No abstract

In premenopausal women, hyperinsulinaemia and decreased DHEA-S levels may contribute to the development of coronary atherosclerosis.

Serum reverse triiodothyronine (reverse T₃), triiodothyronine (T₃), thyroxine (T₄) and thyrotropin (TSH) concentrations were determined by radioimmunoassay in end-stage chronic renal failure, hypothyroidism and control subjects. In advanced chronic renal failure serum reverse T₃ was normal or elevated and serum T₃ concentrations were frequently, and serum T₄ occasionally, lowered. Serum TSH was normal even where serum T₃ and T₄ concentrations were low. Normal or elevated serum reverse T₃ associated with normal serum TSH in chronic renal failure clearly differentiates this disease from primary hypothyroidism in which low serum reverse T₃ and high serum TSH are constantly found.

Objective: The aim of the study was to compare the efficacy and safety of two stress echocardiography methods, exercise and dobutamine, in the diagnosis of coronary artery disease in hypertensive patients with angina. Patients and methods: A total of 197 treated hypertensive patients, age 53 ؎ 9 years (65 women) with no history of myocardial infarction referred for coronary angiography were prospectively investigated with exercise electrocardiography (ECG), exercise and dobutamine echocardiography. Results: Sensitivity of the exercise ECG, exercise echocardiography and dobutamine echocardiography did not differ (77%, 82% and 75%). Negative predictive value of exercise ECG was significantly lower than exercise echocardiography (64% vs 79%, P Ͻ 0.01). Specificity and positive predictive value of exercise ECG were markedly lower than exercise and dobutamine echocar-