The time course of the recovery period was characterised by non-invasive measurements after 4-minute bicycle exercise at 3 separate (50W, 100W, and 150W) work loads in 10 volunteers in whom the peak responses during exercise of heart rate and systolic time intervals were consistent with previous investigations of comparable subjects. Most responses started immediately to return toward resting control values. Despite rapidly falling post-exercise heart rates, left ventricular ejection times fellfurther from their exercise nadirs for the first 5 to 15 seconds of recovery (depending on load) probably because of diminished stroke volume caused by venous pooling and, probably also, by continued rapid ejection rate. The stroke volume change was indicated by a concomitant precipitous fall in ejection time index, which then stabilised in tandem with the subsequently normal (i.e. discordant) left ventricular ejection time-heart rate relation. For the first 30 seconds, heart ratefellfrom load-related exercise peaks, but at equal slopes of changefor all loads; thereafter, rates of return toward resting control were strictly load-related. Changes in pre-ejection period were determined by changes in isovolumic contraction time; the degree of return toward control of pre-ejection period and isovolumic contraction time from their exercise nadirs was load-dependent throughout recovery; loaddependent differences in their rate of return were pronounced in thefirst 30 seconds. The rates of change in the ejection time index and in the ratio pre-ejection period/left ventricular ejection time (PEPILVET) were virtually independent of load throughout most of recovery.Polygraphic recording of systolic time intervals (STI) has been successfully applied during upright exercise (Miller et al., 1970;Pigott et al., 1971;Lindquist et al., 1973;Lance and Spodick, 1975;Xenakis et al., 1975 (Aronow, 1970;Pouget et al., 1971;McConahay et al., 1972), the time course of changes during the recovery period has not been systematically investigated.We studied the post-exercise recovery period after graded dynamic upright exercise. The purpose of this investigation was to characterise the changes in cardiac dynamics, as expressed by the systolic time index in healthy young men throughout the first 5 minutes of recovery after submaximal exercise on a bicycle ergometer, and to study the effect of different exercise loads on the time course of recovery. Methods (A) SUBJECTSTen young healthy male volunteers, ages 23 to 32 (mean 27 years), were studied. They were all normally active but not trained athletes and had a 958

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The diuretic response of patients with congestive heart failure to establish doses of diapamide (750 mg) and furosemide (80 mg) was compared in an open, crossover study. Peak urine output occurred in the first 6 hours after administration of furosemide but somewhat later (12 to 18 hours) with diapamide. Both agents produced active diuresis and natriuresis in most patients. Comparisons of drug effect during the first days of each treatment period and analysis of the entire first treatment period indicated that urine output with furosemide was significantly greater than with diapamide. Urinary sodium excretion on the first day of treatment was not significantly greater with furosemide than with diapamide, nor were the differences significant on subsequent days. The observed differences between drugs on urinary potassium and chloride excretion were not statistically significant. The most frequently occurring adverse reaction was mild to moderate nausea, which was reported by five patients receiving diapamide and two patients receiving furosemide. Diarrhea and vomiting were also more frequent with diapamide. Diapamide would appear to serve a role between the milder thiazide diuretics and the more effective furosemide.

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