CONTENTS OF VOLUME 7

JANUARY 1986 VOLUME 7 NUMBER 1

COOPERATIVE STUDIES

1 Effect of Propranolol in Patients With Myocardial Infarction and Ventricular Arrhythmia. Lawrence M. Friedman, Robert P. Byington, Robert J. Capone, Curt D. Furberg, Sidney Goldstein, Edgar Lichstein, Writing Group for the Beta-Blocker Heart Attack Trial Research Group

9 Comparative Study of Encainide and Quinidine in the Treatment of Ventricular Arrhythmias. Joel Morganroth, John C. Somberg, Peter E. Pool, Ping-Hwa Hsu, lan K. Lee, John Durkee, for the Encainide-Quinidine Research Group

17 Should the Intent of Testing Influence Its Interpretation? Alan Rozanski, George A. Diamond, James S. Forrester, Daniel S. Berman, Denise Morris, Robert H. Jones, Robert Okada, Michael Freeman, H. J. C. Swan

CLINICAL STUDIES

25 Selective Thromboxane A2 Synthetase Inhibition in Vasospastic Angina Pectoris. Yoshiki Yui, Ryuichi Hattori, Yoshiki Takatsu, Chuichi Kawai

30 Editorial Comment Vasospastic Angina: A Continuing Search for Mechanism(s). Gottlieb C. Friesinger, Rose Marie Robertson

32 Coronary Flow Reserve Provided by Sequential Internal M!lmmary Artery Grafts. John McB. Hodgson, Arun K. Singh, Thomas M. Drew, Raymon S. Riley, David O. Williams

38 Circulit Weight Training in Cardiac Patients. Michael H. Kelemen, Kerry J. Stewart, Ronald E. Gillilan, Craig K. Ewart, Stephen A. Valenti, John D. Mqnley, Mark D. Kelemen

METHQDS

43 Nonilllvasive Study of the Presystolic Component of the First Heart Sound in Mitral Stenosis. Yoshiyuki Hada, Keiko Amano, Tsuneo Yamaguchi, Katsu Takenaka, Hisako Takahashi, Reiko Takikawa, Ichiro Hasegawa, Toshiyuki Takahashi, Junichi Suzuki, Tsuguya Sakamoto, Tsuneaki Sugimoto

51 Editorial Comment Presystolic Murmur of Mitral Stenosis Revisited. Morton E. Tavel

53 Noninvasive Identification of Left Main and Triple Vessel Coronary Artery Disease: Improved Accuracy Using Quantitative Analysis of Regional Myocardial Stress Distribution and Washout of Thallium-201. Jamshid Maddahi, Alnoor Abdulla, Ernest V. Garcia, H. J. C. Swan, Daniel S. Berman

61 Reverse Redistribution of Thallium-20l: A Sign of Nonb'ansmural Myocardial Infarction With Patency of the Infarct-Related Coronary Artery. A. Teddy Weiss, Jamshid Maddahi, Allan S. Lew, P. K. Shah, William' Ganz, H. J. C. Swan, Daniel S. Berman

68 Myocardial Relaxation in Atrial Fibrillation. Yasuyuki Nakamura, Takashi Konishi, Hiroshi Nonogi, Tsunetaro Sakurai, Shigetake Sasayama, Chuichi Kawai

74 Isovolumic Relaxation Period in Hypertrophic Cardiomyopathy: Assessment by Radionuclide Angiography. Sandro Betocchi, Robert O. Bonow, Stephen L. Bacharach, Douglas R. Rosing, Barry J. Maron, Michael V. Green

82 Semiquantitative Grading of Severity of Mitral Regurgitation by Real-Time Two-Dimensional Doppler Flow Imaging Technique. Kunio Miyatake, Shiro Izumi, Mitsunori Okamoto, Naokazu Kinoshita, Hirohiko Asonuma, Hiroshi Nakagawa, Katsuhiro Yamamoto, Makoto Takamiya, Hiroshi Sakakibara, Yasuharu Nimura

89 Editorial Comment Real-Time Two-Dimensional Doppler Flow Imaging: A Word of Caution. Martin E. Goldman

EXPERIMENT AL STUDIES

91 Healing After Myocardial Infarction in the Dog: Changes in Infarct Hydroxyproline and Topography. Bodh I. Jugdutt, Roger W. M. Amy

103 Assessment of Coronary Stenoses by Myocardial Perfusion Imaging During Pharmacologic Coronary Vasodilation. VII. Validation of Coronary Flow Reserve as a Single Integrated Functional Measure of Stenosis Severity Reflecting All Its Geometric Dimensions. Richard L. Kirkeeide, K. Lance Gould, Linda Parse I

114 Editorial Comment Efforts Toward Quantitation of Coronary Artery Functional Capacity. Edmund M. Herrold, Jeffrey S. Borer

116 Electrophysiologic Effects of the Levo- and Dextrorotatory Isomers of Sotalol in Isolated Cardiac Muscle and Their in Vivo Pharmacokinetics. Rinya Kato, Nobuo Ikeda, Steven M. Yabek, Ramaswamy Kannan, Bramah N. Singh

126 Effect of Exercise on Acute Myocardial Infarction in Rats. Judith S. Hochman, Bernadine Healy

PEDIATRIC CARDIOLOGY

133 Arrhythmias After the Mustard Operation for Transposition of the Great Arteries: A Long-Term Study. Constance J. Hayes, Welton M. Gersony

138 Use of Cardiac Pacing After the Mustard Operation for Transposition of the Great Arteries. Paul C. Gillette, Deborah G. Wampler, Cathleen Shannon, David Ott

REPORTS ON THERAPY

142 QT Prolongation and the Antiarrhythmic Efficacy of Amiodarone. Vilma Torres, David Tepper, David Flowers, Jonathan Wynn, Stanley Lam, Deborah Keefe, Dennis S. Miura, John C. Somberg

148 Acute and Chronic Effects of Amiodarone on Ventricular Refractoriness, Intraventricular Conduction and Ventricular Tachycardia Induction. Fred Morady, Lorenzo A. DiCarlo, Jr., Ryszard B. Krol, Jeffrey M. Baerman, Michael de Buitleir

