1. The temporal relationship between the myocardial arteriovenous difference of plasma propranolol concentration and heart rate and left ventricular dp/dt maximum was examined for 30 min after intravenous administration of 10mg (0.04 mmol) dl-propranolol in nine patients with ischaemic heart disease. 2. Very large positive myocardial a.v. differences of propranolol within the first 5 min became negative after 5 min, indicating a rapid, avid uptake with subsequent release of propranolol from the heart. 3. The heart rate and left ventricular dp/dt maximum increased 1 min after propranolol administration and did not change after the fifth min of the observation period. 4. The data suggest that a large number of unspecific binding sites for propranolol are present in the heart in addition to the specific beta-receptors.

Adult↗

PubMedDate not supplied

Prognostic value of echocardiography in 190 patients with chronic congestive heart failure. A comparison with New York Heart Association functional classes and radionuclide ventriculography.

Survival in 190 consecutive patients with congestive heart failure, discharged from a general hospital, was studied. Sixteen patients were in New York Heart Association (NYHA) class I, 87 in II, 83 in III and 4 in IV. Median left ventricular ejection fraction (LVEF) from radionuclide ventriculography was 0.30 (range 0.06-0.74). Two-year survival was 68%. Wall motion index was the only echocardiographic variable with significant, independent, prognostic information on survival. The 2-year survival in NYHA classes I and II was 90.7% for wall motion index > or = 1.3, and 78.6% when < 1.3. In classes III and IV survival was 68.9% for wall motion index > or = 1.3 and 39.9% when < 1.3. Addition of LVEF gave further information about survival. This study demonstrates that echocardiography is of great value in determining prognosis in congestive heart failure patients, and that wall motion index contains the majority of the information. Wall motion index is closely correlated to LVEF, however prognostication is improved when information about LVEF is added.

Adult↗