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Öğe Allograft aortic root replacement for aortic valve endocarditis with aortopulmonary fistula(Japan Heart Journal, Second Dept Of Internal Med, 2001) Calkavur, T; Yagdi, T; Islamoglu, F; Atay, Y; Nalbantgil, S; Ozbaran, MAcute infective endocarditis affecting the aortic root and valve associated with development of a fistulous communication between the aorta and pulmonary artery was presented in a young Turkish girl. Emergency surgery was required. Operation consisted initially or closure of the defect on the main pulmonary artery with a pericardial patch. This was followed by allograft aortic root replacement.Öğe Amiodarone reduces the incidence of atrial fibrillation after coronary artery bypass grafting(Mosby, Inc, 2003) Yagdi, T; Nalbantgil, S; Ayik, F; Apaydin, A; Islamoglu, F; Posacioglu, H; Calkavur, T; Atay, Y; Buket, SObjective: The purpose of this study was to evaluate the safety and efficacy of postoperative administration of prophylactic amiodarone in the prevention of new-onset postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting. Methods: In this prospective study 157 patients were randomly divided into two groups: 77 patients (amiodarone group) received intravenous amiodarone in a dose of 10 mg/kg/d for postoperative 48 hours. On postoperative day 2 oral amiodarone was started with a dose of 600 mg/d for 5 days, 400 mg/d for the following 5 days, and 200 mg/d for 20 days, and 80 patients received placebo (control group). Results: Preoperative patient characteristics and operative variables were similar in the two groups. Postoperative atrial fibrillation occurred in 8 patients (10.4%) receiving amiodarone and in 20 (25.0%) patients receiving placebo (P = .017). Duration of atrial fibrillation was 12.8 +/- 4.8 hours for the amiodarone group compared with 34.7 +/- 28.7 hours for the control group (P = .003). The maximum ventricular rate during atrial fibrillation was slower in the amiodarone group than in the control group (105.9 +/- 19.1 beats per minute and 126.0 +/- 18.5 beats per minute, respectively, P = .016). The two groups had a similar incidence of complication other than rhythm disturbances (20.8% vs 20.0%, P = .904). Amiodarone group patients had shorter hospital stays than that of control group patients (6.8 +/- 1.7 days vs 7.8 +/- 2.9 days, P = .014). The in-hospital mortality was not different between two groups (1.3% vs 3.8, P = .620). Conclusions: Postoperative intravenous amiodarone, followed by oral amiodarone, appears to be effective in the prevention of new-onset postoperative atrial fibrillation. It also reduces ventricular rate and duration of atrial fibrillation after coronary artery bypass grafting. It is well tolerated and decreases the length of hospital stay.Öğe Amiodarone reduces the incidence of atrial fibrillation after coronary artery bypass grafting(Mosby, Inc, 2003) Yagdi, T; Nalbantgil, S; Ayik, F; Apaydin, A; Islamoglu, F; Posacioglu, H; Calkavur, T; Atay, Y; Buket, SObjective: The purpose of this study was to evaluate the safety and efficacy of postoperative administration of prophylactic amiodarone in the prevention of new-onset postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting. Methods: In this prospective study 157 patients were randomly divided into two groups: 77 patients (amiodarone group) received intravenous amiodarone in a dose of 10 mg/kg/d for postoperative 48 hours. On postoperative day 2 oral amiodarone was started with a dose of 600 mg/d for 5 days, 400 mg/d for the following 5 days, and 200 mg/d for 20 days, and 80 patients received placebo (control group). Results: Preoperative patient characteristics and operative variables were similar in the two groups. Postoperative atrial fibrillation occurred in 8 patients (10.4%) receiving amiodarone and in 20 (25.0%) patients receiving placebo (P = .017). Duration of atrial fibrillation was 12.8 +/- 4.8 hours for the amiodarone group compared with 34.7 +/- 28.7 hours for the control group (P = .003). The maximum ventricular rate during atrial fibrillation was slower in the amiodarone group than in the control group (105.9 +/- 19.1 beats per minute and 126.0 +/- 18.5 beats per minute, respectively, P = .016). The two groups had a similar incidence of complication other than rhythm disturbances (20.8% vs 20.0%, P = .904). Amiodarone group patients had shorter hospital stays than that of control group patients (6.8 +/- 1.7 days vs 7.8 +/- 2.9 days, P = .014). The in-hospital mortality was not different between two groups (1.3% vs 3.8, P = .620). Conclusions: Postoperative intravenous amiodarone, followed by oral amiodarone, appears to be effective in the prevention of new-onset postoperative atrial fibrillation. It also reduces ventricular rate and duration of atrial fibrillation after coronary artery bypass grafting. It is well tolerated and decreases the length of hospital stay.