CONTENTS OF VOLUME 6

JULY 1985 VOLUME 6 NUMBER 1

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CLINICAL STUDIES

Dynamic Subaortic Obstruction in Hypertrophic Cardiomyopathy: Analysis by Pulsed Doppler Echocardiography. Barry J. Maron, John S. Gottdiener, Javier Arce, Douglas R. Rosing, Yvonne E. Wesley, Stephen E. Epstein

Editorial Comment

Dynamic Subaortic Obstruction in Hypertrophic Cardiomyopathy: Criteria and Controversy.

. -Robert A. Levine. Arthur E. Weyman

Use of Clinical Data in Predicting Improvement in Exercise Capacity After Cardiac Rehabilitation. H. Kirk Hammond, Tamsin Lisa Kelly, Victor F. Froelicher, William Pewen

Prognostic Significance of Normal Quantitative Planar Thallium-201 Stress Scintigraphy in Patients With Chest Pain. Frans J. Th. Wackers, Donald J. Russo, Debra Russo, John P. Clements

Electrophysiologic Testing in Patients at High Risk for Sudden Cardiac Death. I. Nonsustained Ventricular Tachycardia and Abnormal Ventricular Function. Scott R. Spielman, Allan M. Greenspan, Harold R. Kay, Kathy F. Discigil. Charles R. Webb, Neil M. Sokoloff, Alan P. Rae, Joel Morganroth, Leonard N. Horowitz

Editorial Comment

Role of Ventricular Ectopic Activity in Sudden Death. Hein J. J. Wellens

"Ischemia at a Distance" During Intermittent Coronary Artery Occlusion: A Coronary Anatomic Explanation. James F. Brymer, Fareed Khaja, Mario Marzilli, Sidney Goldstein, with the technical assistance of John Alban

Editorial Comment

Ischemia at a Distance-So Close Yet So Far. Richard O. Cannon III

Surgical Repair of Uncomplicated Atrial Septal Defect Without "Routine" Preoperative Cardiac Catheterization. Clarence Shub, A. Jamil Tajik, James B. Seward, Donald J. Hagler, Gordon K. Danielson

METHODS

Evaluation of Aortic Stenosis by Spectral Analysis of the Murmur. Gary R. Johnson, Gordon S. Myers, Robert S. Lees

Editorial Comment

Frequency Content of Systolic Murmurs: An Answer to the Riddle of Aortic Stenosis? Morton E. Tavel

66 Superiority of Two-Dimensional Measurement of Aortic Vessel Diameter in Doppler Echocardiographic Estimates of Left Ventricular· Stroke Volume. Julius M. Gardin, Jonathan M. Tobis, Ali Dabestani, Craig Smith, Uri Elkayam, Eric Castleman, Don White, Alice Allfie, Walter L. Henry

75 Assessment of Single Vessel Coronary Artery Disease: Results of Exercise Electrocardiography, Thallium-201 Myocardial Perfusion Imaging and Radionuclide Angiography. Steven C. Port, Motoo Oshima, Gautam Ray, Patrick McNamee, Donald H. Schmidt

84 Dopami;e: 'Its Potential for I~ducing IschemiC Left Ventricular Dysfunction. Gerald W isenberg, Andrew G. Zawadowski. Vernon A. Gebhardt, Frank S. Prato, Michele D. Goddard, PeterM. Nichol, Peter A. Rechnitzer

93 Coronary Angioscopy During Cardiac Catheterization. 1. Richard Spears, Artur M. Spokojny, H. John Marais

EXPERIMENT AL STUDIES 99 Importance of the Pacing Mode.in the Initiation of

Ventricular Tachyarrhythmia in a Canine Model of Chronic Myocardial Infarction. Hideo Mitamura, Ole-Jorgen Ohm, Eric L. Michelson, Charles Sauermelch, Leonard S. Dreifus

104 Relation Between Left Ventricular Global and Regional Function and Extent of Myocardial Ischemia in the Canine Heart. Makoto Akaishi, Ricky M. Schneider, Richard 1. Mercier, Franco F. Naccarella, Jai B. Agarwal, Richard H. Helfant, William S. Weintraub

113 Importance' of the Duration of Inadequate Coronary Perfusion Pressure on Resuscitation From Cardiac Arrest. Arthur B. Sanders, Karl B. Kern, Matthew Atlas, Steven Bragg, Gordon A. Ewy

119 Independent and Interactive Effects of Digoxin and Quinidine on the Atrial Fibrillation Threshold in Dogs. Robert L. Gold, George B. Bren, Richard J. Katz, P. Jacob Varghese, Allan M. Ross

124 Reentrant Ventricular Arrhythmias in the Late Myocardial Infarction Period. 12. Spontaneous Versus Induced Reentry and Intramural Versus Epicardial Circuits. Nabil El-Sherif. William B. Gough, Robert H. Zeiler, Robert Hariman

133 Inhibition of Premature Ventricular Extrastimuli by Subthreshold Conditioning Stimuli. Brian T. Skale, Michael J. Kallok, Eric N. Prystowsky, Robert M. Gill, Douglas P. Zipes

141 Failure of a Slow Channel Calcium Antagonist, Verapamil, to Retard Atherosclerosis in the Watanabe Heritable Hyperlipidemic Rabbit: An. Animal Model of Familial Hypercholesterolemia. Gregory D. Tilton. L. Maximilian Buja, David W. Bilheimer, Phillip Apprill, Juliet Ashton, Janice McNatt, Toru Kita, James T. Willerson

145 Measurement of Myocardial Infarction Fraction Editorial Comment Using Single Photon Emission Computed

213 Management of Sustained Ventricular Tomography. Christopher L. Wolfe, Samuel E. Lewis, Tachycardia. M. Mirowski, Morton M. Mower, James R. Corbett, Robert W. Parkey, L. Maximilian Philip R. Reid Buja, James T. Willerson 152 Occurrence and Transmission of Localized

Repolarization Abnormalities In Vitro. Joel BASIC CONCEPTS IN CARDIOLOGY Kupersmith, Peter Hoff

215 The Oxygen Free Radical System: Potential Mediator Editorial Comment of Myocardial Injury. Billy Hammond, Michael L.

161 A New Look at Repolarization Abnormalities and Hess Arrhythmias. Allan M. Greenspan

PEDIATRIC CARDIOLOGY

221 Prevention of Sudden Death After Repair of REPORTS ON THERAPY Tetralogy of Fallot: Treatment of Ventricular

163 Acute and Long-Term EtTects of Enalapril on the Arrhythmias. Arthur Garson, Jr., David C. Randall, Cardiovascular Response to Exercise and Exercise Paul C. Gillette, Richard T. Smith, Jeffrey P. Moak, Pat Tolerance in Patients With Congestive Heart Failure. McVey, Dan G. McNamara Mark A. Creager, Barry M. Massie, David P. Faxon,

228 Results of the Modified Fontan Operation for Scott D. Friedman, Barry L. Kramer, Donald A. Weiner, Thomas J. Ryan, Nina Topic, Caroline D. Congenital Heart Lesions in Patients Without

Melidossian Preoperative Sinus Rhythm. Ernerio T. Alboliras, Co-Burn J. Porter, Gordon K. Danielson, Francisco J.

