Richard A. Lange

The natural history of isolated left ventricular diastolic dysfunction.

STUDY OBJECTIVE To assess the natural history of isolated left ventricular diastolic dysfunction. PATIENTS AND METHODS Follow-up (average duration, 68 months) was obtained in 51 patients with isolated left ventricular diastolic dysfunction at cardiac catheterization, characterized by (1) an elevated left ventricular end-diastolic pressure; (2) normal left ventricular end-diastolic and end-systolic volumes; (3) normal left ventricular ejection fraction; (4) no coronary artery disease; and (5) no valvular disease. RESULTS During follow-up, seven patients died, but only one died of cardiac causes. Of the 44 living subjects, 20 (45%) noted new-onset symptoms of congestive heart failure, with 11 (25%) of these requiring hospitalization, and 12 (27%) required hospitalization for recurrent chest pain. CONCLUSIONS Isolated left ventricular diastolic dysfunction is associated with a low cardiac mortality; at the same time, however, it is associated with substantial morbidity.

Electrophysiologic effects of intranasal cocaine

Abstract In conclusion, intranasal cocaine, 2 mg/kg, induced no change in electrocardiographic intervals or a variety of electrophysiologic variables.