Öğe Aspergillus niger aortitis after aortic valve replacement diagnosed by transesophageal echocardiography(Wiley, 2006) Duygu, H; Nalbantgil, S; Ozerkan, F; Kirilmaz, B; Yagdi, TAspergillus aortitis following cardiac surgery has an important role among the cardiac infections as almost all affected cases result in death. Survival of the patient with Aspergillus aortitis is dependent on early initiation of aggressive medical and surgical treatment. Transesophageal echocardiography proved very useful in the diagnosis of this uncommon case of aortitis. In this paper, we present a patient with aortitis caused by Aspergillus niger that hasn't been reported previously diagnosed by transesophageal echocardiography following cardiac surgery.Öğe Asymptomatic cytomegalovirus retinitis after cardiac transplantation(Karger, 2003) Erakgun, T; Afrashi, F; Nalbantgil, S; Ozbaran, M; Mentes, JPurpose: To determine the prevalence and the risk factors of cytomegalovirus (CMV) retinitis after cardiac transplantation in visually asymptomatic patients. Methods: Ophthalmoscopic examinations including fundus fluorescein angiography were performed in asymptomatic patients who had cardiac transplantation at Ege University Hospital between April 1998 and June 2002 to screen for evidence of diagnostic CMV retinitis lesions to determine the prevalence in this population. Results: Thirteen patients (aged 40 +/- 12.6) who had cardiac transplantation underwent ophthalmoscopic examination 2-50 months (23.5 +/- 16.2 months; mean +/- SD) after transplantation. All recipients had positive serology to CMV before transplantation. During the study period, 3 patients developed asymptomatic CMV reactivation. One patient developed CMV disease (pneumonia). All of the patients were visually asymptomatic during the study period. Two patients (15%) had a history of diabetes mellitus and chronic severe arterial hypertension. Seven recipients (53%) had been heavy cigarette smokers and 3 patients (23%) had hyperlipidemia. Two (15%) of 13 patients with arterial hypertension and diabetes had evidence of asymptomatic active CMV retinitis. These patients were treated with intravenous ganciclovir. Conclusions: Active cytomegalovirus retinitis lesions were found in 2 (15%) of 13 cardiac transplantation patients who had no visual symptoms. We think that the patients with systemic microvascular risk factors such as diabetes, hypertension and smoking should be screened closely for the development of CMV retinitis after cardiac transplantation even if the patients have no visual symptoms. Copyright (C) 2003 S. Karger AG, Basel.Öğe Asymptomatic cytomegalovirus retinitis after cardiac transplantation(Karger, 2003) Erakgun, T; Afrashi, F; Nalbantgil, S; Ozbaran, M; Mentes, JPurpose: To determine the prevalence and the risk factors of cytomegalovirus (CMV) retinitis after cardiac transplantation in visually asymptomatic patients. Methods: Ophthalmoscopic examinations including fundus fluorescein angiography were performed in asymptomatic patients who had cardiac transplantation at Ege University Hospital between April 1998 and June 2002 to screen for evidence of diagnostic CMV retinitis lesions to determine the prevalence in this population. Results: Thirteen patients (aged 40 +/- 12.6) who had cardiac transplantation underwent ophthalmoscopic examination 2-50 months (23.5 +/- 16.2 months; mean +/- SD) after transplantation. All recipients had positive serology to CMV before transplantation. During the study period, 3 patients developed asymptomatic CMV reactivation. One patient developed CMV disease (pneumonia). All of the patients were visually asymptomatic during the study period. Two patients (15%) had a history of diabetes mellitus and chronic severe arterial hypertension. Seven recipients (53%) had been heavy cigarette smokers and 3 patients (23%) had hyperlipidemia. Two (15%) of 13 patients with arterial hypertension and diabetes had evidence of asymptomatic active CMV retinitis. These patients were treated with intravenous ganciclovir. Conclusions: Active cytomegalovirus retinitis lesions were found in 2 (15%) of 13 cardiac transplantation patients who had no visual symptoms. We think that the patients with systemic microvascular risk factors such as diabetes, hypertension and smoking should be screened closely for the development of CMV retinitis after cardiac transplantation even if the patients have no visual symptoms. Copyright (C) 2003 S. Karger AG, Basel.