To assess regional coronary reserve in hypertrophic cardiomyopathy, regional myocardial blood flow was measured in 23 patients with hypertrophic cardiomyopathy and 12 control subjects by means of nitrogen-13 ammonia and dynamic positron emission tomography. In patients with hypertrophic cardiomyopathy at baseline study, regional myocardial blood flow was 1.14 +/- 0.43 ml/min per g in the hypertrophied (20 +/- 3 mm) interventricular septum and 0.90 +/- 0.35 ml/min per g (p less than 0.05 versus septal flow) in the nonhypertrophied (10 +/- 2 mm) left ventricular free wall. These were not statistically different from the corresponding values in control subjects (1.04 +/- 0.25 and 0.91 +/- 0.21 ml/min per g, respectively, p = NS). After pharmacologically induced coronary vasodilation (dipyridamole, 0.56 mg/kg intravenously over 4 min), regional myocardial blood flow in patients with hypertrophic cardiomyopathy increased significantly less than in control subjects both in the septum (1.63 +/- 0.58 versus 2.99 +/- 1.06 ml/min per g, p less than 0.001) and in the free wall (1.47 +/- 0.58 versus 2.44 +/- 0.82 ml/min per g, p less than 0.001). In addition, patients with hypertrophic cardiomyopathy who had a history of chest pain had more pronounced impairment of coronary vasodilator reserve than did those without a history of chest pain. After dipyridamole, coronary resistance in the septum decreased by 38% in patients without a history of chest pain, but decreased by only 14% in those with such a history (p less than 0.05). Coronary resistance in the free wall decreased by 45% in patients without and by 27% in those with a history of chest pain (p = 0.06).(ABSTRACT TRUNCATED AT 250 WORDS)

Dexrazoxane given at a dexrazoxane:epirubicin dose ratio of 10:1 protects against epirubicin-induced cardiotoxicity and does not affect the clinical activity and the noncardiac toxicity of epirubicin. The clinical use of dexrazoxane should be recommended in patients whose risk of developing cardiotoxicity could hamper the eventual use and possible benefit of epirubicin.

In five supine spontaneously breathing anesthetized dogs we injected into the pleural space 0.5-1 ml of saline solution containing 2 mg/ml albumin labeled with technetium-99m. By use of a gamma camera placed horizontally over the chest, we followed, up to 120 min, the activity over the whole lung and over the preferential accumulation areas of the label (regions of interest, ROI) that corresponded to the apical, mediastinal, and laterodiaphragmatic regions. Activities were corrected for the decay rate of the isotope used. On the average, the activity over the whole lung decreased by 27% up to 120 min. The overall activity over the ROI amounted to 44.3% after the injection and decreased to 24% of total at 120 min, thus accounting for 75% of the total decrease in activity. At 10 min, the activity per unit surface of the gamma camera image (As) was from 2.2- to 5.7-fold higher over the ROI than for the rest of the lung image. The decrease of As at 120 min was 18-, 13-, and 5-fold greater for mediastinal, diaphragmatic, and apical regions, respectively, compared with the rest of the lung image. The time course of the changes in As are discussed in terms of regional albumin egress rate based on the functional interaction between the Starling and the lymphatic mechanisms.

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