158 Symptomatic "Isolated" Carotid Sinus Hypersensitivity: Natural History and Results of Treatment With Anticholinergic Drugs or Pacemaker. Dec/an D. Sugrue, Bernard J. Gersh, David R. Holmes, Jr., Douglas L. Wood, Michael J. Osborn, Stephen C. Hammill

DIAGNOSTIC TECHNIQUES

163 Trallsesophageal Two-Dimensional Echocardiography for the Detection olf Left Atrial Appendage Thrombus. Wolfgang Aschenberg, Michael Schluter, Peter Kremer, Erwin Schroder, Volker Siglow, Walter Bleifeld

167 Characterization of Retrograde Conduction by Direct Emlocardial Recording From an Accessory Atrioventricular Pathway. William G. 0' Callaghan, Paul G. Colavila, G. Neal Kay, Kenneth A. Ellenbogen, Marcel R. Gilbert, Lawrence D. German

CASE REPORTS

172 Regression in Thromboembolic Type of Primary Pulmonary Hypertension During 21/2 Years of Antithrombotic Therapy. Marc Cohen, William D. Edwards, Valentin Fuster

176 Paroxysmal Fascicular Tachycardia and Ventricular Tachycardia Due to Mechanical Stimulation by ~ Mitral Valve Prosthesis. Sung Soon Kim, Jose Gallastegui, William J. Welch, Robert A. Bauernfeind

180 Atrioventricular Block Complicating Amiodarone•Induced Hypothyroidism in a Patient with Pre-excitation and Rate Dependent Bilateral Bundle Branch Block. Lucia Mangiardi, Fiorenza Gaila, Susanna Brun, Patrizia Presbitero, Koonlawee Nademanee, Bramah N. Singh

185 Reduced Acetylation of Procainamide by Para•aminobenzoic Acid. Eric S. Nylen, Andrew I. Cohen, Marc H. Wish, John 1. Lima, James D. Finkelstein

SYMPOSIUM ON THE ATHLETE HEART. Barry J. Maron, Stephen E. Epstein, Guest Editors

189 Introduction. Barry J. Maron, Stephen E. Epstein

190 Structural Features of the Athlete Heart as Defined by Echocardiography. Barry J. Maron

204 Causes of Sudden Death in Competitive Athletes. Barry J. Maron, Stephen E. Epstein, William C. Roberts

215 Exercise: A Risk for Sudden Death in Patients With Coronary Heart Disease. Leonard A. Cobb, W. Douglas Weaver

220 Sudden Death and the Competitive Athlete: Perspectives on Preparticipation Screening Studies. Stephen E. Epstein, Barry J. Maron

231 Mitral Valve Prolapse: Definition and Implications in Athletes. Robert M. Jeresaty

237 Tachyarrhythmias in Young Athletes. Aldo Coelho, Edwin Palileo, William Ashley, Steven Swiryn, A. Tom Petropoulos, William J. Welch, Robert A. Bauernfeind

EDITORIALS

244 The Continuing Problem 9f Retracted Papers. Simon Dack

246 LETTERS TO THE EDITOR

ACC NEWS

248 President's Page. William W. Parmley

FEBRUARY 1986 VOLUME 7 NUMBER 2

COOPERATIVE STUDIES

251 Persantine-Aspirin Reinfarction Study. Part II. Secondary Coronary Prevention With Persantine and Aspirin. Prepared for the Investigator Group by Christian R. Klimt, Gene!! L. Knatterud, Jeremiah Stamler, Paul Meier

CLINICAL STUDIES

270 Left Ventricular Mechanical Efficiency in Coronary Artery Disease. Allen B. Nichols, Mulva H. Pearson, Robert R. Sciacca, Paul J. Cannon

280 Editorial Comment Cardiac Efficiency and Coronary Heart Disease. John Ross, Jr.

282 Editorial Comment Left Ventricular Mechanical Efficiency in Coronary Artery Disease. Joel S. Karliner

284 Hemodynamic Differentiation of Pathologic and Physiologic Stenosis in Mitral Porcine Bioprostheses. Lawrence S. C. Czer, Richard J. Gray, Timothy M. Bateman, Michele A. DeRobertis, Kenneth Resser, Aurelio Chaux, Jack M. Matloff

295 The Electrocardiogram in Obesity: Statistical Analysis of 1,029 Patients. Stuart Frank, Jerry A. Colliver, Arthur Frank

300 Recurrent Acute Pericarditis: Follow-Up Study of 31 Patients. Noble O. Fowler, A. Daniel Harbin III

METHODS

307 Assessment of Pericardial Constraint: The Relation Between Right Ventricular Filling Pressure and Pericardial Pressure Measured After Pericardiocentesis. Otto A. Smiseth, Michael A. Frais, Iris Kingma, Alan V. M. White, Merril L. Knudtson, James M. Cohen, Dante E. Manyari, Eldon R. Smith, John V. Tyberg

315 Editorial Comment Measuring Pericardial Constraint. Ralph Shabetai

317 Quantitative Assessment of Regional Left Ventricular Motion Using Endocardial Landmarks. Cornelis J. Slager, Ton E. H. Hooghoudt, Patrick W. Serruys, Johan C. H. Schuurbiers, Johan H. C. Reiber, Geert T. Meester, Pieter D. Verdouw, Paul G. Hugenholtz

327 Edlitorial Comment Assessment of Regional Myocardial Function. William Grossman

REPORTS ON THERAPY

329 Effort Angina With Adequate Beta-Receptor Blockade: Comparispn With Diltiazem Alone and in Combination. Dennis P. Humen, Pamela O'Brien, Paul Purves, Donald Johnson, William J. Kostuk

336 Editorial Comment Combination Therapy for Angina Pectoris. Joel S. Karliner

338 Mexiletine and Tocainide: Does Response to One Predict Response to the Other? Michael Hession, Richard Blum, Philip J. Podrid, Steven Lampert, Joseph Stein, Bernard Lown