Öğe Autologous peripheral stem cell transplantation in patients with congestive heart failure due to ischemic heart disease(Elsevier Science Bv, 2004) Ozbaran, M; Omay, SB; Nalbantgil, S; Kultursay, H; Kumanlioglu, K; Nart, D; Pektok, EObjective: Ischemic heart disease accounts for 50% of all cardiovascular deaths and is the leading cause of congestive heart failure. Medical therapy, cardiac assist devices and surgical procedures including heart transplantation have limited efficiency and availability. Stem cell transplantation represents a new therapeutic opportunity for such patients. Method: Six patients with the diagnosis of ischemic cardiomyopathy were included in this study. All of the patients had clinical, radiological and echocardiographic signs of heart failure, and reduced left ventricular ejection fraction (LVEF less than or equal to25%). They underwent coronary angiography and stress tests with dobutamine echocardiography, thallium scintigraphy and positron emission tomography to assess myocardial ischemia and viability. Peripheral stem cells were mobilized and collected by apheresis. They were transplanted into areas of injury with open-heart surgery. To increase blood flow to the engrafted areas, coronary artery by-pass surgery was also performed. Results: The patients were followed at least for 4 months. Echocardiography, thallium scintigraphy and positron emission tomography were repeated after at least 6 weeks following surgery. There was a significant increase in life quality and NYHA class. Some benefit was documented on echocardiography, thallium scintigraphy, and positron emission tomography. Conclusion: This approach opens a new window in the treatment of 'no hope' patients with congestive heart failure. (C) 2003 Elsevier B.V. All rights reserved.Öğe Autologous peripheral stem cell transplantation in patients with congestive heart failure due to ischemic heart disease.(Amer Soc Hematology, 2003) Omay, SB; Ozbaran, M; Nalbantgil, S; Kultursay, H; Kumanlioglu, K; Nart, D; Pektok, EÖğe Autologous peripheral stem cell transplantation in patients with congestive heart failure due to ischemic heart disease.(Amer Soc Hematology, 2003) Omay, SB; Ozbaran, M; Nalbantgil, S; Kultursay, H; Kumanlioglu, K; Nart, D; Pektok, EÖğe Cardiac hydatid cyst located in the interventricular septum(Elsevier Science Inc, 2002) Posacioglu, H; Nalbantgil, S; Ozbakkaloglu, M; Halil, H; Buket, SÖğe Clinically additive effect between doxazosin and amlodipine in the treatment of essential hypertension(Elsevier Science Inc, 2000) Nalbantgil, S; Nalbantgil, I; Onder, RThe Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure has reported that combinations of low doses of antihypertensive agents from different classes may provide additional antihypertensive efficacy and minimize the likelihood of dose-dependent adverse effects. Doxazosin and amlodipine, alone and in combination, were compared for efficacy in reducing blood pressure (BP) in 75 patients with predominantly moderate (Stage 2) hypertension. This was a double-blind, randomized, crossover study. After a 2-week washout period, patients in group A (n = 37) received amlodipine 10 mg and patients in group B (n = 38) received doxazosin 4 mg for 6 weeks. All patients then received reduced-dose combination therapy (amlodipine 5 mg and doxazosin 2 mg) for 6 weeks. Subsequently, patients received 6 weeks of monotherapy with the alternate medication (group A received doxazosin 4 mg and group B received amlodipine 10 mg). During both monotherapy periods, doxazosin and amlodipine significantly reduced systolic and diastolic BP (P < .001 v baseline). BP further decreased with combination therapy (P < .01 v monotherapy). The percentage of patients with Stage 2 hypertension who achieved a target BP of < 140/ < 90 mm Hg increased from 78% with monotherapy to 94% with combination therapy. Fewer adverse effects were observed during combination therapy. It is concluded that there is an additional fall in blood pressure when reduced doses of doxazosin and amlodipine are used in combination for the treatment of hypertension, suggesting that doxazosin should be considered as an effective add-on treatment to calcium-channel blockers. (C) 2000 American Journal of Hypertension, Ltd.