Editorial Comment Puga, Hartzell V. Schaff, Mary J. Rice, David J. 171 Is the Renin-Angiotensin System Really Driscoll

Unnecessary in Patients With Severe Chronic 234 Ductus Arteriosus Aneurysm Presenting as Heart Failure: The Price We Pay for Interfering Pulmonary Artery Obstruction: Diagnosis and With Evolution. Milton Packer Management. Raymond R. Fripp, Victor Whitman,

174 Absence of Rebound From DiItiazem Therapy in John A. Waldhausen, Danielle K. Boal Prinzmetal's Variant Angina. John S. Schroeder,

Anomalous Left Coronary Artery From the Steve D. Walker, M. Lorie Skalland, Judith A. 237 Hemberger Pulmonary Artery: Significance of Associated

179 Rate-Dependent EtTects of Intravenous Lidocaine, Intracardiac Defects. Carol M. Cottrill, Daron Davis, Marilyn McMillen, William N. O'Connor, Jaqueline A.

Procainamide and Amiodarone on Intraventricular Noonan, Edward P. Todd Conduction. Fred Morady, Lorenzo A. DiCarlo, Jr., Jeffrey M. Baerman, Ryszard B. Krol

CASE REPORTS

243 Accelerated Atherosclerosis in a Cardiac Transplant HYPERTENSION Patient. Robert S. Nitkin, Sharon A. Hunt, John S.

186 Cardioselective and Nonselective Beta-Adrenoceptor Schroeder

Blocking Drugs in Hypertension: A Comparison of 246 Extracardiac Left to Right Shunt in a Patient With Their EtTect on Blood Pressure During Mental and Biventricular Postinfarction Rupture and Physical Activity. John S. Floras, M. Osman Hassan, Pseudoaneurysm. Luigi Chiariello, Francesco Macrina, John Vann Jones, Peter Sleight Quintilio Caretta, Francesco S. Leonardi Cattolica, Ugo

Papalia, Benedetto Marino

250 Right Coronary Spasm Complicating Electrode

CARDIAC PACING Catheter Ablation of a Right Lateral Accessory

Noninvasive Assessment of Pacemaker Pathway. Geoffrey O. Hartzler, Lee V. Giorgi, Antoni

196 M. Diehl, William R. Hamaker Hemodynamics by Doppler Echocardiography:

Ventricular Tachycardia and Sudden Death in Importance of Left Atrial Size. Arthur J. Labovitz, 254 George A. Williams, Robert M. Redd, Harold L. Myotonic Dystrophy: Clinical, Electrophysiologic and Kennedy Pathologic Features. Leeanne E. Grigg, William Chan,

201 Automatic Pacemaker Termination of Two DitTerent Harry G. Mond, Jitu K. Vohra, William F. Downey

Types of Supraventricular Tachycardia. Karel den 257 VerapamiI-Induced Polymorphous Ventricular Dulk, Pedro Brugada, Bernd Waldecker, Malcolm Tachycardia. Stephen L. Winters, Paul Schweitzer, joel Begemann, Tom van der Schotte Olivier, Hein J. 1. Kupersmith, Joseph A. Gomes Wellens

206 Permanent Triggered Antitachycardia Pacemakers in 260 LETTERS TO THE EDITOR the Management of Recurrent Sustained Ventricular

ACC NEWS Tachycardia. John M. Herre, Jerry C. Griffin, Anton P. Nielsen. David E. Mann, Jerry C. Luck. Sharon A. 262 President's Page. William W. Parmley

Magro, Terry Scheunemeyer, Christopher R. C. 264 Philip Reichert, MD, FACC, 1897-1985. Wyndham Louis Faugeres Bishop

AUGUST 1985 VOLUME 6 NUMBER 2

CLINICAL STUDIES 336 Sustained Regional Abnormalities in Cardiac

267 Amelioration by Nitroglycerin of Left Ventricular Metabolism After Transient Ischemia in the Chronic

Ischemia Induced by Percutaneous Transluminal Dog Model. Markus Schwaiger, Heinrich R. Schelbert,

Coronary Angioplasty: Assessment by Hemodynamic Douglas Ellison, Herbert Hansen, Lawrence Yeatman,

Variables and Left Ventriculography. Andrew J. Jacob Vinten-Johansen, Carl Selin, Jorge Barrio, M. E.

Doorey, Helmuth C. Mehmel, Franz X. Schwarz. Phelps

Wolfgang Kubler 348 BOOKS RECEIVED

275 Silent Myocardial Ischemia: Hemodynamic Changes During Dynamic Exercise in Patients With Proven

METHODS Coronary Artery Disease Despite Absence of Angina Pectoris. Heinz O. Hirzel, Ruth Leutwyler. Hans P. 349 Tomographic Gated Blood Pool Radionuclide Krayenbuehl Ventriculography: Analysis of Wall Motion and Left

Ventricular Volumes in Patients With Coronary 285 Angiographic Occurrence and Clinical Correlates of Artery Disease. James R. Corbett, Donald E. Jansen,

Intraluminal Coronary Artery Thrombus: Role of Samuel E. Lewis, Gregory I. Gabliani, Pascal Nicod, Unstable Angina. Dennis R. Bresnahan. James L. Neil G. Filipchuk. Gregory A. Redish, Marvin S. Davis. David R. Holmes. Jr.. Hugh C. Smith Akers, Christopher L. Wolfe, James S. Rellas, Robert

W. Parkey, James T. Willerson 290 Significance of the Pericardium in Human Subjects:

Effects on Left Ventricular Volume, Pressure and 359 Quantitative Assessment of Pulmonary Hypertension Ejection. Dennis T. Mangano, Donald C. Van Dyke. in Patients With Tricuspid Regurgitation Using Robert F. Hickey, Robert J. Ellis Continuous Wave Doppler Ultrasound. Marvin

2% Editorial Comment: Threshold of Pericardial Berger. Azriel Haimowitz, Andrew Van Tosh, Russell

Constraint: The Pericardial Reserve Volume and L. Berdoff. Emanuel Goldberg

Auxiliary Pericardial Functions. David H. Spodick 366 Editorial Comment: Increasing Importance of

298 Determinants of the Outcome of Electrophysiologic Doppler Echocardiography. Harvey Feigenbaum

Study in Patients With Ventricular Tachyarrhythmias. Mark H. Schoenfeld. Brian MORPHOLOGIC STUDIES McGovern, Hasan Garan. Elizabeth Kelly, Gail Grant. Jeremy N. Ruskin 369 Intimal Proliferation of Smooth Muscle Cells as an

307 Ventricular Arrhythmias After Coronary Artery Explanation for Recurrent Coronary Artery Stenosis After Percutaneous Transluminal Coronary

