No clinical benefit of a high-dose concentrate of n-3 fatty acids compared with corn oil was found despite a favorable effect on serum lipids.

A 2 MHz continuous waveform noninvasive ultrasound doppler system has been used in the present investigation. With the aid of the audio signals of the frequency shifts, the ultrasound probe was positioned on the external chest so that the axis of the incident ultrasonic beam coincided with the direction of the maximum velocity vectors of the mitral jet. The frequency shifts due to the mitral jet were frequency analyzed and the time course of the maximum frequency shitl was determined. The time course of the maximum mitral jet velocity was then determined from the doppler equation and the time course of the mitral pressure gradient from an orifice equation. The usefulness of the technique was evaluated by studying 25 patients with mitral stenosis and 10 without heart disease. The patients with mitral stenosis were studied during cardiac catheterization and the ultrasound data, the pulmonary artery wedge pressure, and the left ventricular pressure were recorded simultaneously. A table is presented where the gradient determined with the ultrasound technique, Mu, is compared with the gradient determined from the pressure tracings, APM. Averaged over the 25 patients studied, APU was 1.7 mmHg smaller than

No abstract

In a multicenter double-blind study, 227 THE CALCIUM ANTAGONIST nifedipine has been shown during the last decade to be effective in the treatment of angina pectoris' and more recently in the treatment of hypertension2 and heart failure.3 A cardioprotective effect of nifedipine has also been demonstrated after experimental coronary occlusion.4 6 There are several reasons why nifedipine might limit myocardial damage in patients with acute myocardial infarction (AMI). By reducing systemic vascular resistance, nifedipine might improve left ventricular unloading and reduce left ventricular workload.7 Dilatation of coronary arteries9 10 might enhance collateral flow to the ischemic region and possibly restore blood flow in situations in which spasm contributes to the ischemia. " Furthermore, nifedipine might inhibit detrimental cellular uptake of Ca ++ during ischemia. 2 This trial was primarily designed to investigate MethodsPatient selection and recruitment. All patients who were admitted to the four participating hospitals with suspected AMI during the trial period (885 patients) were screened for inclusion. Inclusion criteria were (1) severe central chest pain for at least 30 min, continuing on admission or until an analgesic was given, or (2) electrocardiographic changes suggesting an AMI (not previously recognized ST segment elevation >0.2 mV in precordial leads or >0.1 mV in extremity leads, or a Q wave >-0.04 sec that had not been previously recognized). These inclusion criteria were fulfilled by 623 patients, 396 (64%) of whom were excluded (table 1).Allocation and treatment. After informed consent was obtained, eligible patients of both sexes were randomly assigned to treatment with either nifedipine (10 mg capsules) or placebo. Patients at each center were assigned in blocks of 10 and given capsules from prenumbered bottles. A patient was considered to be included in the trial when he or she took the first capsule sublingually. Subsequent doses were 10 mg orally and were begun 30 min after the first dose unless systolic blood pressure was below 90 mm Hg. For the first 2 days 10 mg was given five CIRCULATION

The parmacokinetics of disopyramide (DP) in 10 patients with imminent to moderate cardiac failure has been studied and compared with the results in normal volunteers. The biological half life of rapid distribution (T1/2 alpha) and of elimination (T1/2 beta) were increased (11.1 +/- 4.4 min and 9.7 +/- 4.2 h, respectively). Total body clearance (Clt) was decreased (0.467 +/- 0.215 ml . min-1 . kg-1), and the volume of distribution (Vd) was slightly reduced (0.610 +/- 0.1361 . kg-1), probably due to the lower cardiac index. After oral administration, the time of peak serum concentration was increased (139 +/- 89 min), and the mean peak serum concentration (2.4 +/- 0.8% dose . 1-1) was also higher than reported in normal subjects. Comparison of the areas under the concentration versus time curves after intravenous and oral administration (AUC i. v. and AUC oral) showed that DP was almost completely absorbed, its bioavailability being 97.5 +/- 15.0%.