The FRANCE TAVI registry provided reassuring data regarding trends in TAVR performance in an all-comers population on a national scale. Nonetheless, given that TAVR indications are likely to expand to patients at lower surgical risk, concerns remain regarding potentially life-threatening complications and pacemaker implantation. (Registry of Aortic Valve Bioprostheses Established by Catheter [FRANCE TAVI]; NCT01777828).

An important side-effect of antiarrhythmic drugs is their negative inotropic action. To investigate this after i.v. administration we compared the newer class-I-antiarrhythmic drug flecainide (2 mg, 4 mg and 8 mg kg-1) with disopyramide (1 mg, 4 mg and 8 mg kg-1), quinidine (5 mg and 10 mg kg-1) and saline (controls). Isovolumic measurements of ventricular function by short aortic crossclamping were performed in 82 open-chest rats and peak left ventricular isovolumic pressure (LVSP) and peak isovolumic dp/dt max were determined 5 and 15 minutes after intravenous drug injection. All drugs decreased isovolumic indices of myocardial function dose-dependently. Flecainide reduced peak isovolumic LVSP and dp/dt max only after 8 mg kg-1 (to 85 +/- 3% and 45 +/- 5%, resp., means +/- SE, P less than 0.01), 2 mg kg-1 and 4 mg kg-1 had no significant effect. Disopyramide influenced myocardial function already at 4 mg kg-1 (peak LVSP 88 +/- 4%, P less than 0.05, peak dp/dt max 64 +/- 7%, P less than 0.01, means +/- SE), 8 mg kg-1 had an even more marked depressive effect (peak LVSP 81 +/- 4%, peak dp/dt max 50 +/- 8%, means +/- SE, P less than 0.01). 5 mg kg-1 and 10 mg kg-1 quinidine both decreased peak LVSP and peak dp/dt max (91 +/- 3% and 92 +/- 1%, resp., and 80 +/- 5% and 74 +/- 6% means +/- SE, P less than 0.05). Thus, disopyramide had the most marked negative inotropic potential of the investigated class-I-antiarrhythmic drugs.(ABSTRACT TRUNCATED AT 250 WORDS)

An intermittent swimming training of 40 rats for eight weeks resulted in an increase of 17% in heart weight, which is regarded as an index for the degree of hypertrophy.Measurement of left ventricular pressure and volume in the isovoIumetrically beating and the arrested heart of open chest rats gave the following results of the trained rats, as compared with controls of the same age and body weight:1. Due to the increased ventricular capacity, the diastolic and systolic pressurevolume curves are shifted to higher volumes. 2. In spite of the enlarged radius the diastolic wall stress is only slightly increased for a given diastolic pressure. Thus diastolic load of left ventricular myocardium should not be essentially increased in the intact animal. 3. The passive elastic wall properties are practically unaltered in this type of hypertrophy. The elastic stiffness (tangent modulus) as a function of wall stress is not decreased. The "regulative Dilatation" is not to be attributed to a functional decrease of "diastolic tone", but is sufficiently explained by muscle fibre growth. 4. Under the condition that the same diastolic wall stress corresponds with practically the same length of sarcomeres, the correlation between isovolumetric systolic wall stress as well as velocity of wall stress development and the corresponding diastolic wall stress reveals a slight increase in contractile capability. 5. In the isovolumetric mechanograrn the point of inflexion is reached later, but at higher pressures. The slight decrease of the quotient (dp/dtmax)/P i cannot be interpreted as decreased contractily.These findings are in agreement with former findings in our laboratory on the linear cardiac muscle strip (Goltz et al., 1972, Kiimmereit, 1973.Upon critical evaluation of the results and their meaning in relation to the cardiac performance, it can be confirmed that the performance of the total i) Supported by the Deutsche Forschungsgemeinschaft. ~) Herrn Prof. Dr. K. Spang, Stuttgart, zum 65. Geburtstag.

A 35-year-old women developed symptoms of multiple system disease. Three months later she was admitted to hospital and died six days after admission, with signs suggestive of mitral stenosis. Postmortem examination indicated primary chorion carcinoma of the right ovary with metastases to the left atrium, lungs, brain, kidneys, pancreas, mesenteric arteries, and spleen. The signs and symptoms, and the morphological and histological findings at necroscopy, are discussed.

Intravenous 5-fluorouracil in combination with low doses of folinic acid can induce severe nonischemic heart failure. In such a case, an intra-aortic balloon pump could be useful by providing left ventricular function support when inotropic agents and vasopressors fail to restore normal hemodynamics.