These data demonstrate that radiographic contrast agents impede fibrinolysis. This previously undescribed interaction was demonstrated using an in vitro test system, but these findings may have clinical relevance when thrombolytic drugs are used at the time of angiography.

Left ventricular shape is an aspect of the left ventricular image (on the two‐dimensional echocardiogram) that has hitherto received little attention. Although it has long been known to cardiologists that patients with dilated cardiomyopathy tend to have more spherical hearts than normal individuals, this remained a qualitative “impression,” and a quantitative approach to left ventricular shape is not part of routine clinical echocardiography. The few published studies that did address overall left ventricular shape used a simple length/width ratio as the index of shape. Using left ventricular shape descriptors, which are ratios of various left ventricular dimensions (and area) to each other, we characterized left ventricular shape in normals and in patients with dilated cardiomyopathy in a quantitative manner, independent of left ventricular size. We confirmed the previous “impression” that left ventricular chamber shape is abnormal (more spherical) in patients with dilated cardiomyopathy. We showed that dilated but normally contracting, volume overloaded left ventricles do not show such spherical shape alteration. We have recently found that abnormal spherical shape change of a similar degree to that observed in classical dilated cardiomyopathy is also seen in patients with diffuse hypokinetic cardiomyopathy whose left ventricular chambers are not dilated, or only marginally dilated, beyond the normal range. It may be worthwhile, therefore, to perform the simple measurements and calculations necessary to obtain left ventricular shape descriptors in patients with suspected myocardial disease. (ECHOCARDIOGRAPHY, Volume 8, March 1991)

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