Left ventricular systolic dysfunction is common among 75-year-olds with a prevalence of 6.8% in our estimate. The condition is more likely to affect men than women. In nearly half of 75-year-olds with left ventricular systolic dysfunction there is no clinical evidence of heart failure.

Echocardiography was used to assess normal values in the right and left ventricular cavity and wall in 127 male elite endurance athletes. M-mode and two dimensional measurements of left ventricle and left and right atria were also obtained. All subjects were high-performance orienteers, cross-country skiers and middle-distance runners. They all had a normal electrocardiogram at rest and no echocardiographic evidence of heart disease. With the use of multiple right ventricular cross-sections and two-dimensional measurements, we found a significantly greater right ventricular inflow tract and right and left atrial measurements in endurance athletes compared with earlier studies of normal, active subjects. The right ventricular free wall was slightly thicker than reported in normal active subjects but the differences were small. Left ventricular diastolic diameter was consistent with previous reports of endurance athletes. Of the 127 subjects, 13% had left ventricular wall thickness above 13 mm but none of the athletes had wall thickness above 15 mm. These data suggest that cardiac enlargement occurs symmetrically in both right and left cavities, probably reflecting increased haemodynamic loading, a mechanism by which athletes sustain a high cardiac output during exercise.

By using contrast echocardiography, a large increase in stroke volume in endurance athletes could be explained by an almost linear increase in end-diastolic volume and an initial small decrease in end-systolic volume during incremental upright exercise.

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Purpose: To evaluate and compare the diagnostic accuracy of duplex ultrasound (US) and MR angiography (MRA) at 1.0 T in aortoiliac arterial disease using digital subtraction angiography (DSA) as the reference standard. In addition, a comparison of the 2D time‐of flight (TOF) and 3D contrast‐enhanced MRA (CE MRA) techniques was performed. Material and Methods: Prospectively, 39 patients with symptoms of lower‐extremity arterial occlusive disease were examined using US, TOF MRA, CE MRA and DSA. Significant lesions (stenosis 50%) and occlusions were evaluated blindly for each method. Results: For all segments, the sensitivity for US, TOF MRA and CE MRA with regard to significant lesions was 0.72, 0.81 and 0.81, respectively, and the specificity for each was 0.97, 0.91 and 0.92, respectively. For significant lesions above the inguinal ligament the corresponding sensitivity was 0.84, 0.89 and 0.94 and the specificity 0.93, 0.82 and 0.73, respectively. The specificity was higher when the two MRA methods were combined. TOF MRA overgraded 7 segments as occluded. In most cases, the length of the occlusions was correctly determined on CE MRA, overestimated on TOF MRA and uncertain on US. Conclusion: Neither US nor MRA were sufficiently accurate to fully replace angiography. MRA was preferable to US as a non‐invasive test when vascular intervention was contemplated. Although CE MRA was superior to TOF MRA, the most accurate results were achieved when the two methods were combined.

The effect of physical training on the post-exercise blood pressure reaction in the ankle was studied in 63 patients with intermittent claudication but without angina pectoris. After three months of supervised training the maximal walking distance increased by 67% and the pain-free walking distance by 73%. Compared with that after the pre-training treadmill test, the ankle blood pressure was significantly higher 2-16 min after the post-training test and more rapidly returned to the initial resting value, both with similar work loads and with a higher post-training work load. Blood pressure measurement in the ankle after exercise is useful as an objective test of the circulatory effect of training in patients with intermittent claudication.