A comparison of the hemodynamics in six months old female SHR and normotensive ones, on the basis of cardiac output, heart rate, blood pressure and organ blood flow data is presented. Compared to the normotensive rats the SHR showed highly elevated values of systolic, diastolic and mean blood pressures, Lower values of the heart rate, and cardiac output but elevated total peripheral resistance. Distribution of the cardiac output was nearly equale in normotensive and SHR except the heart, where the flow-fraction was nearly doubled. Considerable differences were found in organ flows if expressed as in ml per 1g of tissue. Skeletal muslce, uterus, thyroid gland and kidneys have lower blood supply in SHR.

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The clinical and pathophysiological features of 41 patients with advanced pure mitral insufficiency of rheumatic origin, were investigated and statistical analysis of the hemodynamic parameters was made with special reference to their correlations. 1. A history compatible with acute rheumatic fever was obtained in 31 patients (75.6 per cent). The average age at the time of initial attack was 13.1 years and the asymptomatic intervals averaged 6.8 years. 2. Exertional dyspnea (95 per cent), palpitation (78 per cent) and excess fatigability (76 per cent) were the early and most common symptoms of the patients. 3. In addition to the loud apical pansystolic murmur constantly present, a middiastolic murmur was heard in 33 patients (.81 per cent). A third sound or diastolic gallop sound was present in over a half of the patients (56 per cent). 4. Auricular fibrillation was found in over two-thirds of the patients (68 per cent). Patients with auricular fibrillation was older and had longer duration of the disease in comparison with those of sinus rhythm. The average period since first attack of rheumatic fever or equivalents was 15 years in patients with auricular fibrillation. The majority of patients revealed electrocardiographic evidence of combined ventricular hyper-trophy (54 per cent) and right ventricular hypertrophy alone was observed in 5 per cent of patients. 5. The cardiac size as expressed by cardio-thoracic ratio ranged from 0.52 to 0.87 with an average of 0.70 and marked cardiomegaly (cardio-thoracic ratio exceeding 0.81) was noted in 7.5 per cent of the patients. Giant left atrium was present in 1 2.8 per cent of the cases. 6. The cardiac index ranged from 2.0 to 4.5 L/min/M2 BSA with an average of 3.1 and low cardiac index (less than 2.6 L/min/M2 BSA) was encountered in 37 per cent of patients. 7. The peak systolic pressure in the pulmonary artery ranged from 25 to 105 mmHg, averaging 55; the mean pressure varied from 14 to 65 with an average of 37. Moderately severe to severe pulmonary hypertension (pulmonary-systemic peak systolic ratio of over 0.7) was observed in 17 per cent of patients. The total pulmonary resistance ranged from 286 to 2, 329 dynes sec. cm^-5 with an average of 81 5. The values in excess of 1, 300 dynes sec. cm^-5 was noted in 17 per cent of patients. 8. The various hemodynamic parameters were analysed in relation to duration of the disease and degree of the mitral insufficiency, and factors influencing pulmonary vascular reactivity were assessed in addition. The pressure-volume relationships of the left side of the heart in rheumatic mitral insufficiency were complex. Myocardial malfunction secondary to the under-lying rheumatic process as well as to increased myocardial burden because of the presence of mitral insufficiency, size and compliance of the left atrium and presence or absence of auricular fibrillation might greatly influence and shape the total cardiac dynamics. The possible interrelationships between mitral regurgitant flow and pulmonary vascular reactivity were also discuss-ed. 9. The most reliable method for estimating the severity of mitral insufficiency was selective left ventriculography. With no exception, the severity could be graded as 3 plus or greater in a total of 30 patients in whom the diagnosis was confirmed at surgery. 10. Selected pathological findings obtained at surgery were reported and the status of rheumatic fever as well as the prevalence of cardiac involvement in this subtropical or tropical zone was sepculated.

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Myocardial infarction frequently occurs suddenly, and the prediction of its onset is said to be difficult. However, concept of coronary risk factors have drawn attention through epidemiological studies on ischemic heart disease. Since anginal pain is frequently experienced prior to the attack of myocardial infarction, pursuit of coronary risk factors and angina pectoris makes prediction of myocardial infarction possible to Results and Discussion some extent. Materials and Methods In 11, 188 cases of ambulant and hospitalized patients and subjects admitted for examination, follow-up studies by questionaires and direct examination were carried out. Prognosis was established in 3, 851 cases. 2621 cases of these after exclusion of young subjests below the age of 30 and insufficiently examined subjects, and 110 cases observed from pre-attack period in other institutions, a total of 2, 731 cases, were employed in this study. They were subdivided in following three groups: group of 265 cases of myocardial infarction (MI) (208 males and 57 females), group of 215 cases of angina pectoris (AP) (132 males and 83 females) and group of 2, 251 cases of control subjects (CS) (1 .253 males and 998 females). In MI group, 165 cases (132 males and 33 females) had experienced anginal attack prior to (MIA), AP group consisted of the patients of angina pectoris without subsequent development of myocardial infarction for at least one year of follow-up period. Coronary risk factors were compared among MI group, AP group and CS group. Moreover, these factors and clinical course of angina pectoris were also compared between AP group and MIA group. There were little difference in average age among these groups.

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The ballistocardiogram (BCG) or finger plethysmogram (FPG) is one of the bloodless examination methods related to cardiovascular dynamics. The effects of amyl nitrite and methoxamine on BCG, FPG and ECG (electrocardiogram) were studied in order to find out the mechanisms constructing ballistocardiographic waves. Materials and Methods: Seventy healthy persons without cardio-pulmonary diseases were divided into 2 groups: Group I, consisting of 40 young persons less than 35 years of age; and Group 2, consisting of 30 older persons over 50 years of age. The longitudinal BCG through von Wittern's sublow-frequency table, FPG and ECG w, ere recorded simultaneously while holding the breath, before 0.25 ml amyl nitrite inhalation for 15 seconds, and 15, 30, 45, 60 and 90 seconds after the beginning of the inhalation. In 10 minutes after the inhalation, the BCG, FPG and ECG returned to their original levels. Then they were recorded again before the 25-second intravenous injection of 0.08 mg/Kg methoxamine and 30 seconds, 1, 2, 3 and 5 minutes after the beginning of the injection. The effects of the agents were controlled by FPG and ECG. Twenty items (14 items in the longitudinal BCG, 5 items in the FPG and one item in the ECG) were selected from the findings of the records obtained. These items were measured and calculated for the study. The heights of H, I, J, K and N, the amplitudes of HI, IJ, JK and LM, the amplitude ratios of HI/IJ, JK/IJ and LM/IJ, and the times of Q-J and Q-N were measured as usual in longitudinal BCG. Q-J time meant the time from the beginning of the Q wave in the ECG to the tip of J wave in BCG. Q-N time had similar meaning. The tip of the FPG wave was named "B", the incisura named "C", the starting point of the FPG wave on the base line named "S", the amplitude of the wave named "b", and the height of the incisura named "c". The "c/b" was called incisura ratio. "b", "c", "c/b", "SB time" and "SC time" were measured and calculated. R-R time only was measured in ECG.

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