Bypass Graft Surgery: Incidence, Risk Factors and Angioplasty. Garth E. Austin. Norman B. Ratliff, Jay Long-Term Prognosis. David A. Rubin. Karen E. Hollman, Seyed Tabei, Daniel F. Phillips Nieminski, Judith C. Monteferrante, Thomas Magee. George E. Reed, Michael V. Herman

PEDIATRIC CARDIOLOGY

376 A Possible Increase in the Incidence of Congenital Heart Defects Among the Offspring of Affected

EXPERIMENT AL STUDIES Parents. Vera Rose. Reynold John Morley Gold, Gail Lindsay. Marylin Allen

311 Retention and Clearance of C-Il Palmitic Acid in Ischemic and Reperfused Canine Myocardium. 383 Two-Dimensional Echocardiographic Findings in Markus Schwaiger, Heinrich R. Schelbert, Randy Keen. Double Orifice Mitral Valve. Eckardt Trowitzsch. Jacob Vinten-Johansen, Herbert Hansen, Carl Selin. Antonio Bano-Rodrigo, Bruno M. Burger, Steven D. Jorge Barrio, Sung-Cheng Huang, Michael E. Phelps Colan. Stephen P. Sanders

321 Histamine-Induced Spasm Not Significantly 388 Two-Dimensional Echocardiographic Evaluation of Modulated by Prostanoids in a Swine Model of Right Ventricular Size and Function in Newborns Coronary Artery Spasm. Hiroaki Shimokawa. With Severe Right Ventricular Outflow Tract Hitonobu Tomoike, Shozo Nabeyama, Hideo Obstruction. Eckardt Trowitzsch. Steven D. Colan, Yamamoto, Motoomi Nakamura Stephen P. Sanders

328 Synchronized Diastolic Coronary Venous 394 Histologic Studies on Normal and Persistent Ductus Retroperfusion: Results of a Preclinical Safety and Arteriosus in the Dog. Adriana C. Gittenberger-de Efficacy Study. J. Kevin Drury, Shigeru Yamazaki, Groot. Jan L. M. Strengers. Monica Mentink, Robert E. Michael C. Fishbein, Samuel Meerbaum, Eliot Corday Poelmann, Donald F. Patterson

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510

REPORTS ON THERAPY Spencer H. Kubo, Daniel Leonard, Paul Daly, Howard

Treatment of Atrial Automatic Tachycardia by Rutman

Ablation Procedures. Paul C. Gillette, Deborah G. Wampler. Arthur Garson. Jr., Alex Zinner. David Ott, REVIEWS Denton Cooley 461 The Automatic Implantable Cardioverter-

Limitations of Failure of Procainamide During Defibrillator: An Overview. M. Mirowski

Electrophysiologic Testing to Predict Response to DIAGNOSTIC TECHNIQUES Other Medical Therapy. Alan P. Rae. Neil M.

Sokoloff. Charles R. Webb. Scott R. Spielman, Allan 467 Echocardiographic Manifestations of Tense M. Greenspan, Leonard N. Horowitz Pericardia! Effusion. Charles Z. Naggar, William D.

Diagnostic and Therapeutic Use of Adenosine in Dillon, John R. Butterly, Robert F. Malacoff

Patients With Supraventricular Tachyarrhythmias. 471 M-mode Echocardiography in Constrictive John P. DiMarco. T. Duncan Sellers, Bruce B. Lerman, Pericarditis. Peter J. Engel, Noble O. Fowler, Chuwa Mark L. Greenberg, Robert M. Berne, Luiz Belardinelli Tei, Pravin M. Shah, Harry J. Driedger, Ralph

Shabetai, A. Daniel Harbin. Robert H. Franch Regional Wall Motion Improvement After Coronary Thrombolysis With Recombinant Tissue Plasminogen 475 Isolated Prolapse of the Tricuspid Valve. David J. Activator: Importance of Coronary Angioplasty. Eric Weinreich, James F. Burke. Saroja Bharati. Maurice J. Topol. James L. Weiss. Jeffrey A. Brinker. Kenneth Lev P. Brin. Sidney O. Gottlieb. Lewis C. Becker. Bernadine H. Bulkley. Nisha Chandra, John T. Flaherty, CASE REPORTS Gary Gerstenblith, Sheldon H. Gottlieb, Alan D.

Out-of-Hospital Automatic Cardioversion of Guerci, Pamela Ouyang, Michaelene P. Llewellyn, 482 Myron L. Weisfeldt, Edward P. Shapiro Ventricular Tachycardia. Rodolphe Ruffy, Priscilla

Smith, Michael Laseter, Roop La\, Sung Soon Kim Results of a Randomized Prospective Trial of Intraaortic Balloon Counterpulsation and 486 Angioinvasive Pulmonary Aspergillosis: Presentation Intravenous Nitroglycerin in Patients With Acute as Massive Pulmonary Saddle Embolism in an Myocardial Infarction. John T. Flaherty, Lewis C. Immunocompr.omised Patient. James M. Kirshenbaum. Becker, James L. Weiss, Jeffrey A. Brinker, Bernadine Beverly H. LoreJl, Frederick J. Schoen, Michael A. H. Bulkley, Gary Gerstenblith, Clayton H. Kallman, Beumann, Geoffrey B. Thompson Myron L. Weisfeldt

490 Paradoxical Pulmonary Vasoconstriction Induced by A Dose-Ranging, Placebo-Controlled, Double-Blind Nitroglycerin in Idiopathic Pulmonary Hypertension. Trial of Nisoldipine in Effort Angina: Duration and Brian Hoit, Gabriel Gregoratos, Ralph Shabetai Extent of Antianginal Effects. Jules Lam, Bernard R. Chaitman, Peter Crean, Richard Blum, David D. Waters 493 LETTERS TO THE EDITOR

Milrinone in Congestive Heart Failure: Acute and ACC NEWS Chronic Hemodynamic and Clinical Evaluation. Charles A. Simonton, Kanu Chatterjee. Robert J. Cody, 495 President's Page. William W. Parmley

SEPTEMBER 1985 VOLUME 6 NUMBER 3

EDITORIAL REVIEWS

Nuclear Magnetic Resonance Spectroscopy: Its Evolving Role in the Study of Myocardial Metabolism. Eugene J. Barrett, Jeffry R. Alger. Barry L. Zaret

COOPERA TIVE STUDIES

Accuracy of Cardiokymography During Exercise Testing: Results of a Multicenter Study. Donald A. Weiner and Principal Investigators

Bethanidine Sulfate: Efficacy in Prevention of Ven­tricular Tachyarrhythmias During Programmed Stimulation. Report of a Multicenter Study of 56 Patients. Sam L. Teichman. Lawrence E. Waspe.