REPORTS ON HYPERTENSION

344 Acute and Chronic Sympathetic Reflex Activation and AIIItihypertensive Response to Nifedipine. Wolfgang Kiowski, Paul Erne, Osmund Bertel, Peter Bolli, Fritz Biihler

MORPHOLOGIC STUDIES

349 Infarct Expansion: Pathologic Analysis of 204 Patients With a Single Myocardial Infarct. John S. Pirolo, Grover M. Hutchins, G. William Moore

PEDIATRIC CARDIOLOGY

355 Sensitivity, Specificity and Predictive Value of Two•Dimensional Echocardiography in Detecting Coronary Artery Aneurysms in Patients With Kawasaki Disease. Thomas E. Capannari, Stephen R. Daniels, Richard A. Meyer, David C. Schwartz, Samuel Kaplan

361 Hypoplastic Left Heart Syndrome: Report of a Unique Survivor. Martin Ehrlich, Fredrick Z. Bierman, Kent Ellis, Welton M. Gersony

REVIEWS

366 Left Main Coronary Artery Originating From the Right Sinus of Valsalva anlt Coursing Between the Aorta and Pulmonary Trunk. Charles W. Barth III, William C. Roberts

374 Inltraoperative Two-Dimensional Echocardiography: New Application of an Old Technique~ Martin E. Goldman, Bruce P. Mindich

EXPERIMENTAL STUDIES

383 Contrast Echocardiography in Acute Myocardial Ischemia. III. An in Vivo Comparison of the Extent of Abnormal Wall Motion With the Area at Risk for Necrosis. Sanjiv Kaul, Natesa G. Pandian, Linda D. Gillam, John B. Newell, Robert D. Okada, Arthur E. Weyman, with the technical assistance of Donna Lutrario

393 Editorial Comment Acute Myocardial Ischemia: From Tennant and Wiggers to Contrast Echocardiography. William F. Armstrong

395 Editorial Comment Promise and Status of Myocardial Contrast-Enhanced Two-Dimensional Echocardiography: Delineation of Ischemic Risk Zone and Quantitation of Myocardial Perfusion Defects. Samuel Meerbaum

397 Effect of Lidocaine and Bretylium on Energy Requirements for Transthoracic Defibrillation: Experimental Studies. Richard E. Kerber, Natesa G. Pandian, Susan R. Jensen, Luis Constantin, Robert A. Kieso, Jef/rey Melton, Michelle Hunt

406 Action and Localization of Vasoactive Intestinal Peptide in the Coronary Circulation: Evidence for Nonadrenergic, Noncholinergic Coronary Regulation. Jose M. Brum, Alfred A. Bove, Qian Sufan, William Reilly, Vay L. W. Go

414 Afferent Reinnervation of the Autotransplanted Heart in Dogs. Pramod K. Mohanty, Marc D. Thames, John R. Capehart, Akira Kawaguchi, Bruce Bailon, Richard R. Lower

419 Myocardial Norepinephrine, Epinephrine and Dopamine Concentrations After Cardiac Autotransplantation in Dogs. Pramod K. Mohanty, James R. Sowers, Marc D. Thames, Fran W. J. Beck, Akira Kawaguchi, Richard R. Lower

DIAGNOSTIC TECHNIQUES

425 Right Atrial Flow Topography in Healthy Subjects Studied With Real Time Two-Dimensional Doppler Flow Imaging Technique. Kunio Miyatake, Shiro Izumi, Akihiko Shimizu, Naokazu Kinoshita, Mitsunori Okamoto, Hiroshi Sakakibara, Yasuharu Nimura

432 Flexible Fiberoptic Pericardioscopy for the Diagnosis of Pericardial Disease. George T. Kondos, Stuart Rich, Sidney Levitsky

CASE REPORTS

435 Coronary Artery Venous Bypass Graft Aneurysm With Symptomatic Coronary Artery Emboli. Charles P. Taliercio, Hugh C. Smith, James R. Pluth, Raymond J. Gibbons

438 Unruptured Sinus of Valsalva Aneurysm With Right Ventricular Outflow Obstruction Diagnosed by Two•Dimensional and Doppler Echocardiography. Robert W. Kiefaber, Burton S. Tabakin, Laurence H. Coffin, Thomas C. Gibson

443 Congenital Aneurysm of the Left Sinus of Valsalva With an Aortopulmonary Tunnel. Daniel Scagliotti, Elizabeth A. Fisher, Barbara J. Deal, David Gordon, Eva V. Chomka, Bruce H. Brundage

EDITORIALS

446 Coronary Artery Spasm: The Pendulum Continues Swinging. Robert A. Chahine

449 LETTERS TO THE EDITOR

450 CORRECTIONS

ACC NEWS

451 President's Page. William W. Parmley

FEBRUARY 1986 VOLUME 7 NUMBER 2 (SUPPLEMENT A)

Abstracts of Papers to Be Presented at the 35th Annual Scientific Session of the American College of Cardiology, Atlanta, Georgia, March 9-13, 1986

lA Abstracts

253A Acknowledgments

255A Author Index

265A SUbject Index

MARCH 1986 VOLUME 7 NUMBER 3

CLINICAL STUDIES

455 Effect of Coronary Occlusion During Percutaneous Transluminal Angioplasty in Humans on Left Ventricular Chamber Stiffness and Regionai Diastolic Pressure•Radius Relations. William Wijns, Patrick W. Serruys, Cornelis J. Slager, Joerg Grimm, Hans P. Krayenbuehl, Paul G. Hugenholtz, Otto M. Hess

464 Extent and Severity of Myocardial Hypoperfusion as Predictors of Prognosis in Patients With Suspected Coronary Artery Disease. Marc L. Ladenheim, Brad H. Pollock, Alan Rozanski; Daniel S. Berman, Howard M. StaniloJf, James S. Forrester, George A. Diamond

472 Angiographic Evolution of Coronary Artery Morphology in Unstable Angina. John A. Ambrose, Stephen L. Winters, Rohit R. Arora, Angie Eng, Albert Riccio, Richard Gorlin, Valentin Fuster

479 Seven Year Survival of Patients With Normal or Near Normal Coronary Arteriograms: A CASS Registry Study. Harvey G. Kemp, Richard A. Kronmal, Ronald E. Vlietstra, Robert L. Frye and participants in the Coronary Artery Surgery Study

