[show abstract][hide abstract] ABSTRACT: A 60-year-old female was admitted to our hospital for further examination of heart murmur. Chest radiography revealed cardiomegaly and pulmonary congestion. Two-dimensional echocardiography showed a mobile and pedunculated mass, approximately 20 mm in diameter, attached to the right ventricular outflow tract, and perimembranous ventricular septal defect. Cardiac catheterization and blood sampling were performed, which showed a pulmonary to systemic flow ratio of 3.70. She underwent surgical excision of the tumor, ventricular septal defect patch suture and tricuspid annuloplasty. Histological examination confirmed papillary fibroelastoma. The predominant location of papillary fibroelastoma is the valvular surface. This very rare case of papillary fibroelastoma was located in the right ventricular outflow tract.
Journal of Cardiology 05/2007; 49(4):199-203. · 2.30 Impact Factor
[show abstract][hide abstract] ABSTRACT: Cardiovascular events occur most frequently in the morning. To study the effects of the long-acting lipophilic angiotensin-converting enzyme (ACE) inhibitor trandolapril on morning blood pressure (BP), we performed ambulatory BP monitoring (ABPM) before and after administration of trandolapril just before going to bed (bedtime-administered group: n=17) or in the morning (morning-administered group: n=20) in 37 hypertensive patients. Both sets of ABPM data were available in 30 patients. The 24-h systolic BP (SBP) levels were significantly decreased by 7.2 mmHg in the morning-administered group (p=0.02) and by 5.2 mmHg in the bedtime-administered group (p=0.04). In the bedtime-administered group, prewaking SBP (the average of the 2-h SBP values just before waking) and morning SBP (the average of the 2-h SBP values just after waking) were significantly decreased by 11 mmHg (p=0.005) and by 8.4 mmHg (p=0.03), respectively. On the other hand, in the morning-administered group, the reduction of prewaking SBP (3.9 mmHg, n.s.) and morning SBP (6.6 mmHg, n.s.) did not reach the level of statistical significance. However, the differences in the reductions of prewaking and morning SBPs between the two groups were not statistically significant. There was no additional reduction of the nighttime lowest BP in either administration group. In conclusion, bedtime administration of the long-acting ACE inhibitor trandolapril seems to be a safe and effective means of controlling morning BP in hypertensive patients without an excessive fall in nocturnal BP.
Hypertension Research 02/2004; 27(1):15-20. · 2.79 Impact Factor