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The reliability of a new noninvasive method for evaluating ejection fraction and the mean velocity of circumferential fiber shortening by apexcardiography and carotid pulse tracing has been evaluated. Three groups of subjects were considered. Group 1: 30 normal subjects (mean age 43 years); Group 2: 34 patients with aortic valve disease (mean age 51 years); Group 3: 76 patients with coronary artery disease (mean age 50 years). The mechano-cardiographic tracing points were acquired by an ultrasonic digitizing system and compared with the same indexes measured from the ventriculogram. In 53 patients M-mode echocardiographic evaluations also were performed. The correlations between the apexcardiographic derived ejection phase indexes and the angiographic measurements were highly significant in all subjects and in each group of patients. The correlations between the ejection phase indexes determined by echocardiography and the same angiographic data were also significant, but the r-values were somewhat lower than those found between the apexcardiographic and angiographic parameters in the same patients. Our results have assessed the reliability of this new method and demonstrated that this noninvasive technique can be applied not only in coronary disease but also in aortic valve disease and in normal subjects. It can be concluded that the apexcardiographic evaluation of cardiac performance appears applicable to patients in whom a means of assessing and sequentially following ventricular function is indicated.

This study was undertaken to determine the acute effects of nifedipine on left ventricular filling, examined by Doppler echocardiography in patients with arterial hypertension and normal left ventricular systolic function. Twenty-seven patients with mild to moderate systemic hypertension, and 18 normotensive subjects were studied. Pulsed Doppler, M-mode and B-mode measurements were performed before and 30 min after sublingual nifedipine administration (10 mg). Peak E, peak A, area A, area E, ratio area A/area E, E deceleration and E acceleration time were measured. Before administering nifedipine, some of these diastolic filling parameters were significantly different in the hypertensive patients as compared with normal subjects. After nifedipine, in patients with arterial hypertension, peak E and area E increased significantly (p less than 0.01), while ratio peak A/E and ratio area A/area E showed a significant decrease (p less than 0.001). No significant changes were observed in normal subjects. The result of this study demonstrates that the acute administration of nifedipine modifies transmitral flow velocity pattern in hypertensive patients, suggesting that the left ventricular filling abnormalities are in part dynamic and reversible.

To evaluate the metabolic or cardiovascular effects induced by self-administration of human growth hormone (HGH) alone or combined with testosterone and anabolic steroids, we conducted a study with 15 male body builders. Of these, 8 (control group) did not take any hormonal substances; 6 (experimental group) self-administered testosterone, anabolic steroids, and HGH for 6 weeks in various dosages; 1 subject self-administered only HGH for an equal period of time. At the end of the period of treatment with the hormonal combination, the experimental group continued for 2 additional weeks with anabolic steroids and testosterone only. All maintained the same, unaltered type and intensity of training, and constant diet. Before the beginning of treatment with hormonal substances, after 6 weeks, and at the end of treatment (for a total of 8 weeks), they were tested for total and HDL-cholesterol (t-chol and HDL-chol), apolipoproteins A-1 and B (apo A-1 and B), and triglycerides (tg). Before the start and after 6 weeks, an echocardiographic examination was performed to assess left ventricular dimensions and function in all 15 body builders. The most interesting result is a significant decrease of HDL-chol and apo A-1 derived from self-administration of anabolic steroids and HGH together.