Search

Twenty-six consecutive patients had measurement of ejection fraction by gated blood-pool imaging at rest and during isometric exercise, following recovery from an uncomplicated myocardial infarction. We found there was a highly significant fall in ejection fraction at rest from 56 +/- 3% to 43 +/- 3% during isometric exercise (p less than 0.0001). There was a dramatic fall in ejection fraction during isometric exercise in some patients with a normal resting value. These patients may be a cause for concern. Our preliminary findings suggest these latter patients are at risk for future cardiac events such as, unstable angina, further myocardial infarction and future coronary bypass surgery.

Levels of plasma lipoprotein lipids and anthropometric and physical fitness measurements were followed in 12 normal men over a 16 month period including training for two marathon runs separated by one year. As judged from pulse rate at submaximal work, the physical fitness of the men increased during training for the marathons and also over the whole study. High density lipoprotein (HDL) cholesterol levels which had been raised by training for the first marathon, were at similar levels at peak training prior to the second marathon. Estimated alcohol consumption was significantly higher prior to marathon II compared to the level prior to marathon I but this did not result in increased plasma high density lipoprotein cholesterol levels. The trend towards increased low density lipoprotein (LDL) cholesterol levels early in the study continued until the levels were finally significantly higher than pretraining values. It is possible that plasma high density lipoprotein cholesterol levels in the men reached personal maximum levels after training for the first marathon and were unaffected by an apparent increase in aerobic fitness achieved after training for the second marathon. This study also indicated that the effects of long term training on plasma lipids and lipoproteins may differ from those observed following shorter periods of exercise.

All patients entering a coronary care unit had data collected and stored prospectively on a computer file. Family history and risk factor data have been abstracted for those with confirmed myocardial infarction. These data are compared between those aged less than 50 years and those aged between 50 and 70 years. Cigarette smoking habits are compared with age matched data from the 1976 census population study of cigarette smoking habits. The risk factors of hypercholesteolaemia, obesity, diabetes, hypertension and cigarette smoking greater than 20 per day, do not separate the two age groups although cigarette smoking is more prevalent in the patient groups compared with the census population. Age of fathers' death is not different between the two age groups but death from myocardial infarction, presence of ischaemic heart disease during life in fathers and fewer nonsmokers in the younger age group clearly separate them from older age group patients. This study serves to emphasise that in order to prevent the development of myocardial infarction special attempts sould be made to prevent cigarette smoking in those whose fathers have died of a myocardial infarction or have symptoms of ischaemic heart disease.

A case of sudden unexpected death in an apparently fit and healthy young man is reported. Autopsy showed severe atherosclerotic heart disease. There was a family history of a disorder of lipid metabolism.

AN448 is a new anorectic agent, which in the dose used, is without the CNS stimulant properties of the amphetamines. Patients entering the trial were a highly resistant group at least 20 percent above ideal weight chosen from an ischaemic-hyperlipidaemic clinic population. In a double blind trial of 12 patients on the active drug and nine patients on placebo, a highly significant weight loss occurred over 12 weeks in the active group only. A significant reduction in serum cholesterol occurred independently of weight loss but there was no reduction in the serum triglycerides and no change in the lipoprotein electrophoretic pattern. The drug is shown to be effective for this group of patients and may also be useful as a cholesterol lowering agent.