This report details the two-dimensional echocardiographic assessment of 41 patients with Ebstein's anomaly. The anatomic spectrum of Ebstein's anomaly is correlated with surgical and autopsy observations in 66% of these patients. Morphologic abnormalities of the tricuspid valve and right heart structures were uniquely assessed by noninvasive two-dimensional echocardiographic examination. Features of the tricuspid valve that best related to decreased functional capacity were: 1) absence of the septal leaflet, and 2) pronounced tethering, restriction of motion and displacement of the anterior leaflet of the tricuspid valve. This 4 1/2 year experience suggests that two-dimensional echocardiography can replace angiography as the procedure of choice for diagnostic and morphologic assessment of Ebstein's anomaly. Cardiac catheterization is necessary only when specific hemodynamic questions or clinical inconsistencies exist.

To evaluate whether a significant statistical correlation exists between earlobe crease (EC) and coronary heart disease (CHD), 1000 Japanese adult patients (573 males, 427 females) were examined for the presence or absence of EC, clinical or angiographic evidence of CHD, and the following coronary risk factors: male sex, age over 50 years, obesity, hypertension, diabetes mellitus, cigarette smoking, and hyperlipidemia. Patients were divided into two groups according to clinical evidence of CHD: 237 patients with angina pectoris and/or myocardial infarction (CHD+ group); 720 patients without evidence of CHD (CHD- group). Coronary angiography was performed on 200 patients from this sample population; these patients were also divided into two groups: 119 patients with greater than 50% luminal narrowing of at least one major coronary artery (stenosis+ group); 81 patients with no significant atherosclerotic changes in the coronary arteries (stenosis- group). EC was present in 58 of 237 CHD+ patients (24.5%) but in only 35 of 720 CHD- patients (4.8%; P less than 0.001); it was present in 31 of 199 stenosis+ patients (26.1%) but in only 3 of 81 stenosis- patients (3.7%; P less than 0.01). EC was also found to correlate significantly with some coronary risk factors; the correlations between the presence of EC and the presence of CHD and coronary risk factors were investigated by multivariate analysis. In a multivariate setting, the existence of CHD and an age of over 50 years was significantly related to the presence of EC. To investigate the relationship between EC and advancing age, all patients were separated into age-groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Two-dimensional

No abstract

School, Minamikawachi-machi, Tochigi Prefecture, Japan 1 The cardiovascular effects of three single intravenous doses of a Pl-adrenoceptor partial agonist, xamoterol (0.025, 0.05 and 0.1 mg kg-') and placebo were studied in six healthy volunteers at rest using a single-blind design. 2 In addition to heart rate and blood pressure measurements, cardiac contractility was measured by means of M-mode echocardiography and systolic time intervals. Ambulatory 24 h Holter-monitoring of the electrocardiogram was performed. Plasma concentrations of xamoterol were measured. 3 Compared to baseline, xamoterol (0.025 mg kg-) increased heart rate (61 + 3-68 ± 3 beats min-1, means and SEM) and systolic blood pressure (119 ± 3-138 + 5 mm Hg) but decreased pre-ejection period (100 + 4-76 + 5 msec). Stroke volume (88 ± 6-104 + 10 ml), cardiac output (4.8 ± 0.4-6.6 ± 0.6 1 min-'), velocity of circumferential fibre shortening (1.15 ± 0.06-1.50 ± 0.06 circ s-1) were increased by xamoterol. No significant changes were produced by placebo. 4 No dose-dependent effects were seen and maximum effects were produced by 0.025 mg kg-' xamoterol. Significant effects were observed for 2 h. The areas under the plasma concentration curves (AUCO.12) showed a linear dose response.