocardial anoxia. Since porpranolol may maintain myocardial glycogen levels after acute stress by blockade of catecholamine-induced glycogenolysis, we evaluated the effect of propranolol treatment in the isolated perfused isovolumic paced rat heart. Forty-one rats were studied after 10 min of ice-water immersion: half were pretreated with propranolol, 20 mg/kg/day x3, and half with saline.