BISHOP LECTURE

484 The Electrocardiogram 80 Years After Einthoven. Hein J. 1. Wellens

EPIDEMIOLOGIC STUDIES

492 Characteristics and Prognosis of Incomplete Right Bundle Branch Block: An Epidemiologic Study. Youlian Liao, Linda Ann Emidy, Alan Dyer, John S. Hewitt, Richard B. Shekelle, Oglesby Paul, Ronald Prineas, Jeremiah Stamler

METHODS

501 Noninvasive Assessment of Valve Area in Patients With Aortic Stenosis. Jan Ohlsson, Bengt Wranne

509 Determination of the Stenotic Aortic Valve Area in Adults Using Doppler Echocardiography. Catherine M. Otto, Alan S. Pearlman, Keith A. Comess, Robyn P. Reamer, Carolyn L. Janko, Lee L. Huntsman

518 Noninvasive Assessment of Left Ventricular Diastolic Functiol1: Comparative Analysis of Doppler Echocardiographic and Radionuclide Angiographic Techniques. Paolo Spirito, Barry J. Maron, Robert O. Bonow

527 Determination of the Quantitative Thallium Imaging Variables That Optimize Detection of Coronary Artery Disease. Sanjiv Kaul, Charles A. Boucher, John B. Newell, David A. Chesler, Joshua M. Greenberg, Robert D. Okada, H. William Strauss, Robert E. Dinsmore, Gerald M. Pohost

538 Abnormal Thallium Kinetics in Postoperative Coarctation of the Aorta: Evidence for Diffuse Hypertension-Induced Vascular Pathology. Brian P. Kimball, Bette L. Shurvell, Richard R. Mildenberger, Sylvain Houle, Peter R. McLaughlin

546 Endocardial Photoablation by Excimer Laser. Eugene Downar, Jagdish Butany, Anthony Jares, Boris P. StoicheJf

EXPERIMENTAL STUDIES

551 Coronary Venous Retroinfusion of Procainamide: A New Approach for the Management of Spontaneous and Inducible Sustained Ventricular Tachycardia During Myocardial Infarction. Hrayr S. Karagueuzian, Masao Ohta, 1. Kevin Drury, Michael C. Fishbein, Samuel Meerbaum, Eliot Corday, William J. Mandel, Thomas Peter, with the technical assistance of Avile McCullen

564 Effects of Staged Versus Sudden Reperfusion After Acute Coronary Occlusion in the Dog. Shigeru Yamazaki, Yozo Fujibayashi, Ram E. Rajagopalan, Samuel Meerbaum, Eliot Corday

573 Sodium Nuclear Magnetic Resonance Imaging of Myocardial Tissue of Dogs After Coronary Artery Occlusion and Reperfusion. Paul J. Cannon, Andrew A. Maudsley, Sadek K. Hilal, Howard E. Simon, Frederick Cassidy

580 Reversal of Dysfunction in Postischemic Stunned Myocardium by Epinephrine and Postextrasystolic Potentiation. Lewis C. Becker, Joseph H. Levine, Anthony F. DiPaula, Thomas Guarnieri, Thomas Aversano

CARDIAC PACING

590 Selective Atrial Sensing in Dual Chamber Pacemakers Eliminates Endless Loop Tachycardia. peter T. Klementowicz, Seymour Furman

595 Effect of Variation in PQ Interval on Patterns of Atrioventricular Valve Motion and Flow in Patients With Normal Ventricular Function. Roger A. Freedman, Paul G. Yock, Debra S. Echt, Richard L. Popp

PEDIATRIC CARDIOLOGY

603 Temporal Flow Velocity Profile in the Descending Aorta in Coarctation. Stephen P. Sanders, Debbie MacPherson, Scott B. Yeager

610 Hypoplastic Left Heart Syndrome: Is Echocardiography Accurate Enough to Guide Surgical Palliation? Stephen E. Bash, James C. Huhta, G. Wesley Vick Ill, Howard P. Gutgesell, David A. Ott

617 Subaortic Obstruction in Complex Congenital Heart Disease: Management by Proximal Pulmonary Artery to Ascending Aorta End to Side Anastomosis. Angela E. Lin, Hillel Laks, Gerald Barber, Alvin J. Chin, Roberta G. Williams

625 Two-Dimensional Echocardiographic Diagnosis of Pulmonary Artery Sling in Infancy. Scott B. Yeager, Alvin J. Chin, Stephen P. Sanders

630 Pulmonary Atresia With Ventricular Septal Defect: Preoperative and Postoperative Responses to Exercise. Gerald Barber, Gordon K. Danielson, Francisco J. Puga, Charles T. Heise, David J. Driscoll

HYPERTENSION

639 The Prevalence and Correlates of Echocardiographic Left Ventricular Hypertrophy Among Employed Patients With Uncomplicated Hypertension. Isaac W. Hammond, Richard B. Devereux, Michael H. Alderman, Elizabeth M. Lutas, Mariane C. Spitzer, Joan S. Crowley, John H. Laragh

651 Double-Blind Comparison of Captopril and Enalapril in Mild to Moderate l!ypertension. Peter H. Vlasses, Dale P. Conner, Heschi H! f!.otmensch, Richard J. Fruncillo, Janice R. Danzeisen, Kenneth J. Shepley, Roger K. Ferguson

REPORTS ON THERAPY

661 Survival of Patients With Severe Congestive Heart Failure Treated With Oral Milrinone. Donald S. Baim, Wilson S. Colucci, E. Scott Monrad, Harton S. Smith, Richard F. Wright, Alyce Lanoue, Diane F. Gauthier, Bernard 1. Ransil, William Grossman, Eugene Braunwald

671 Role of the Renin-Angiotensin System in the Development of Hemodynamic and Clinical Tolerance to Long-Term Prazosin Therapy in Patients With Severe Chronic Heart Failure. Milton Packer, Norma Medina, Madeline Yushak

