Toshikatsu Sada

Hemodynamic effects of nifedipine in congestive heart failure

Nifedipine, a potent coronary vasodilator, was administered in a single sublingual dose of 20 mg to eight patients with mild to moderate congestive heart failure. Nifedipine produced a slight increase in heart rate (mean +/- standard error of the mean 73.3 +/- 3.2 versus 80.9 +/- 2.1 beats/min, p < 0.025) and an increase in cardiac index (from a control value of 3.51 +/- 0.22 to 4.06 +/- 0.31 liters/min per m2, p < 0.01). Arterial blood pressure decreased from 112.9 +/- 6.2/67.7 +/- 4.2 (mean 84.9 +/- 4.0) to 100.8 +/- 4.4/56.4 +/- 11.0 (mean 76.1 +/- 4.3) mm Hg (p < 0.01) and total systemic vascular resistance also decreased from a control value of 15.6 +/- 1.0 to 12.4 +/- 0.8 units (p < 0.01) after administration of nifedipine. These data suggest that nifedipine may be useful for vasodilation in congestive heart failure.

Polarcardiographic study of inferior myocardial infarction: Global projection of heart vector

The sensitivity of electrocardiographic, vectorcardiographic and polarcardiographic criteria for inferior myocardial infarction was studied. ECG and Frank system VCG were recorded in 50 normal cases and 40 cases of inferior myocardial infarction, whose acute phase was documented by typical electrocardiographic and serum enzymatic changes. The records were made from one month to 16 years after acute attacks. Polarcardiograms were obtained by a specially-designed analogue computer from X, Y and Z signals of the VCG, and recorded at a paper speed of 1000 mm/sec by Mingograph. The polarcardiographic tracings were measured at every 5 msec after onset of the QRS wave, and plotted on the Aitoffs equal-area projection. In normal cases, the QRS vectors plotted on Aitoffs projection passed through the narrow area between 15 to 35 msec after the QRS onset. Electrocardioraphic diagnosis of myocardial infarction was correctly made in 22 cases (55%), and by VCG the sensitivity was improved to 32 cases (80%). Polarcardiographic diagnosis was made in 33 cases (82.5%). Global plots of heart vector on Aitoffs projection were a useful display to visualize the sequential changes of heart vector. In inferior myocardial infarction, the QRS vector passed through the more superior portion to normal, and the diagnosis was accurately made in 33 cases (82.5%).