Treatment of XXXX : relation to pathological mechanisms.

@entity1 @entity1353 @entity1855 @entity594 @entity891 @entity951 @entity460 @entity299 @entity1121 @entity616
In @entity1 with @entity1121 , clinical symptoms such as exertional @entity1353 , @entity951 and @entity891 are considered to be rather the consequence of diastolic than of @entity299 of the left ventricle. Beta-blocker therapy is aimed at reducing systolic overcontraction while @entity460 blockers predominantly therapy is aimed at reducing systolic overcontraction while @entity460 blockers predominantly improve diastolic filling characteristics. Therefore 61 consecutive @entity1 with well defined @entity1121 were treated with @entity460 channel blockers: 60 @entity1 with @entity1855 at average dose 530 mg (320 to 720 mg/d) and one @entity1 received 30 mg @entity594 . All @entity1 had clinical, noninvasive and cardiac catheterization evaluation at the time of entry into the study. Therapy was continued for an average of 54 months (10 to 96). Follow-up studies were performed at 6-month intervals. Subjective improvement was achieved in 47 of 55 symptomatic @entity1 (85%). Heart size, judged as heart volume from tele-chest X-ray in supine position, showed a reduction in 36/61, no change in 15/61 and increase in 10/61. On average in all 61 @entity1 , a significant reduction from 947 to 833 ml/1.73 m2 was seen. Twenty-six @entity1 who had been followed for an average of 24 months prior to @entity1855 therapy on beta blockers or no treatment had heart volume increases averaging 12% in the pre- @entity1855 period. Electrocardiography (ECG) showed a significant reduction in QRS amplitude and a tendency towards normalization of ST/T segments. Serial echocardiography study showed small but significant reduction in left atrial diameter. Repeat catheterization was performed in 19 @entity1 and a significant reduction in intraventricular pressure gradient, left ventricular muscle mass and coronary artery diameter was demonstrated. Three @entity1 died during the study (256 @entity1 -treatment-years) for an annual mortality rate of 1.3%. This mortality is considerably lower than reported for @entity1 receiving no treatment, beta-blockade, or surgery. Of all 61 @entity1 only one had surgery related to the @entity1121 . One @entity1 had the dose of @entity1855 reduced because of the occurrence of @entity616 . No @entity1 discontinued the drug because of side-effects. Utilizing serial noninvasive and invasive studies, we conclude that @entity1855 therapy in @entity1121 results in objective and subjective improvement, a low death rate and little need for operation as compared to standard therapy.