DIAGNOSTIC TECHNIQUES

681 Doppler Echocardiographic Evaluation of Hancock and Bjork-Shiley Prosthetic Valves. Kiran B. Sagar, L. Samuel Wann, Walter H. J. Paulsen, Donald W. Romhilt

688 Noninvasive Tissue Characterization: Diagnosis of Lipomatous Hypertrophy of the Atrial Septum by Nuclear Magnetic Resonance Imaging. Robert A. Levine, Arthur E. Weyman, Robert E. Dinsmore, James Southern, Bruce R. Rosen, David E. Guyer, Thomas J. Brady, Robert D. Okada

693 Atrial Contraction is an Important Determinant of Pulmonary Venous Flow. Gad Keren, Alan Bier, Jack Sherez, Dennis Miura, Deborah Keefe, Thierry LeJemtel

CASE REPORTS

696 Aneurysm of the Left Aortic Sinus Caused by Takayasu's Arteritis: Compression of the Left Coronary Artery Producing Coronary Insufficiency. Takeshi Nakano, Hideji Okano, Tokuji Konishi, Hideo Takezawa

701 Cardiac Arrest in an Adolescent With Atrial Fibrillation and Hypertrophic Cardiomyopathy. Wayne J. Stafford, Richard G. Trohman, Martin Bilsker, Liaqat Zaman, Agustin Castellanos, Robert 1. Myerburg

EDITORIALS

705 Laser Angioplasty: Unraveling the Gordian Knot. Jeffrey M. Isner, Richard H. Clarke

709 Nuclear Magnetic Resonance Imaging: With or Without Nuclear? Gerald M. Po host, Gabriel A. Elgavish, William T. Evanochko

711 The Coronary Sinus: An Alternate Channel for Administration of Arterial Blood and Pharmacologic Agents for Protection and Treatment of Acute Cardiac Ischemia. Eliot Corday, Samuel Meerbaum, J. Kevin Drury

ACC NEWS

715 Newly Elected Members of the College

APRIL 1986 VOLUME 7 NUMBER 4

COOPERATIVE STUDIES

717 Early Thrombolysis in Acute Myocardial Infarction: Limitation of Infarct Size and Improved Survival. Maarten L. Simoons, Patrick W. Serruys, Marcel van den Brand, Jan Res, Freek W. A. Verheugt, X. Hanno Krauss, Willem J. Remme, Frits Bar, Chris de Zwaan, Arnoud van der Laarse, Frank Vermeer, Jacobus Lubsen, for the Working Group on Thrombolytic Therapy in Acute Myocardial Infarction of the Netherlands Interuniversity Cardiology Institute

729 Preservation of Global and Regional Left Ventricular Function After Early Thrombolysis in Acute Myocardial Infarction. Patrick W. Serruys, Maarten L. Simoons,

Haryanto Suryapranata, Frank Vermeer, William Wijns, Marcel van den Brand, Frits Bar, Chris Zwaan, X. Hanno Krauss, William J. Remme, Jan Res, Freek W. A. Verheugt, Ronald van Domburg, Jacobus Lubsen, Paul G. Hugenholtz, for the Working Group on Thrombolytic Therapy in Acute Myocardial Infarction of the Netherlands Interuniversity Cardiology Institute

CLINICAL STUDIES

743 Acute Thrombotic Obstruction With Disc Valve Prostheses: Diagnostic Considerations and Fibrinolytic Treatment. Laurent D. Ledain, Joiil P. Ohayon, J. P.

Colle, Fram;oise M. Lorient-Roudaut, Raymond P. Roudaut, Pierre M. Besse

752 Factors Influencing Survival After Out-of-Hospital Cardiac Arrest. W. Douglas Weaver, Leonard A. Cobb, Alfred P. Hallstrom, Carol Fahrenbruch, Michael K. Copass, Roberta Ray

758 Contribution of Vasopressin to Vasocopstriction in Patients With Congestive Heart Failure: Comparison With the Renin-Angiotensin System and the Sympathetic Nervous System. Mark A. Creager, David P. Faxon, Sally S. Cutler, Osvaldo Kohlmann, Thomas J. Ryan, Haralambos Gavras

766 Editorial Comment Pathophysiologic Relevance of Neurohumoral Measurements in Chronic Q:eart Failure. Thierry H. LeJemtel

768 Diastolic Mitral Regurgitation in Patients With Atrioventricular Conduction Abnormalities: A Common Finding by Doppler Echocardiography. Ioannis P. Panidis, John Ross, Brian Munley, Pasquale Nestico, Gary S. Mintz

METHODS

775 Noninvasive Assessment of Coronary Stenoses by Myocardial Perfusion Imaging During Pharmacologic Coronary Vasodilation. VIII. Clipical Feasibility of Positron Cardiac Imaging Without a Cyclotron Using Generator-Produced Rubidium-82. K. Lance Gould, Richard A. Goldstein, Nizar A. Mullani, Richard L. Kirkeeide, Wai-Hoi Wong, Timothy J. Tewson, Marc S. Berridge, Leonqrd A. Bolomey, Ross K. Hartz, Richard W. Smalling, Francisco Fuentes, Akira Nishikawa

790 Editorial Comment Positron Tomography and Coronary Flow Reserve: Toward a More Sophisticated Understanding of Coronary Artery Disease. Alan G. Wasserman

793 Detection of Skeletal Muscle Hypoperfusion During Exercise Using Phosphorus-31 Nuclear Magnetic Resonance Spectroscopy. David H. Wiener, John Maris, Britton Chance, John R. Wilson

800 Instantaneous Pressure Gradient: A Simultaneous Doppler and Dual Catheter Correlative Study. Philip J. Currie, Donald J. Hagler, James B. Seward, Guy S. Reeder, Derek A. Fyfe, Alfred A. Bove, A. Jamil Tajik

807 Prospective Evaluation of the Left Main Coronary Artery Using Digital Two-Dimensional Echocardiography. Thomas Ryan, William F. Armstrong, Harvey Feigenbaum

813 In Vivo Validation of the Origin of the Esophageal Electrocardiogram. Philip F. Binkley, Charles A. Bush, Bruce L. Fleishman, Carl V. Leier