518

526

Jeffrey A. Matos, Soo G. Kim. John D. Fisher and participating members of a Multicenter Bethanidine Study

CLINICAL STUDIES

Time From Onset of Symptoms to Thrombolytic Therapy: A Major Determinant of Myocardial Salvage in Patients With Acute Transmural Infarction. Detlef G. Mathey, Florence H. Sheehan. Joachim Schofer, Harold T. Dodge

Angioplasty in Total Coronary Artery Occlusion: Experience in 76 Consecutive Patients. Dean J. Kereiakes. Matthew R. Selmon. Bruce J. McAuley. David B. McAuley. Dennis J. Sheehan. John 8. Simpson

534 Systemic Embolism in Chronic Left Ventricular 603 Spatial R Wave Amplitude Changes During Exercise: Aneurysm: Incidence and the Role of Relation With Left Ventricular Ischemia Anticoagulation. Andre C. J..,apeyre III, Peter M. and Function. Jonathan Myers, Staffan Ahnve, Steele, Francis J. Kazmier, James H. Chesebro, Victor Froelicher, Michael Sullivan Ronald E. Vlietstra, Valentin Fuster

609 Two-Dimensional Echocardiographic Monitoring

539 Discordance Between Ambulatory Monitoring and During Percutaneous Endomyocardial Biopsy.

Programmed Stimulation in Assessing Efficacy of Gregory Strachovsky, Steven M. Zeldis, Stanley Katz,

Class IA Antiarrhythmic Agents in Patients With Mary McNulty-Mackey

Ventricular Tachycardia. Soo G. Kim, Steven W. 612 Myocardial Perfusion Imaging in Humans by Seiden, Jeffrey A. Matos, Lawrence E. Waspe,

John D. Fisher Contrast Echocardiography Using Polygelin Colloid Solution. Teguh Santoso, Jos Roelandt,

545 L~ft Ventricular Diastolic Function in Elite Athletes Hans Mansyoer, Nurhay Abdurahman,

With Physiologic Cardiac Hypertrophy. Steven D. Richard S. Meltzer, Paul G. Hugenholtz

Colan, Stephen P. Sanders, Debbie MacPherson, 621 Editorial Comment: Myocardial Perfusion Imaging Kenneth M. Borow by Contrast Echocardiography: Where Are

We Going? Richard S. Meltzer

550 Increased Right Ventricular Wall Thickness in Left PEDIATRIC CARDIOLOGY Ventricular Pressure Overload: Echocardiographic

Determination of Hypertrophic Response of the 623 The Newborn Transitional Circulation: A Two-"Nonstressed" Ventricle. John S. Gottdiener, Dimensional Doppler Echocardiographic Study. Judith A. Gay, Barry J. Maron, Ross D. Fletcher Larry T. Mahoney, Kathryn G. Coryell, Ronald M.

Lauer

556 Effect of the Renin-Angiotensin System on Limb Functional Aortic Valve Atresia in Transposition of Circulation and Metabolism During Exercise in 630

Patients With Heart Failure. John R. Wilson, the Great Arteries. Alexander J. Muster, Farouk S.

Nancy Ferraro Idriss, Saroja Bharati, Thomas W. Riggs, Maurice Lev, Walter S. Culpepper III, Milton H. Paul

REPORTS ON THERAPY METHODS

635 Hemodynamic and Clinical Significance of the

565 Comparison of High Pulse Repetition Frequency and Pulmonary Vascular Response to Long-Term

Continuous Wave Doppler Echocardiography in the Captopril Therapy in Patients With Severe Chronic

Assessment of High Flow Velocity in Patients With Heart Failure. Milton Packer, Wai Hung Lee,

Valvular Stenosis and Regurgitation. William J. Norma Medina, Madeline Yushak

Stewart, Kathleen A. Galvin, Linda D. Gillam, David E. Guyer, Arthur E. Weyman CARDIAC PACING

646 Respiration-Dependent Ventricular Pacing Compared 572 Electrocardiographic Detection of Left Ventricular With Fixed Ventricular and Atrial-Ventricular

Hypertrophy: Development and Prospective Synchronous Pacing: Aerobic and Hemodynamic Vjllidation of Improved Criteria. Paul N. Casale, Variables. Paolo Rossi, Giorgio Rognoni, Eraldo Richard B. Devereux, Paul Kligfield, Occhetta, Franco Aina, Maria D. Prando, Gianni Richard R. Eisenberg, David H. Miller, Plicchi, Marco Minella Banvir S. Chaudhary, Malcolm C. Phillips

EXPERIMENT AL STUDIES

581 Interaction of "Supplementary" Scintigraphic 653 Variable Effects of Changes in Flow Rate Through Indicators of Ischemia and Stress the Aortic, Pulmonary and Mitral Valves on Valve Electrocardiography in the Diagnosis of Multivessel Area and Flow Velocity: Impact on Quantitative Coronary Disease. Behxhet Canhasi, Michael Dae, Doppler Flow Calculations. William J. Stewart, Elias Botvinick, Peter Lanzer, Norberta Schechtmann, Leng Jiang, Robert Mich, Natesa Pandian, Jose Luis Donald Faulkner, William O'Connell, Nelson Schiller Guerrero, Arthur E. Weyman

Peak Regional Acceleration: A Method to Identify 663 Editorial Comment: Determination of Cardiac

589 Output by Echocardiographic Doppler Methods: Subtle Regional Ventricular Dysfunction From Gated Relative Accuracy of Various Sites Blood Pool Scans at Rest in Patients With Coronary for Measurement. David J. Sahn Artery Disease. Robert J. Schwarzberg, David W. Seldin, Philip O. Alderson, Lynne L. Johnson 665 Effects of Experimental Myocardial Infarction on the

ST Segment Response to Tachycardia. David M. 597 Effects of Left Ventricular Asynchrony on Time Mirvis, Jack L. Wilson, Kodangudi B. Ramanathan

Constant and Extrapolated Pressure of Left Ventricular Pressure Decay in Coronary 674 Effects of Verapamil and Lidocaine in a Canine Artery Disease. Motoshi Takeuchi, Kazuhiro Fujitani, Model of Sudden Coronary Death. Peter N. Temesy-Keiji Kurogane, Hong-Tai Bai, Chuichi Toda, Armos, Mary Legenza, Stephen R. Southworth, Tohru Yamasaki, Hisashi Fukuzaki Brian F. Hoffman

682 Defibrillator Electrode-Chest Wall Coupling Agents: 701 Cardiac Function in Patients With Cystic Fibrosis: Influence on Transthoracic Impedance and Evaluation by Two-Dimensional and Doppler Shock Success. Philip E. Aylward, Robert Kieso, Echocardiography. Ioannis P. Panidis, Jian-Fang Pamela Hite, Francis Charbonnier, Richard E. Kerber Ren, Douglas S. Holsclaw, Morris N. Kotler, Gary S.

Mintz, John Ross 687 Functional and Pathologic Effects of Multiple

Echocardiographic Contrast Injections on the Myocardium, Brain and Kidney. Linda D. Gillam, CASE REPORTS Sanjiv Kaul, John T. Fallon, Robert A. Levine,

Fatal Vasculitis (Periarteritis Nodosa) of the E. Tessa Hedley-Whyte, J. Luis Guerrero, 707 Arthur E. Weyman Coronary Arteries: Angiographic Ambiguities and

Absence of Aneurysms at Autopsy. Randal S.

