The action of sublingual nitroglycerin (0.6 mg) and intravenous propranolol (0.1 mg/kg) on shortening of right ventricular fibers was investigated in patients with and without coronary artery disease. This was accomplished with a newly devised strain gauge catheter. Hemodynamic parameters and changes in the oxidation-reduction potential of heart muscle were determined. Nitroglycerin results in decrease in shortening and velocity of shortening of ventricular fibers, heart rate, left ventricular end-diastolic and systemic pressure, dp/dt, tension-time index, stroke index, peripheral resistance, and left ventricular minute work in normal and arteriosclerotic subjects. Intravenous propranolol leads to a fall in velocity of shortening of myocardial fibers, heart rate, dp/dt, stroke index, and left ventricular minute work. However, there is an increase in tension-time index and peripheral resistance with no change in systemic pressure. Left ventricular end-diastolic pressure rises significantly in arteriosclerotic patients. The myocardial oxidation-reduction potential increases after nitroglycerin whereas it falls after propranolol in normal and arteriosclerotic patients. Additional Indexing Words: HemodynamicsVelocity of fiber shorte:Lactic-pyruvic acid ratio

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In April 1976 the attack rate of chills and fever with or without falls in blood pressure increased in association with cardiac catheterizations. Fevers were associated with coronary angiography and right and left heart catheterizations. Blood cultures were negative, and reactions did not correlate with amounts of contrast materials infused or with procedures done by a single operator. Significant numbers of Acinetobacter calcoaceticus (var. anitratus) and a Pseudomonas species were cultured from hospital-reservoir distilled water when it was flushed through a catheter before gas sterilization. This same water after ethylene oxide sterilization contained 2 x 10(5) ng/mL of endotoxin by limulus lysate test and was positive by rabbit pyrogen test. When washed reusable cardiac catheters were sterilized daily or when disposable catheters were substituted, febrile reactions ended. Pyrogenic reactions in patients undergoing cardiac catheterizations correlated with emptying retained endotoxin with injected contrast material from reused washed-sterilized catheters.

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