819 Reproducibility of Arrhythmia Induction With Intracardiac Electrophysiologic Testing: Patients With Clinical Sustained Ventricular Tachyarrhythmias. Peter J. Kudenchuk, Jack Kron, Charles G. Walance, Edward S. Murphy, Cynthia D. Morris, Karen K. Griffith, John H. McAnulty

829 Editorial Comment Inducibility and Reproducibility of Veptricular Arrhythmias: Therapeutic Implications. J. Anthony Gomes

832 BOOKS RECEIVED

EXPERIMENTAL STUDIES

833 Cellular Electrophysiologic Changes and "Arrhythmias" During Experimental Ischemia and Reperfusion in Isolated Cat Ventricular Myocardium. Shinichi Kimura,

Arthur L. Bassett, Nadir C. Saoudi, John S. Cameron, Patricia L. Kozlovskis, Robert J. Myerburg

843 Serial Imaging of Canine Myocardial Infarction by in Vivo Nuclear Magnetic Resonance. Peter W. Pflugfelder, Gerald Wisenberg, Frank S. Prato, Katherine L. Turner, S. Edwin Carroll

850 Inducible Sustained Ventricular Tachycardia and Ventricular Fibrillation in Conscious Dogs With Isolated Right Ventricular Infarction: Relation to Infarct Structure. Hrayr S. Karagueuzian, Kaoru Sugi, Masao Ohta, Michael C. Fishbein, William J. Mandel, Thomas Peter, with the technical assistance of Avile McCullen

859 Twenty-Four Hour Survival in a Canine Model of Cardiac Arrest Comparing Three Methods of Manual Cardiopulmonary Resuscitation. Karl B. Kern, Alice B. Carter, Russel L. Showen, William D. Voorhees III, Charles F. Babbs, Willis A. Tacker, Gordon A. Ewy

868 Effects of Prednisolone on Acute Viral Myocarditis in Mice. Nobuyoshi Tomioka, Chiharu Kishimoto, Akira Matsumori, Chuichi Kawai

PEDIATRIC CARDIOLOGY

873 Comparison of High Pulse Repetition Frequency and Contin~ous Wave DOPPler Echocardiography for Velocity Measurement and Gradient Prediction in Children With Valvular and Congenital Heart Disease. A. Rebecca Snider, J. Geoffrey Stevenson, James W. French, Albert P. Rocchini, MacDonald Dick II, Amnon Rosenthal, Dennis C. Crowley, Robert H. Beekman, Jane Peters

880 Doppler Echocardiographic Estimation of Systolic Pulmonary Artery Pressure in Patients With Aortic•Pulmonary Shunts. Gerald R. Marx, Hugh D. Allen, Stanley J. Goldberg

886 Editorial Comment The Optimal Doppler Examination: Pulsed, Continuous Wave or Both? Patricia C. Come

889 Doppler and Two-Dimensional Echocardiographic Observations of Systolic Anterior Motion of the Mitral Valve in d-Transposition of the Great Arteries: An Explanation of the Left Ventricular Outflow Tract Gradient. Eugenio Moro, Folkert J. ten Cate, Conny Tirtamart, James J. Leonard, Jos Roelandt

894 Mucocutaneous Lymph Node Syndrome (Kawasaki Disease): Delayed Aortic and Mitral Insufficiency Secondary to Active Valvulitis. Samuel S. Gidding, Stanford T. Shulman, Michel Ilbawi, Frank Crussi, C. Elise Duffy

LASER THERAPY

898 Use of Pulsed Energy Delivery to Minimize Tissue Injury Resulting From Carbon Dioxide Laser Irradiation of Cardiovascular Tissues. Lawrence I. Deckelbaum, Jeffrey M. Isner, Roberta F. Donaldson, Sylvie M. Laliberte, Richard H. Clarke, Deeb N. Salem

909 A New Model to Study Quantitative Effects of Laser Angioplasty on Human Atherosclerotic Plaque. Marc E. Shelton, Ben Hoxworth, James A. Shelton, Renu Virmani, Gottlieb C. Friesinger

~YPERTENSION

916 Similarities and Differences in the Antihypertensive Effect of Two Calcium Antagonist Drugs, Verapamil and Nifedipine. Enrico Agabiti-Rosei, Maria L. Muiesan, Giuseppe Romanelli, Maurizio Castellano, Marina Beschi, Luigi Corea, Giulio Muiesan

CARDIAC PACING

925 Comparative Survival After Permanent Ventricular and Dual Chamber Pacing for Patients With Chronic High Degree Atrioventricular Block With and Without Preexistent Congestive Heart Failure. Martin A. Alpert, Jack J. Curtis, John F. Sanfelippo, Greg C. Flaker, Joseph T. Walls, Vaskar Mukerji, Daniel Villarreal, S. K. Katti, Niall P. Madigan, Ryszard B. Krol

933 Combined Bipolar Dual Chamber Pacing and Automatic Implantable Cardioverter/Defibrillator. Rodolphe Ruff';, Roop Lal, Nicholas T. Kouchoukos, Sung Soon Kim

REPORTS ON THERAPY

938 Utility of Ambulatory Electrocardiographic Monitoring for Predicting Recurrence of Sustained Ventricular Tachyarrhythmias in Patients Receiving Amiodarone. Neil M. Sokoloff, Scott R. Spielman, Allan M. Greenspan, Alan P. Rae, Patricia M. Brady, Harold R. Kay, Leonard N. Horowitz

DIAGNOSTIC TECHNIQUES

942 Venous Systolic Thrill and Murmur in the Neck: A Consequence of Severe Tricuspid Insufficiency. M orteza Amidi, James M. Irwin, Rosemarie Salemi, Steven J. Lavine, James R. Zuberbuhler, James A. Shaver, Donald F. Leon

946 Quantitation of Shunting at the Atrial Level Using. Rapid Acquisition Computed Tomography With Comparison With Cardiac Catheterization. Robert M. MacMillan, Michael R. Rees, W. Jay Eldredge, Vladir Maranhao, Donald L. Clark

CASE REPORTS

949 Echocardiographic Demonstration of Outlet Strut Fracture of a Bjork-Shiley Mitral Prosthesis. James A. Goldstein, Robert P. Zucker, Bradford Y. Lee

953 SuccessfUl Medical Therapy of Mitral Anular Abscess Complicating Infective Endocarditis. Richard L. Kunis, Mark V. Sherrid, 1. Brandt McCabe, Michael H. Grieco, Edward M. Dwyer, Jr.