DIAGNOSTIC STUDIES Cassling, John B. Lortz, Daniel R. Olson, Theodore F. Hubbard, Bruce M. McManus

695 Epicardial Wall Motion and Left Ventricular Function During Coronary Graft Angioplasty in Humans. Brian E. Jaski, Patrick W. Serruys, ACC NEWS with the technical assistance of Harald ten Katen, Simon Meij 715 President's Page. William W. Parmley

OCTOBER 1985 VOLUME 6 NUMBER 4

CLINICAL STUDIES 757 Editorial Comment: Noninvasive Intracardiac

717 Lactate Production During Maximal and Submaximal Pressure Measurement Using Doppler Ultrasound.

Exercise in Patients With Chronic Heart Failure. Richard L. Popp, Paul G. Yock

Karl T. Weber, Joseph S. Janicki REPORTS ON THERAPY

725 Methionine Intolerance: A Possible Risk Factor for 759 Sustained Ventricular Tachyarrhythmias Within 2 Coronary Artery Disease. Douglas R. Murphy- Months of Acute Myocardial Infarction: Results of Chutorian, Mark P. Wexman, Anthony J. Grieco, James Medical and Surgical Therapy in Patients A. Heininger, Ephraim Glassman, Gerald E. Gaull, Resuscitated From the Initial Episode. John P. Steven K. C. Ng, Frederick Feit, Karen Wexman, DiMarco, Bruce B. Lerman, Irving L. Kron, T. Arthur C. Fox Duncan Sellers

731 Survival Aftl!r Hospital Discharge in Matched 769 Editorial Comment: Malignant Ventricular Populations With Inferior or Anterior Myocardial Arrhythmias Early After Myocardial Infarction: Infarction. Alan S. Maisel, Elizabeth Gilpin, Brian Brighter Prospects. John M. Miller, Mark E. Hoit, Martin LeWinter, Staffan Ahnve, Hartmut Josephson Henning, Daniel Collins, John Ross, Jf.

737 Echocardiographic Findings in Systemic Amyloidosis: 772 Short- and Long-Term Experience With Flecainide

Spectrum of Cardiac Involvement and Relation to Acetate in the Management of Refractory Life-

Survival. Luis Cueto-Garcia, Guy S. Reeder, Robert A. Threatening Ventricular Arrhythmias. Roop La!,

Kyle, Douglas L. Wood, James B. Seward, James Peter D. Chapman, Gerald V. Naccarrelli, Paul J.

Naessens, Kenneth P. Offord, Philip R. Greipp, William Troup, Robert L. Rinkenberger, Anne H. Dougherty,

D. Edwards, A. Jamil Tajik Rodolphe Ruffy

744 Smoke-Like Echo in the Left Atrial Cavity in Mitral 780 Clinical Evaluation of Oral Mexiletine Therapy in the Valve Disease: Its Features and Significance. Shintaro Treatment of Ventricular Arrhythmias. John C. Beppu, Yasuharu Nimura, Hiroshi Sakakibara, Seiki Rutledge, Fred Harris, Ezra A. Amsterdam, with the Nagata, Yung-Dae Park, Shiro Izumi, with the technical technical assistance of Elizabeth Skalsky assistance of Masae Ueoka, Yoshikazu Masuda, lzuru Nakasone 735 Potentiation by Nifedipine and Diltiazem of the

Hypotensive Response After Contrast Angiography.

METHODS D. Lynn Morris, Judith A. Wisneski, Edward W. Gertz, Mark Wexman, Richard Axelrod, Jonathan J. Langberg

750 Continuous Wave Doppler Determination of Right Ventricular Pressure: A Simultaneous Doppler- 792 Hemodynamic Effecls of an Oral Dopamine Receptor Catheterization Study in 127 Patients. Philip J. Agonist (Fenoldopam) in Patients With Congestive Currie, James B. Seward, Kwan-Leung Chan, Derek A. Heart Failure. James B. Young, Carlos A. Leon, Craig Fyfe, Donald J. Hagler, Douglas D. Mair, Guy S. M. Pratt, Jose M. Suarez, Robert D. Aronoff, Robert Reeder, Rick A. Nishimura, A. Jamil Tajik Roberts

797 Lack of Objective Improvement in Ventricular PEDIATRIC CARDIOLOGY Systolic Function in Patients With Myocarditis Treated With Azathioprine and Prednisone. Jeffrcy 871 Atrial Flutter in the Young: A Collaborative Study of D. Hosenpud. John H. McAnulty. Nelson R. Nib 380 Cases. Arthur Garson. Jr.. Margreet Bink-Boclkens.

Peter S. Hcsslein. Allan J. Hordof. John F. Keane. 802 Amiodarone Pulmonary Toxicity: Early Changes in William H. Neches. Co-burn J. Porter and the other

Pulmonary Function Tests During Amiodarone investigators of the Pediatric Electrophysiology Socicty Rechallenge. Enrico P. Vcltri. Philip R. Reid

879 Left Ventricular Hyperkinesia at Rest and During

806 Amiodarone in the Treatment of Life-Threatening Exercise in Normotensive Patients 2 to 27 Years

Ventricular Tachycardia: Role of Holter Monitoring After Coarctation Repair. Martha A. Carpenter. John

in Predicting Long-Term Clinical Efficacy. Enrico P. F. Dammann. Denny D. Watson. Roy Jedeikin. Dorothy

Veltri. Philip R. Reid. Edward V. Platia. Lawrcnce S. G. Tompkim. George A. Beller

C. Griffith 887 Editorial Comment: A Long Look at Surgery for

814 Amiodarone: Risk Factors for Recurrence of Coarctation of Aorta. Mary Allen Engle

Symptomatic Ventricular Tachycardia Identified at 889 Intelligence and Hypoxemia in Children With Electrophysiologic Study. Gerald V. Naccarelli. Naomi

S. Fineberg. Douglas P. Zipes. James J. Heger. Georgia Congenital Heart Disease: Fact or Artifact? Dorothy

Duncan. Eric N. Prystowsk y M. Aram. Barbara L. Ekelman. Giora Ben-Shachar. Morris W. Levinsohn

822 Editorial Comment: Amiodarone and the American 894 Percutaneous Balloon Angioplasty in an Infant With Way. Roger A. Winkle Obstructed Total Anomalous Pulmonary Vein

Return. Christian Rcy. Philippe Marache. Charles Francart. Claude Dupuis

EXPERIMENT AL STUDIES

825 Contrast Echocardiography in Acute Myocardial Ischemia. II. The Effect of Site of Injection of

SEMINAR ON CARDIAC VALVE Contrast Agent on the Estimation of Area at Risk for Necrosis After Coronary Occlusion. Sanjiv Kaul. REPLACEMENT-I. John H. K. Vogel. Guest Editor

Linda D. Gillam. Arthur E. Weyman. with thc technical assistance of J. Luis Guerrero. Christopher Slater

897 Introduction: Valve Replacement: The First Quarter 831 Artifadual Regional Gray Level Variability in Century. Brucc C. Paton. John H.K. Vogel

Contrast-Enhanced Two-Dimensional Echocardiographic Images: Effect on Measurement of 899 The Starr-Edwards Valve. Albert Starr the Coronary Perfusion Bed. Anne L. Taylor. Steve M. Collins. David J. Skorton. Robcrt A. Kieso. Jeffrey 904 A 6 Year Experience With the St. Jude Medical Melton. Richard E. Kerber Valve: Hemodynamic Performance, Surgical Results,

Biocompatibility and Follow-Up. Lawrence S. C.

