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Seven hundred and ninety-five consecutive patients with the diagnosis of angina pectoris were studied by coronary angiography and followed for 2-7 years. The prognosis is greatly determined by the extent of coronary artery involvement. Concomitant mitral insufficiency or ventricular aneurysm influence the prognosis adversely. There was no significant difference in prognosis between men and women. As regards patients with three-vessel disease and elevated left ventricular end-diastolic pressure, the prognosis was better in operated than in non-operated patients. The prognosis seems to have improved when angina pectoris materials collected in the 70s are compared with materials from the 60s.

Twelve patients with congestive heart failure were monitored with invasive and noninvasive techniques to evaluate the effect of vasodilator treatment. During the 18 hours of strict bed rest before administration of prazosin, the hemodynamics improved substantially while only small and transient heModynamic changes were observed after introduction of prazosin. At 6 weeks' control the effect of vasodilator treatment with prazosin, 3 mg x 4, was lost. The beneficial results often credited to vasodilators in studies on congestive heart failure might in part be due to the concomitant bed rest introduced during the monitoring of the patients.

Prosthetic valve implantation was performed in 36 patients with bacterial endocarditis. Thirty-two of them were in functional class III or IV (NYHA). The early mortality rate was 16.7%. In six patients perivalvular fistulas occurred and were of haemodynamic significance in three of them. At follow-up after 44 months on average, the clinical condition was excellent (functional class I or II) in 20 of the 26 survivors. The results encourage an active attitude towards surgical intervention in patients with valvular insufficiency due to bacterial endocarditis.

Platelet function was studied in blood sampled from the caval vein of 56 patients through various heart catheters. Reduced platelet retention was the most consistent finding while aggregation was not influenced by the sampling procedure. Polyurethane (Cordis and Positrol) catheters affected platelets less than catheters of woven dacron (Sones and Zucker). Sones catheters increased plasma beta-thromboglobulin levels slightly, and some platelets were trapped in the Zucker catheters. Much the same reduction in retention was induced by heparinized as by other catheters. Platelet retention values had a poorer reproducibility than the other platelet function parameters in samples collected at intervals of 45 min, while an acceptable correlation existed between parallel samples. The influence on platelets of blood sampled via polyurethane catheters was very moderate, and should allow the detection of alterations in platelet functions that occur in the circulation.

The effect of timolol on blood platelet function was studied in coronary sinus and caval vein blood at rest and during pacing-induced angina in 20 patients with coronary heart disease. During pacing-induced angina, lactate measurements confirmed that coronary sinus blood was sampled from ischemic regions in 13 men. The ischemia did not influence platelet function. In blood from non-ischemic myocardium, platelet activation was found during pacing: the ADP-induced aggregation, platelet retention and plasma beta-thromboglobulin levels increased moderately but significantly. Timolol administration prevented this platelet activation, possibly by inhibiting catecholamine release from the myocardium, and reduced the ischemic response during pacing as judged from lactate measurements and ST depressions. It is concluded that timolol reduced platelet activation induced in non-ischemic regions of the heart during tachycardia stress as well as myocardial ischemia.