956 Malignant Fibrous Histiocytoma Complicating Mitral Valve Replacement. Eliezer Holtzman, Ginette Schiby, Pesach Segal, Israel Priel

961 LETTERS TO THE EDITOR

962 CORRECTION

ACC NEWS

963 1986-1987 Board of Governors

965 President's Page: What Should a Specialist Be? John Ross, Jr.

MA Y 1986 VOLUME 7 NUMBER 5

CLINICAL STUDIES

967 Myocardial Mechanics in Hyperthyroidism: Importance of Left Ventricular Loading Conditions, Heart Rate and Contractile State. Ted Feldman, Kenneth M. Borow, David H. Same, Alex Neumann, Roberto M. Lang

975 Prevalence and Severity Of Mitral Regurgitation in the Mitral Valve Prolapse Syndrome: A Doppler Echocardiographic Study of 80 Patients. Ioannis P. Panidis, Michael McAllister, John Ross, Gary S. Mintz

982 Effects of Physical Deconditioning After Intense Endurance Training on Left Ventricular Dimensions and Stroke Volume. Wade H. Martin lll, Edward F. Coyle, Susan A. Bloomfield, Ali A. Ehsani

990 Prevalence and Severity of Circumflex Coronary Artery Disease in Electrocardiographic Posterior Myocardial Infarction. Edward W. Bough, Kenneth S. Korr

997 Isolated Coronary Ostial Stenosis in Women. Richard Thompson

METHODS

1004 Value and Limitation of Biplane Rest and Exercise RadionucIide Angiography for Assessing Individual Bypass Grafts: A Prospective Study. Michael B. Higginbotham, Robert N. Belkin, Kenneth G. Morris, R. Edward Coleman, Frederick R. Cobb

EXPERIMENTAL STUDIES

1015 Intracavitary Electrode Catheter Cardioversion of Atrial Tachyarrhythmias in the Dog. David N. Dunbar, H. Gareth Tobler, Joseph Fetter, Charles C. Gornick, D. Woodrow Benson, Jr., David G. Benditt

1028 Comparison of an Implanted Abdominal Aortic Counterpulsation Device With the Intraaortic Balloon Pump in a Heart Failure Model. John N. Nanas, Jay W. Mason, Yoshiyuki Taenaka, Don B. Olsen

1036 Experimental Exercise-Induced Ischemia: Drug Therapy Can Eliminate Regional Dysfunction and Oxygen Supply•Demand Imbalance. Brian D. Guth, Tsukasa Tajimi, Rainald Seitelberger, Jong-Dae Lee, Masunori Matsuzaki, John Ross, Jr.

1047 Disparity of Reperfusion Arrhythmias After Reversible Myocardial Ischemia in Open Chest and Conscious Dogs. Roberto Bolli, Mary Lee Myers, Wei-Xi Zhu, Robert Roberts

1057 Regional Myocardial Blood Flow in Experimental Myocardial Infarction After Pretreatment With Aspirin. Wolfgang Ruf, Glenn T. Suehiro, Anthony Suehiro, J. Judson McNamara

MORPHOLOGIC STUDIES

1063 Etiology of Pure Tricuspid Regurgitation Based on Anular Circumference and Leaflet Area: Analysis of 45 Necropsy Patients With Clinical and Morphologic Evidence of Pure Tricuspid Regurgitation. Bruce F. Waller, Ann T. Moriarty, John N. Eble, Diane M. Davey, Dean A. Hawley, John E. Pless

CARDIAC PACING

1075 The Automatic Implantable Cardioverter-DefibriIlatot: Evaluating Suspected Inappropriate Shocks. Peter D. Chapman, Paul Troup

1079 Hemodynamic Influences on Sinus Node Recovery Time: Effects of Autonomic Blockade. Peter C. Nalos, Zhaowen Deng, Mark E. Rosenthal, Eli S. Gang, Daniel S. Oseran, William J. Mandel, Thomas Peter

PEDIATRIC CARDIOLOGY

1087 Exercise Tolerance and Cardiorespiratory Response to Exercise After the Fontan Operation for Tricuspid Atresia or Functional Single Ventricle. David J. Driscoll, Gordon K. Danielson, Francisco J. Puga, Hartzell V. Schaff, Charles T. Heise, Bruce A. Staats

1095 Nuclear Magnetic Resonance Imaging in Evaluation and Follow-Up of Children Treated for Coarctation of the Aorta. Robert A. Boxer, Michael A. LaCorte, Sharanjeet Singh, Rubin Cooper, Marcia C. Fishman, Mitchell Goldman, Harry L. Stein

1099 Progressive Obstruction of the Foramen Ovale in Patients With Left Atrioventricular Valve Atresia. Thomas J. Starc, Welton M. Gersony

1104 Evaluation of Pulmonary Vascular Resistance in the Presence of a Large Pulmonary Arteriovenous Malformation. Robert N. Vincent, Oscar G. Casiro, Andrew N. Pelech, George F. N. Collins

REPORTS ON THERAPY

1107 Systemic and Coronary Effects of Intravenous Milrinone and Dobutamine in Congestive Heart Failure. Richard Grose, Janet Strain, Mark Greenberg, Thierry H. LeJemtel

1114 Comparative Antiarrhythmic Efficacy of VerapamiI, 17-Monochloracetylajmaline, Mexiletine and Amiodarone in Patients With Severe Chagasic Myocarditis: Relation With the Underlying Arrhythmogenic Mechanisms. Alejandro H. Haedo, Pablo A. Chiale, Jorge D. Bandieri, Julio O. Lazzari, Marcelo V. Elizari, Mauricio B. Rosenbaum

1121 Effect of Encainide and Flecainide on Chronic Ectopic Atrial Tachycardia. Klaus-Peter Kunze, Karl-Heinz Kuck, Michael Schluter, Walter Bleifeld