839 Early Infarct Expansion: Structural or Functional? Czer. Jack Matloff. Aurelio Chaux. Michele DeRobertis. Jay A. Erlebacher. Richard C. Richter. Daniel R. Ajit Yoganathan. Richard J. Gray Alonso. Richard B. Devereux. William A. Gay. Jr.

845 Effects of a New Nonionic and a Conventional Ionic DIAGNOSTIC TECHNIQUES

Contrast Agent on Coronary Sinus Ionized Calcium 913 Echocardiographic Recognition of Paraseptal

and Left Ventricular Hemodynamics in Dogs. Patrick Structures. Andre Keren. Margaret E. Billingham.

D. Bourdillon. Michael A. Bettmann. Sara McCracken. Richard L. Popp

Philip A. Poole-Wilson. William Grossman 920 Atrial Level Right to Left Intracardiac Shunt

854 Editorial Comment: Mechanism of Cardiovascular Associated With Postoperative Hypoxemia: Demonstration With Contrast Two-Dimensional

Effects of Contrast Media: Evidence for Transient Echocardiography. Gregory C. Rose. William F. Myocardial Calcium Ion Imbalance. Charles B. Armstrong. YouseI' Mahomed. Harvey Feigenbaum Higgins

923 Recognition of Left Coronary Artery Fistula to the 856 Effects of Nitroglycerin-Induced Hypotension on Left and Right Ventricles by Contrast

Myocardial Blood Flow in a Two Vessel Occlusion- Echocardiography. Michael J. Cooper. Daniel Stenosis Anesthetized Canine Model. Joseph A. Bernstein. Norman H. Silverman Gascho. Maire S. Mahanes. Terry L. Flanagan. George A. Beller 927 PseudosimuItaneous Fast and Slow Pathway

Conduction: A Common Electrophysiologic Finding 864 Energy Metabolism in Reperfused Heart Muscle: in Patients With Dual Atrioventricular Nodal

Metabolic Correlates to Return of Function. Heinrich Pathways. San-lou Yeh. Yahn-Chyurn Wu. Fun-Chung Taegtmeyer. Ann F. C. Roberts. Anthony E. G. Raine Lin. lui-Sung Hung. Delon Wu

933

937

CASE REPORTS

Right Coronary Artery-Pulmonary Artery Arteriovenous Fistula Secondary to Open Heart Surgery. Armand H. Rothschild, Mustafa H. Adatepe, George J. Magovern, Marylee A. Rothschild, Claude R. Joyner

Intractable Heart Failure, Conduction Disturbances and Myocardial Infarction by Massive Myocardial Invasion of Malignant Lymphoma. Toshihisa

942

956

Miyazaki, Teruhiko Yoshida, Hidezo Mori, Kazuto Yamazaki, Shunnosuke Handa, Yoshiro Nakamura

EDUCATION UPDATE

Adult and Pediatric Cardiovascular Training Programs in the United States

LETTERS TO THE EDITOR

NOVEMBER 1985 VOLUME 6 NUMBER 5

957

963

COOPERATIVE STUDIES

High Dose Intravenous Streptokinase for Acute Myocardial Infarction: Preliminary Results of a Multicenter Trial. L. David Hillis, Jeffrey Borer, Eugene Braunwald, James H. Chesebro, Lawrence S. Cohen, James Dalen, Harold T. Dodge, Charles K. Francis, Genell Knatterud, Philip Ludbrook, John E. Markis, Hiltrud Mueller, Patrice Desvigne-Nickens, Eugene R. Passamani, Eric R. Powers, A. Koneti Rao, Robert Roberts, William C. Roberts, Allan Ross, Thomas J. Ryan, Burton E. Sobel, David o. Williams, Barry L. Zaret and Co-investigators

Effect of Oxprenolol on Ventricular Arrhythmias: The European Infarction Study Experience. KlaUs­Peter Bethge, Dietrich Andresen, Jean-Pierre Boissel, Enz-Riidiger von Leitner, Jean-Claude Peyrieux, Rolf Schroder, Ulrich Tietze, for the European Infarction Study Group

973 Editorial Comment: Why Do Beta-Receptor Blockers Decrease Mortality After Myocardial Infarction? Edgar Lichstein

976 Association of Digitalis Therapy With Mortality in Survivors of Acute Myocardial infarction: Observations in the Beta-Blocker Heart Attack Trial. Robert Byington, Sidney Goldstein, for the BHAT Research Group

CLINICAL STUDIES

983 Immediate and Short-Term Benefit of Multilesion Coronary Angioplasty: Influence of Degree of Revascularization. Michel G. Vandormael, Bernard R. Chaitman, Thomas Ischinger, Umit T. Aker, Michael Harper, Jorge Hernandez, Ubeydullah Deligonul, Harold L. Kennedy

992 Editorial Comment: Percutaneous Transluminal Coronary Angioplasty. Emilio R. Giuliani

995 A Prospective Clinical, Scintigraphic, Angiographic and Functional Evaluation of Patients After Inferior Myocardial Infarction With and Without Right Ventricular Dysfunction. David E. Haines, George A. Beller, Denny D. Watson, Thomas W. Nygaard, George B. Craddock, Ann A. Cooper, Robert S. Gibson

1004 Reversal of Rest Myocardial Asynergy During Exercise: A Radionuclide Scintigraphic Study. Asher Kimchi, Alan Rozanski, Caryl Fletcher, Jamshid Maddahi, H. J. C. Swan, Daniel S. Berman

1011 Serial Exercise Testing in Patients With Effort Angina: Variable Tolerance, Fixed Threshold. David D. Waters, John L. McCans, Peter A. Crean

1016 Echocardiographic Study of Cardiac Abnormalities in Families of Patients With Marfan's Syndrome. Chih W. Pan, Chin C. Chen, Shi P. Wang, Tsui L. Hsu, Benjamin N. Chiang.

