Cerivastain(LIPOBAY®) is recently developed HMG-CoA reductase inhibitor which is effective in lowering serum cholesterol levels at microgram does. We evaluated the clinical efficacy and safety of cerivastatin(LIPOBAY®) in patients with hypercholesterolemia.

Thirty-seven patients(male : 13, female : 24) with hypercholesteolemia defined as baseline serum total cholesterol ≥240mg/dl, or ≥220mg/dl in patients with known coronary artery disease were included for this study. After 2 weeks of low cholesterol diet, if the serum total choesterol level meet the criteria, cerivastain 0.4mg/day was prescribed for 8 weeks. Clinical follow-up and laboratory tests were performed 4 weeks and 8 weeks after medication.

After 4 weeks of cerivastain 0.4mg/day treatment, low density lipoprotein(LDL) cholesterol decreased 38% and total cholesterol decreased 28.8% from baseline. Triglyceride decreased 11.6%, and high density lipoprotein(HDL) cholesterol decreased 7.8% from baseline. Total cholesterol/HDL ratio decreased 20.8% and LDL/HDL ratio decreased 31.1% from baseline. After 8 weeks of treatment, no further significant changes were noted compared with the values at 4 weeks. Cervastatin was discontinued in one patient(2.7%) due to continuous liver enzyme elevation.

Cerivastatin 0.4mg/day is effective in lowering serum cholesterol levels without significant adverse reactions. Cerivastatin is effective and safe for patients with hypercholesterolemia who needs aggressive LDL cholesterol lowering.

Percutaneous mitral valvuloplasty(PMV) became a treatment modality or mitral stenosis because of its low morbidity, short hospital stay, and low cost. We reviewed clinical and hemodynamic results after PMV for the patients with mitral stenosis in Ewha Womans University Mokdong hospital.

We compared the results of echocardiographic, hemodynamic, and clinical parameters before and after PMV. PMV was performed under fluoroscopic guidance in 21 patients(M:4, F:17, mean age 43±12 years) with mitral stenosis from October 1993 to April 1999. Transesophageal echocardiography(TEE) and Transthoracic echocardiography(TTE) were performed for the evaluation of mitral valve, chamber size, and the presence of left atrial thrombus before procedures. TIE was also used for follow-up evaluation. On presentation, all patients showed at least NYHA class II. Five patients had atrial fibrillation. Two patients with thrombus in the left atrium were included to study group after thrombolytic treatment with coumadin. Echo-score of our patients was not greater than 8.

Mean mitral valve area(MVA) by 2 dimensional or Doppler echocardiography was increased from 1.16±0.36cm² before PMV to 2.06±0.33cm² after PMV. There were marked improvements in transmitral gradients(11.60±5.54mmHg before PMV vs 4.93±2.53mmHg after PMV, p<0.001), left atrial dimension(46.41±14.66mm vs 42.03±15.01mm, p=0.042), and cardiac output(4.21±1.25L/min vs 6.88±9.57L/min, p<0.0001) following PMV, Severe(≥GIII) mitral insufficiency or severe postprocedural complications were not noted. This suggested that all procedure was successful.

The Procedural success rate of PMV in Ewha Womans University Mokdong hospital was 100%. Low echo score of our patients might explain this high procedural success rate. Long-term-follow-up is warranted in the near future.

Although angiotensin converting enzyme inhibitors have provided plausible effect for the management of hypertension and congestive heart failure, it does have drawbacks such as dry cough in as much as 15 to 30% of patients and incomplete blocking of angiotensin II production. Losartan(Cozaar®) is the first angiotensin II receptor antagonist that has become clinically available as an antihypertensive agent. Because the agent effectively blocks the final common pathway of renin-angiotensin system, it is recognized as an ideal drug for the treatment of hypertension.

We tested the antihypertensive effect and clinical safety of Losartan(Cozaar®) 50mg/day in 22 patients(male : 12, female : 10, age : 51±11, range : 33-70) with stage I and II hypertension from July 1998 to October 1999. The patients were enrolled in the study after two weeks of washout period if the patient was using other antihypertensive drugs. Blood pressure and side effects were monitored at zero, second, sixth, and twelfth week. Baseline chemistry was done before drug administration and follow-up chemistry was done at twelfth week.

Losartan(Cozaar®) showed good patient compliance and good antihypertensive effect without significant changes of laboratory results or clinical complications. At twelfth week, mean systolic blood pressure dropped l9mmHg, and mean diastolic blood pressure dropped 11mmHg. The heart rate showed no significant change during the study period. Blood pressure was controlled below 140/90mmHg in 12(54.5%) patients with Losartan 50mg/day. Five patients complained of minor side effects(dizziness, facial numbness, epigastric discomfort, etc) but no patients discontinued medication due to side effects.

Losartan(Cozaar®) is a safe and effective antihypertensive agent for the treatment of stage I and II hypertensive patients as a single once-a-day treatment.