1127 Flecainide and Amiodarone Interaction. Patrick Shea, Roop Lal, Sung Soon Kim, Kenneth Schechtman, Rodolphe Ruffy

1131 Procainamide Pharmacokinetics in Patients With Acute Myocardial Infarction or Congestive Heart Failure. Kenneth M. Kessler, David S. Kayden, Daneil M. Estes, Patricia L. Koslovskis, Rafael Sequeira, Richard G. Trohman, Andres R. Palomo, Robert J. Myerburg

BASIC CONCEPTS IN CARDIOLOGY Arnold M. Katz, Guest Editor

1140 Quantitative Structural Analysis of the Myocardium During Physiologic Growth and Induced Cardiac Hypertrophy: A Review. Piero Anversa, Roberto Ricci, Giorgio Olivetti

DIAGNOSTIC TECHNIQUES

1151 Utility of Echocardiography in the Management of Patients With Penetrating Missile Wounds of the Heart. Alycia Hassett, Jon Moran, David C. Sabiston, Joseph Kisslo

1157 Echocardiographic Abnormalities and Disease Severity in Fabry's Disease. Martin E. Goldman, Richard Cantor, Marcia F. Schwartz, Maureen Baker, Robert J. Desnick

1162 Reversibility of Long-Standing Left Ventricular Aneurysm Predicted by Thailium-201 Imaging. Warren M. Breisblatt, David L. Brown, Frederick L. Weiland

CASE REPORTS

1167 Echocardiographic Identification of an Aortic Valve Ring Abscess. Scott J. Pollak, Joel M. Feiner

1174 Intracardiac Thrombus Causing Peritoneovenous Shunt Failure: Detection by Two-Dimensional Echocardiography. Valentina Ugolini, James F. Norcross, J. Tracy Schreiber, Richard E. Kuntz, Anne L. Taylor

1177 Hemodynamic Compromise (Tricuspid Stenosis and Insufficiency) Caused by an Unruptured Aneurysm of the Sinus of Valsalva. Kenneth L. Gibbs, Michael J. Reardon, Neil E. Strickman, Carlos M. de Castro, Joseph A. Gerard, James L. Rycyna, Robert J. Hall, Denton A. Cooley

1182 LETTERS TO THE EDITOR

JUNE 1986 VOLUME 7 NUMBER 6

EDITORIAL

1187 On the Training of Cardiologists. J. Willis Hurst

1191 17TH BETHESDA CONFERENCE: Adult Cardiology Training. Robert C. Schlant, Conference Chairman

1192 Participants

1195 Introduction. Robert C. Schlant

1196 Task Force I: Training in Clinical Cardiology. Robert L. Frye, William W. Parmley, Bruce Brundage, Nicholas Fortuin, Noble O. Fowler, Valentin Fuster, W. Proctor Harvey, J. Willis Hurst, John W. Joyce, Charles E. Rackley, Elliot Rapaport, Richard J. Reitemeier, Richard O. Russell, Jr., Thomas J. Ryan, Donald E. Saunders, Jr.

1201 Task Force II: Training in Electrocardiography. Charles Fisch, E. William Hancock, Paul L. McHenry, Arthur Selzer, Peter M. Yurchak

1205 Task Force III: Training in Cardiac Catheterization. C. Richard Conti, David P. Faxon, Andreas Gruentzig, Rolf M. Gunnar, Michael Lesch, T. Joseph Reeves

1207 Task Force IV: Training in Echocardiography. Anthony N. DeMaria, Michael H. Crawford, Harvey Feigenbaum, Richard L. Popp, A. Jamil Tajik

1209 Task Force V: Training in Nuclear Cardiology and Nuclear Magnetic Resonance. Gerald M. Pohost, Robert J. Adolph, George A. Beller, Jack W. Fleming, James L. Ritchie

1213 Task Force VI: Training in Cardiac Pacing. J. Warren Harthorne, Victor Parsonnet

1215 Task Force VII: Arrhythmias and Specialized Electrophysiologic Studies. Jeremy N. Ruskin. Nancy C. Flowers. Mark E. Josephson. Shahbudin H. Rahimtoola

1217 Task Force VIII: Training in Cardiovascular Research. Eugene Braunwald. Harry A. Fozzard. Donald C. Harrison. Robert A. O·Rourke. John T. Shepherd. Burton E. Sobel

CLINICAL STUDIES

i219 Determinants of the Spontaneous Ectopic Activity in Repetitive Monomorphic Idiopathic Ventricular Tachycardia. Marc Zimmermann. Pierre Maisonblanche. Bruno Cauchemez. Jean-Fran

DIAGNOSTIC STUDIES

1392 Intracardiac Electrode Catheter Recordings of Atrioventricular Bypass Tracts in Wolff-Parkinson-White Syndrome: Techniques, Electrophysiologic Characteristics and Demonstration of Concealed and Decremental Propagation. Stephen L. Winters, J, Anthony Gomes

1404 Bundle Branch Reentrant Tachycardia Treated by Electrical Ablation of the Right Bundle Branch. Paul Touboul, Gilbert Kirkorian, Georges Atallah, Pierre Lavaud, Pierre Moleur, Michel Lamaud, Marie P. Mathieu

CASE REPORTS

1410 Percutaneous Mitral Valvuloplasty in an Adult Patient With Calcific Rheumatic Mitral Stenosis. Raymond G. McKay, James E. Lock, John F. Keane, Robert D. Safian, Julian M. Aroesty, William Grossman

1416 Percutaneous Transvenous Balloon Valvotomy in a

Patient With Severe Calcific Mitral Stenosis. Igor F. Palacios, James E. Lock, John F. Keane, Peter C. Block

EDITORIAL

1420 The Use of Catheter Intervention Procedures for Congenital Heart Disease. James E. Lock, John F. Keane, Kenneth E. Fellows

1424 LETTERS TO THE EDITOR

ACC NEWS

1426 1986-1987 Committee Appointments

INDEXES

1430 Author Index: Volume 7

1433 Subject Index: Volume 7