Öğe Comparison of candesartan and felodipine alone and combined in the treatment of hypertension: A single-center, double-blind, randomized, crossover trial(Excerpta Medica Inc, 2003) Nalbantgil, S; Zoghi, M; Ozerkan, F; Boydak, B; Nalbantgil, I; Onder, R; Akin, MBackground. In the past decade, many studies have indicated that the combination of low doses of different classes of antihypertensive agents may be more efficacious than monotherapy while minimizing the likelihood of dose-dependent adverse effects (AEs). Objective: The aim of this study was to determine whether combination therapy with lower doses of candesartan and a calcium antagonist, felodipine, would be more effective and tolerable in controlling mild to moderate hypertension compared with either drug used alone. Methods: In this 18-week, single-center, double-blind, crossover study, patients with mild to moderate essential hypertension were randomized to 1 of 2 treatment groups after a 2-week placebo washout period. Patients in group 1 received candesartan 16 mg once daily and patients in group 2 received felodipine 5 mg once daily, for 6 weeks. All patients then received half-dose combination therapy (candesartan 8 mg plus felodipine 2.5 mg, once daily) for 6 weeks. Finally, patients received 6 weeks of monotherapy with the alternate medication (group 1 received felodipine 5 mg once daily and group 2 received candesartan 16 mg once daily). Results: Thirty patients (18 men, 12 women; mean [SD] age, 54.0 [4.9] years; range, 39-62 years) were included in the study. During both monotherapy periods, candesartan and felodipine significantly reduced blood pressure (BP) (both P < 0.001). BP further decreased with combination therapy (P < 0.001 in both groups). Overall, 90.0% (27/30) of the patients achieved the target BP at the end of combination therapy. The incidence of AEs was similar with combination therapy compared with either monotherapy. Conclusions: In this study population, candesartan and felodipine had additive effects when used in combination, even at low doses, in the treatment of hypertension. Therefore, the combination of candesartan and felodipine is an effective alternative to that of candesartan and hydrochlorothiazide. Copyright (C) 2003 Excerpta Medica, Inc.Öğe Comparison of candesartan and felodipine alone and combined in the treatment of hypertension: A single-center, double-blind, randomized, crossover trial(Excerpta Medica Inc, 2003) Nalbantgil, S; Zoghi, M; Ozerkan, F; Boydak, B; Nalbantgil, I; Onder, R; Akin, MBackground. In the past decade, many studies have indicated that the combination of low doses of different classes of antihypertensive agents may be more efficacious than monotherapy while minimizing the likelihood of dose-dependent adverse effects (AEs). Objective: The aim of this study was to determine whether combination therapy with lower doses of candesartan and a calcium antagonist, felodipine, would be more effective and tolerable in controlling mild to moderate hypertension compared with either drug used alone. Methods: In this 18-week, single-center, double-blind, crossover study, patients with mild to moderate essential hypertension were randomized to 1 of 2 treatment groups after a 2-week placebo washout period. Patients in group 1 received candesartan 16 mg once daily and patients in group 2 received felodipine 5 mg once daily, for 6 weeks. All patients then received half-dose combination therapy (candesartan 8 mg plus felodipine 2.5 mg, once daily) for 6 weeks. Finally, patients received 6 weeks of monotherapy with the alternate medication (group 1 received felodipine 5 mg once daily and group 2 received candesartan 16 mg once daily). Results: Thirty patients (18 men, 12 women; mean [SD] age, 54.0 [4.9] years; range, 39-62 years) were included in the study. During both monotherapy periods, candesartan and felodipine significantly reduced blood pressure (BP) (both P < 0.001). BP further decreased with combination therapy (P < 0.001 in both groups). Overall, 90.0% (27/30) of the patients achieved the target BP at the end of combination therapy. The incidence of AEs was similar with combination therapy compared with either monotherapy. Conclusions: In this study population, candesartan and felodipine had additive effects when used in combination, even at low doses, in the treatment of hypertension. Therefore, the combination of candesartan and felodipine is an effective alternative to that of candesartan and hydrochlorothiazide. Copyright (C) 2003 Excerpta Medica, Inc.