Eight patients with isolated ventricular septal defect and two patients with tetralogy of Fallot were studied by UCG. Two of, these patients showed notchings and five showed flutterings on F-A portions of the anterior mitral leaflet echoes. Fluttering seemed to be recorded more frequently in patients with right-to-left shunts such as cyanotic tetralogy of Fallot. It was considered that these functional changes of mitral valve echoes during diastole would be caused by the direction and amounts of blood now across the defect and the velocity and amounts of blood flow through the mitral valve. Fluttering of mitral valve echo during diastole may be observed in normal subjects or in patients with other cardiac abnormalities, such as aortic insufficiency, atrial fibrillation or flutter. Flutterings seen in ventricular septal defect and tetralogy of Fallot are, however, of low amplitudes and of high frequencies, and are observed mainly between F and A points.

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Intravenous (I.V.) injection of 0.1mg/kg of ADP within one second in 13 rats caused a prompt drop in platelet count to 55.1±3.2% of the preinjection value with a statistical significance (p < 0.01) at 30 seconds after the injecttion. At that time, mean arterial pressure and arterial PO₂ decreased, while central venous pressure increased. Heart rate decreased with an appearance of sinus bradycardia and variable A-V block. Various respiratory effects such as shallow or slow respiration or apnea appeared. Such changes showed a tendency to recovery within 3 minutes. Splenectomy did not prevent these changes in 6 rats. In 6 thrombocytopenic and leukopenic rats treated with busulfan, these changes did not appear. Intra-arterial injection of the same amount of ADP induced almost no response. When ADP was injected twice 20 seconds apart in 10 rats, the second injection resulted in no effects or slight responses. In contrast, when 10 rats were injected twice 180 seconds apart, both the first and second injections showed the same effects on platelets and cardiopulmonary functions. The results suggest that the effects observed following I.V. ADP are probably due to transient obstruction of coronary and pulmonary microvessels by platelet aggregates. Reduced response following two successive injections may be due either to the reduced platelet count or to a refractory state induced by, the first injection. ADP is probably rapidly metabolized in systemic microvascular beds.

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Over the past decade, many procedures have been developed for the assessment of cardiac function in man. Several workers, using intracardiac pressure and precordial movement, have studied the correlation between both techniques. The purpose of this report is to document the observation that the left ventricular component of apexcardiogram (ACG) and carotid pulse tracing formance measured by intracardiac pressure. The author have recorded simultaneous apex-cardiogram, corotid pulse tracing and left ventricular pressure curves at rest. pressure curves at rest. Materials and Methods: A total of 45 patients were studied, of whom 24 were hypertensive patients, 13 coronary heart disease and 8 miscellaneous diseases. The ages of those suffering from various heart diseases were between 16 and 61, with a median of 42. Left ventricular pressure and its first derivative dp/dt were recorded by an No. 8 Kifa catheter introduced via femoral artery. Indirect determinations were made from simultaneous recordings of phonocardiograms, carotid pulse, apexcardiogram and electrocardiogram. All data were recorded on a multichannel recorder at a paper speed of 100mm/sec with time lines indicating 10 msec. Results: 1) Correlation between a wave ratio and LVEDP. Highly significant correlations were observed between a wave ratio and LVEDP. The 4 patients with normal LVEDP (≤ 14 mmHg) had high a wave ratio ( ≥ 12%). 2) Correlations among PEP, ICT and Vpm, Vmax. A statistically significant corelation was observed between PEP and Vpm or Vmax (r=-0.419, p<0.01). The correlations of ICT with Vpm and Vmax were significantly high (r= 0.473, p<0.01 ).

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Echocardiographic study was designed to evaluate the slopes and amplitudes of anterior mitral valve motion (anterior mitral valve echogram, AMVE) in 100 patients (pts) with Ischemic Heart Disease (IHD). The results were compared with those of 53 normal subjects. Soon after the Echocardiographic study, the P terminal force (PTF) was determined from the P wave in lead V₁ and the calculated PTF was attempted to correlate with each velocity of the AMVE. Sudjects and Methods; 23 pts with Myocardial Infarction (MI) (3 recent and 20 remote), 8 pts with angina Pectoris (AP) and 69 pts without the symptom of Ischemic Cardiac Pain (ICP), whose ages ranged from 43 to 81 years (yrs) with a mean age of 61 yrs underwent echocardiographic study. Criteria for diagnosis of pts without the symptom of ICP were as follows: 1) diminution of amplitude of the T wave (T/QRS ratio of less then 10%) 2) ischemic S-T segment depression 1.0mm or greater 3) a depression of S-T segment greater than 0.5mm at the point of 0.04 second after the J junction. Those who satisfied the Master's criteria of Master's single two-step test were also included in the group, if the above mentioned criteria were not satisfied. 18 chronic hypertensive subjects under good control with salt restriction and antihypertensive drugs were included in the group and neither those with valvular heart disease nor those with cardiomyopathy were included. Those with papillary muscle dysfunction syndrome were not included in the pts with AP or MI and those with clinical ecidence of congestive heart failure were excluded from the pts without the symptom of ICP. Finally, subjects who had any signs or X-ray evidence suggestive of chronic obstructive pulmonary disease were excluded from the study. Electrocardiograms showed normal sinus rhythm with no P-R prolongation.

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