METHODS

1021 Left Ventricular Mass and Volume/Mass Ratio Determined by Two-Dimensional Echocardiography in Normal Adults. Benjamin F. Byrd III, Dennis Wahr, Yin Shi Wang, Alain Bouchard, Nelson B. Schiller

EXPERIMENTAL STUDIES

1026 Inotropic Stimulation of Reperfused Myocardium With Dopamine: Effects on Infarct Size and Myocardial Function. J. Malcolm O. Arnold, Eugene Braunwald, Tamas Sandor, Robert A. Kloner

1035 Different Relations Between Infarct Size and Occluded Bed Size in Barbiturate-Anesthetized Versus Conscious Dogs. Bodh I. Jugdutt, with the technical assistance of Marie Riesel, John Henriksen, Christine Wortman

1047 Reduction in Blood Flow in Normal and Narrowed Coronary Arteries of Dogs by Leukotriene C4 •

Thomas War.govich, Jawahar Mehta, Wilmer W. Nichols, Carl 1. Pepine, C. Richard Conti

1052 Laser Recanalization of Acutely Thrombosed Coronary Arteries in Live Dogs: Early Results. Filippo Crea, Albert Fenech, Wendie Smith, C. Richard Conti, George S. Abela

1057 Alterations in Intravascular Volume Affect the Relation Between Right Ventricular Diastolic Collapse and the Hemodynamic Severity of Cardiac Tamponade. H. Sidney Klopfenstein, Terrence L. Cogswell, Gregory A. Bernath, L. Samuel Wann, R. Keith Tipton, Raymond G. Hoffmann, Harold L. Brooks, with the technical assistance of Dennis J. Janzer, Donna M. Peterson

1064 Accuracy of Radionuclide Ventriculography for 1138 Long-Term Results of the "Palliative" Mustard Estimation of Left Ventricular Volume Changes and Operation. Janardan P. Dhasmana, Jaroslav Stark, Marc End-Systolic Pressure-Volume Relations. Marvin W. de Leval, Fergus J. Macartney, Philip G. Rees, James Kronenberg, Mark D. Parrish, Donald W. Jenkins, Jr., F. N. Taylor Martin P. Sandler, Gottlieb C. Friesinger, with the technical assistance of Jenny James, Oscar H. Wolfe

1073 Pharmacokinetic Differences Between Peripheral and SEMINAR ON CARDIAC VALVE

Central Drug Administration During REPLACEMENT-II. John H. K. Vogel, Guest Editor

Cardiopulmonary Resuscitation. Uzi Talit, Shimon Braun, Hillel Halkin, Boris Shargorodsky, Shlomo

1142 The Monostrut Bjork-Shiley Heart Valve. Viking O. Laniado Bjork, Dan Lindblom

1078 A Nonsteroid Anti-Inflammatory Drug Exacerbates The Third Generation Carpentier-Edwards Coxsackie B3 Murine Myocarditis. Maria Rosa 1149

Costanzo-Nordin, Elizabeth A. Reap, John B. Bioprosthesis: Early Results. John Reiland, Patrick

O'Connell, John A. Robinson, Patrick J. Scanlon Perier, Bruno Lecointe

MORPHOLOGIC STUDIES DIAGNOSTIC TECHNIQUES 1083 Anatomy of the Crista Supraventricularis: Its 1155 Localization of Aortic Dissection Intimal Flap by

Importance for Understanding Right Ventricular Intraoperative Two-Dimensional Echocardiography. Function, Right Ventricular Infarction and Related Martin E. Goldman, Theresa Guarino, Bruce P. Mindich Conditions. Thomas N. James

1160 Ultrasound Diagnosis of Pseudoaneurysm and 1096 The Disease-Free Wall in Coronary Atherosclerosis: Contiguous Ventricular Septal Defect Complicating

Its Relation to Degree of Obstruction. Hugo E. Saner, Inferior Myocardial Infarction. Karen Hamilton, Fredarick L. Gobel, Erich Salomonowitz, Darryl A. Kenneth Ellenbogen, James E. Lowe, Joseph Kisslo Erlien, Jesse E. Edwards

1164 Subvalvular Left Ventricular Pseudoaneurysm After lIOO Editorial Comment: Coronary Luminal Shape and Mitral Valve Replacement: Two-Dimensional

the Arc of Disease-Free Wall: Morphologic Echocardiographic Findings. Eric B. Carlson, Walter Observations and Clinical Relevance. Bruce F. G. Wolfe, Joseph Kisslo Waller

lI02 The Excimer Laser: Gross, Light Microscopic and CASE REPORTS Ultrastructural Analysis of Potential Advantages for

Closed Chest Catheter Ablation of an Accessory Use in Laser Therapy of Cardiovascular Disease. 1167

Jeffrey M. Isner, Roberta Fortin Donaldson, Lawrence I. Pathway in a Patient With Permanent Junctional Deckelbaum, Richard H. Clarke, Sylvie M. Laliberte, Reciprocating Tachycardia. Eli S. Gang, Daniel Angelo A. Ucci, Deeb N. Salem, Marvin A. Konstam Oseran, Mark Rosenthal, William J. Mandel, Zhaowen

IHO The Conduction System in Patients With a Prolonged Deng, Malte Meesmann, Thomas Peter

QT Interval. Saroja Bharati, Leonard Dreifus, Gunther EDITORIALS Bucheleres, Marian Molthan, Wesley Covitz, Henry S.

Isenberg, Maurice Lev 1172 Tachycardia and Cardiomyopathy: The Chicken-Egg

REPORTS ON THERAPY Dilemma Revisited. John J. Gallagher

1121 Early Myocardial Revascularization for SPECIAL REPORT Postinfarction Angina: Results and Long-Term

The Minimally Appropriate Electrophysiologic Study Follow-Up. Arun K. Singh, Robert Rivera, George N. 1174 Cooper, lr., Karl E. Karlson for the Initial Assessment of Patients With

Documented Sustained Monomorphic Ventricular PEDIATRIC CARDIOLOGY Tachycardia. Albert L. Waldo, Masood Akhtar, Pedro

1126 Idiopathic Dilated Cardiomyopathy in the Young: Brugada, Richard W. Henthorn, Melvin M. Scheinman,

Clinical Profile and Natural History. Charles P. David E. Ward, Hein J. 1. Wellens

Taliercio, James B. Seward, David J. Driscoll, Lloyd D. Fisher, Bernard J. Gersh, Abdul J. Tajik 1178 LETTERS TO THE EDITOR

1132 Doppler Echocardiographic Estimation of Systolic ACC NEWS Pulmonary Artery Pressure in Pediatric Patients 1180 President's Page. William W. Parmley With Interventricular Communications. Gerald R. Marx, Hugh D. Allen, Stanley J. Goldberg 1182 Newly Elected Members of the College

DECEMBER 1985 VOLUME 6 NUMBER 6

1245 Abnormal Coronary Flow Reserve and Abnormal 16TH BETHESDA CONFERENCE: Cardiovascular Radionuclide Exercise Test Results in Patients With Abnormalities in the Athlete: Recommendations Normal Coronary Angiograms. Victor Legrand, John Regarding Eligibility for Competition.Jere H. McB. Hodgson, Eric R. Bates, Fred M. Aueron, G. B. Mitchell, Barry J. Maron, Stephen E. Epstein, John Mancini, Joseph S. Smith, Milton D. Gross, Conference Co-Chairmen Robert A. Vogel

1186 Participants 1254 Editorial Comment: Coronary Flow Reserve in

1189 Introduction. Barry J. Maron, Stephen E. Epstein, Jere Patients With Normal Coronary Angiograms. Melvin L. Marcus, Carl W. White

H. Mitchell

Legal Consequences of Standard Setting for 1257 Effect of Collateral Vessels on Prognosis in Patients

1191 With One Vessel Coronary Artery Disease. Pasquale

Competitive Athletes With Cardiovascular F. Nestico, A-Hamid Hakki, Marc D. Meissner, Charles Abnormalities. John C. Weistart E. Bemis, Demetrios Kimbiris, Gary S. Mintz, Bernard

1198 Classification of Sports. Jere H. Mitchell, C. Gunnar L. Segal, Abdulmassih S. Iskandrian

Blomqvist, William L. Haskell, Frederick W. James, 1264 Scintigraphically Detected Predominant Right Henry S. Miller, Jr., William W. Miller, William B.