Öğe Effect of antihypertensive treatment on the prevalence of ventricular arrhythmias among patients with isolated systolic hypertension without left ventricular hypertrophy(Excerpta Medica Inc, 2002) Gurgun, C; Nalbantgil, S; Nalbantgil, I; Zoghi, M; Yilmaz, H; Boydak, B; Onder, RBackground: The high incidence of ventricular arrhythmias in patients with hypertension and left ventricular hypertrophy (LVH) is well documented. However, few studies have been conducted on the prevalence of ventricular arrhythmias in patients with isolated systolic hypertension without LVH. Objectives: The objectives of this study were to (1) determine the prevalence of ventricular arrhythmias in patients with systolic hypertension without LVH and (2) estimate the effect of a perindopril/indapamide combination, which does not have an antiarrhythmic effect, on the incidence of ventricular arrhythmias. Methods: Patients with newly diagnosed isolated systolic hypertension (systolic blood pressure [SBP] >160 mm Hg) and a control group of normotensive patients were enrolled. During the 2-week washout period, patients underwent physical examination (including blood pressure measurements), ambulatory electrocardiography monitoring, echocardiography, and laboratory urine and blood tests. Absence of LVH was confirmed by echocardiographic examination. The group of hypertensive patients received 1 tablet of 2 mg perindopril/0.625 mg indapamide per day for a total of 4 weeks. Physical examinations and ambulatory electrocardiographic monitoring were repeated after treatment. Results: A total of 60 hypertensive (mean age, 63.1 years; mean SBP, 176.8 +/- 3.1 mm Hg; mean diastolic blood pressure, 82.6 +/- 2.9 mm Hg) and 60 normotensive patients were enrolled. Ambulatory electrocardiographic monitoring indicated that 18 of the 60 hypertensive patients (30%) had ventricular arrhythmias: 17 had ventricular premature contractions (>100/24 h) and 1 had ventricular tachycardia plus ventricular premature contractions. In the control group, 7 of 60 subjects (11.7%) had ventricular premature contractions. The difference between the 2 groups in incidence of ventricular arrhythmias was significant (P < 0.01). After treatment, mean SBP decreased to 136.1 +/- 3.2 mm Hg, and ventricular premature contractions were found in 9 of 60 hypertensive patients (15%) (P < 0.02 vs pretreatment). Conclusions: The results of this study suggest that in patients with isolated systolic hypertension without LVH, (1) the prevalence of ventricular arrhythmia is higher than in normotensive patients and (2) treatment with perindopril/ indapamide decreases the incidence of ventricular arrhythmias.Öğe Effect of statins on plasma fibrinogen levels in hypertensive hyperlipidemic patients(Lippincott Williams & Wilkins, 2002) Nalbantgil, S; Nalbantgil, I; Boydak, B; Ozerkan, F; Gurgun, C; Zoghi, M; Aytimur, M; Onder, RÖğe The effect of two different pacing modes on global left-ventricular performance in patients with atrioventricular block: a tissue Doppler echocardiography study(W B Saunders Co Ltd, 2003) Zoghi, M; Yavuzgil, O; Nalbantgil, S; Ozerkan, F; Akilli, A; Turkoglu, C; Kultursay, H; Akin, MÖğe The effect of two different pacing modes on global left-ventricular performance in patients with atrioventricular block: a tissue Doppler echocardiography study(W B Saunders Co Ltd, 2003) Zoghi, M; Yavuzgil, O; Nalbantgil, S; Ozerkan, F; Akilli, A; Turkoglu, C; Kultursay, H; Akin, MÖğe The effect of type II diabetes mellitus on platelet aggregation in patients who underwent percutaneous transluminal coronary angioplasty(Lippincott Williams & Wilkins, 2002) Sagcan, A; Nalbantgil, S; Omay, SB; Akin, MBackground In noninsulin-dependent type II diabetic (tIIDM) patients it was reported that ADP-induced platelet aggregation response was increased with decreased level of platelet guanylate cyclase, This study was therefore designed to examine the effects of tIIDM on collagen-induced, in-vitro platelet aggregation in percutaneous transluminal coronary angioplasty (PTCA) patients, Methods Twenty patients with tIIDM and 30 nondiabetic patients who had successful PTCA were included in the study. Platelet-rich plasma samples from the patients before and after PTCA were treated with in-vitro Collagen and platelet aggregation waves were calculated via the turbidometric method of Born. The maximum amplitude (%) and the ratio of changes after PTCA in the study participants were measured by these waves and data were compared by student's t tests and nonparametric methods. The maximum amplitude of collagen-induced platelet aggregation before and after the procedure was also compared using variant analysis. Results The change in collagen-induced maximum amplitude of platelet aggregation in both wave I and wave 2 was significantly more (P < 0.001- P < 0.001) in the tIIDM group. The ratio of restenosis seen in the control coronary angiography made 6 months after intervention was found to be significantly more in the tIIDM group (P < 0.05). Conclusions Collagen-induced platelet aggregation response was greater in patients with tIIDM than in nondiabetic patients. This makes us think that tIIDM patients could need more potent antiplatelet therapy before PTCA after the blood glucose levels have been regulated, Coron Artery Dis 13:45-48 (C) 2002 Lippincott Williams & Wilkins.