No abstract

The effects of bypass graft surgery versus continued medical management in 40 patients with stable angina were evaluated at 2 years: 17 of 20 surgical patients (85%) and 18 of 20 medical patients (90%) were alive, and 5 of 20 surgical patients (25%) and 2 of 20 medical patients (10%) had developed myocardial infarction; 8 of 17 surgical patients (47%) and 4 of 18 medical patients (22%) had no angina, and 13 of 17 surgical patients (76%) and 9 of 18 medical patients (50%) had no angina or greater than 25% increase in exercise time until angina. No statistically significant differences were demonstrated between the medical and surgical groups for all variables submitted to statistical analysis.

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Left ventricular systolic performance was evaluated noninvasively in 102 ambulatory resting adults age 22-96 years who had no evidence of heart disease. Ventricular performance was assessed by peak aortic blood acceleration and peak blood velocity, using a continuous-wave Doppler. All subjects were studied in the supine position with the transducer held at the suprasternal notch. All had a normal cardiac status, based upon the history, physical examination, electrocardiogram and echocardiogram. Peak blood acceleration correlated inversely with age (r = -0.58, p < 0.01). Peak blood acceleration was highest among those 20-39 years (23 ± 5 m/s/s; mean ± SD; p < 0.05). Among subjects 40-59, 60-79, and 80-96 years, peak acceleration was 18 ± 5, 16 ± 3, and 15 ± 4 m/s/s, respectively. Peak velocity also showed an inverse correlation with age (r = -0.69; p < 0.01) and was highest among younger adults (p < 0.05). Among ages 20-39, 40-59, 60-79, and 80-96 years, it was 0.92 ± 0.15,0.71 ± 0.19,0.54 ± 0.15, and 0.58 ± 0.10 m/s, respectively. Although there was a diminution of both peak blood acceleration and peak blood velocity with age, individuals 80-96 years of age showed no greater reduction than those 60-79 years of age. In conclusion, left ventricular systolic function in resting adults with no heart disease is diminished among elderly individuals, although the greatest reduction seemed to occur between the fifth and sixth decades.