Öğe Effects of atorvastatin 10 mg/d on insulin resistance: A 12-week, open-label study in hyperlipidemic patients(Elsevier Science Inc, 2006) Ozerkan, F; Ozdogan, B; Zoghi, M; Nalbantgil, S; Yavuzgil, O; Onder, MRBackground: In addition to their cholesterol-lowering effects, hydroxymethylglutaryl coenzyme A reductase inhibitors ("statins") might have pleiotropic, nonlipid effects. Insulin resistance syndrome is known to increase the risk for cardiovascular disease. However, the effects of statins on insulin resistance are a subject of controversy. Objective: We aimed to investigate the effects of atorvastatin on insulin resistance in hyperlipidemic patients. Methods: This 12-week, prospective, nonrandomized, open-label study was conducted at the outpatient cardiology clinic, Ege University Medical School, Bornova-Izmir, Turkey. Hyperlipidemic patients aged >= 18 years with insulin resistance and no other components of the metabolic syndrome were included in the study. Atorvastatin 10 mg QD (after the evening meal) was administered by mouth (tablet) over a 12-week period. At baseline and after 12 weeks of treatment, insulin sensitivity was assessed using homeostasis model assessment (HOMA) index methodology. Serum lipid parameters and fasting levels of plasma glucose and insulin (FPG and FPI, respectively) were measured at the same 2 time points. The tolerability of atorvastatin was assessed using laboratory analysis and physical examination, including vital sign measurements. Results: Fifteen white patients (9 women, 6 men; mean [SD] age, 52 [8] years) participated in the study. No significant changes in HOMA index were found (mean [SD], 3.1 [1.5] vs 3.2 [1.9]). The lipid profile was improved significantly at 12 weeks compared with baseline (mean [SD] low-density lipoprotein cholesterol, 173.2 [21.3] vs 110.8 [43.6] mg/dL; total cholesterol, 270.9 [21.5] vs 201.2 [46.7] mg/dL; and triglycerides, 269.5 [46.3] vs 205.5 [49.3] mg/dL; all, P < 0.001). No significant change in mean (SD) plasma high-density lipoprotein cholesterol level (45.5 [6.6] vs 43.7 [8.1] mg/dL) was found. In addition, no significant changes in FPG (85.3 [12.7] vs; 84.8 [10.4] mg/dL), or FPI (13.5 [9.7] vs 13.9 [10.1] mu U/mL) were found. None of the patients required withdrawal of medication due to an adverse event. Conclusion: In this pilot study in hyperlipidemic patients with insulin resistance, 12 weeks of treatment with atorvastatin 10 mg QD was effective in controlling hyperlipidemia but did not reduce the severity of insulin resistance.Öğe Effects of valsartan and enalapril on regression of left ventricular hypertrophy in patients with mild to moderate hypertension: A randomized, double-blind study(Excerpta Medica Inc, 2000) Nalbantgil, S; Yilmaz, K; Gurun, C; Ozerkan, F; Nalbantgil, I; Onder, RObjective: This study was undertaken to compare the effects of valsartan with those of enalapril on regression of left ventricular hypertrophy in patients with mild to moderate hypertension. Background: The effect of angiotensin II receptor antagonists on regression of left ventricular hypertrophy in patients with hypertension has been established in several studies. The effects of these agents have also been compared with those of other antihypertensive drugs such as diuretics or beta-receptor blocking agents. However, no study has compared angiotensin II receptor antagonists with angiotensin-converting-enzyme (ACE) inhibitors. The effect of ACE inhibitors on regression of left ventricular hypertrophy is superior to that of other antihypertensive drugs. Methods: Forty patients with mild to moderate hypertension and left ventricular hypertrophy were included in this randomized, double-blind study. Patients were divided into 2 groups. No between-group differences were noted with regard to age, systolic and diastolic blood pressures, duration of hypertension, and left ventricular mass index, which was measured by M-mode echocardiography. Twenty patients received enalapril 20 mg/d, and 20 patients received valsartan 80 mg/d. Echocardiographic measurements were repeated at 3 and 6 months, and blood pressure was measured every 15 days. Results: Systolic and diastolic blood pressures decreased significantly at 3 and 6 months in both groups (P < 0.001), as did left; ventricular mass index (P < 0.02 and P < 0.01, respectively). Cough and fatigue occurred in 3 (15%) and 2 (10%) patients in the enalapril group. No adverse effects were reported in the valsartan group. Conclusions.. In patients with left ventricular hypertrophy caused by hypertension, valsartan is as effective as enalapril in reducing left ventricular hypertrophy.