Strong Ventricular Dysfunction in Acute Myocardial Infarction: Clinical and Hemodynamic Correlates

1200 Task Force I: Congenital Heart Disease. Dan G. and Implications for Therapy and Prognosis.

McNamara, J. Timothy Bricker, Frank M. Galioto, Jr., Prediman K. Shah, Jamshid Maddahi, Daniel S.

Thomas P. Graham, Jr., Frederick W. James, Amnon Berman, Max Pichler, H. J. C. Swan

Rosenthal

1273 Electrocardiographic Findings in Acute Right 1209 Task Force II: Acquired Valvular Heart Disease. Ventricular Infarction: Sensitivity and Specificity of

Melvin D. Cheitlin, Robert O. Bonow, William W. Electrocardiographic Alterations in Right Precordial Parmley, William C. Roberts, H. J. C. Swan, John F. Leads V4R, V3R, VI, V2 and V3• Jose Lopez-Sendon, Williams, Jr. Isabel Coma-Canella, Soledad Alcasena, Jorge Seoane,

1215 Task Force III: Hypertrophic Cardiomyopathy, Carlos Gamallo

Other Myopericardial Diseases and Mitral Valve 1280 Pattern of Endocardial Activation During Sustained Prolapse. Barry J. Maron, F. Andrew Gaffney, Robert

M. Jeresaty, William J. McKenna, William W. Miller Ventricular Tachycardia. John M. Miller, Alden H. Harken, W. Clark Hargrove, Mark E. Josephson, with

1218 Task Force IV: Systemic Arterial Hypertension. the technical assistance of T. Franz Orishimo Edward D. Frohlich, David T. Lowenthal, Henry S. Miller, Jr., Thomas Pickering, William B. Strong EXPERIMENT AL STUDIES

1222 Task Force V: Ischemic Heart Disease. Stephen E. 1289 Comparative Echocardiographic Study of Recovery

Epstein, C. Gunnar Blomqvist, L. Maximilian Buja, of Diastolic Versus Systolic Function After Brief

William L. Haskell, Thomas J. Ryan, Paul D. Periods of Coronary Occlusion: Differential Effects of

Thompson Intravenous Nifedipine Administered Before and During Occlusion. Yozo Fujibayashi, Shigeru

1225 Task Force VI: Arrhythmias. Douglas P. Zipes, Yamazaki, Bing-Lo Chang, Ram E. Rajagopalan,

Leonard A. Cobb, Jr., Arthur Garson, Jr., Paul C. Samuel Meerbaum, Eliot Corday

Gillette, Thomas N. James, Ralph Lazzara, Lawrence 1299 Creatine Kinase Release Not Associated With Rink

Myocardial Necrosis After Short Periods of Coronary CLINICAL STUDIES Artery Occlusion in Conscious Baboons. Guy R.

Coronary Angiographic Morphology in Myocardial Heyndrickx, Jun Amano. Twila Kenna, John T. Fallon.

1233 Thomas A. Patrick, W. Thomas Manders, Geoffrey G. Infarction: A Link Between the Pathogenesis of Rogers, Clive Rosendorff, Stephen F. Vatner Unstable Angina and Myocardial Infarction. John A. Ambrose, Stephen L. Winters, Rohit R. Arora, Jacob I. 1304 Editorial Comment: Creatine Kinase Release After Haft, Jonathan Goldstein, K. Peter Rentrop, Richard Brief Coronary Occlusion. Michael C. Fishbein Gorlin, Valentin Fuster

1306 Correlation of Continuous Wave Doppler Velocities 1239 Clinical and Angiographic Assessment 6 Months With Cardiac Catheterization Gradients: An

After Double Vessel Percutaneous Coronary Experimental Model of Aortic Stenosis. Mikel D. Angioplasty. Luis Adolfo Mata, Xavier Bosch, Paul R. Smith, Philip L. Dawson, Jonathan L. Elion, David C. David, Hans J. Rapold, Thierry Corcos, Martial G. Booth, Rodney Handshoe, Oi Ling Kwan, Gary F. Bourassa Earle, Anthony N. DeMaria

METHODS 1393 Editorial Comment: Atrioventricular Nodal or

1315 The Implanted Defibrillator: Relation of Atriojunctional Reentrant Tachycardia? Melvin

Defibrillating Lead Configuration and Clinical M. Scheinman

Variables to Defibrillation Threshold. Paul J. Troup, 1395 Double-Blind Crossover Comparison of the Peter D. Chapman, Gordon N. Olinger, Leonard H. Antianginal Effects of Nifedipine and Isosorbide Kleinman Dinitrate in Patients With Exertional Angina

1322 Diastolic Forward Blood Flow in the Pulmonary Receiving Propranolol. John R. Morse, Richard W.

Artery Detected by Doppler Echocardiography. John Nesto L. Gibbs, Neil Wilson, Maarten Witsenburg, Gordon J. 1402 Use of Amiodarone in the Treatment of Persistent Williams, Stanley J. Goldberg

and Paroxysmal Atrial Fibrillation Resistant to MORPHOLOGIC STUDIES Quinidine Therapy. Leonard N. Horowitz, Scott R.

1329 Smooth Muscle Contraction Bands in the Media of Spielman, Allan M. Greenspan, Gary S. Mintz, Joel

Coronary Arteries: A Postmortem Marker of Morganroth, Robert Brown, Patricia M. Brady, Harold

Antemortem Coronary Spasm? Stephen M. Factor, R. Kay

Sangho Cho BASIC CONCEPTS IN CARDIOLOGY

CARDIAC PACING 1409 Cardiac Calcium Channels and Their Control by 1338 Stability of Atrial Sensing and Pacing After Dual Neurotransmitters and Drugs. Wolfgang Trautwein,

Chamber Pulse Generator Implantation. Peter T. Adolfo Cavalie Klementowicz, Seymour Furman

PEDIATRIC CARDIOLOGY SEMINAR ON CARDIAC VALVE

1343 Pulmonary Blood Supply in Patients With Pulmonary REPLACEMENT-III. John H. K. Vogel, Guest

Atresia and Ventricular Septal Defect. Pui-Kan Liao, Editor

William D. Edwards, Paul R. Julsrud, Francisco J. Puga, Gordon K. Danielson, Robert H. Feldt 1417 Seven and One-Half Years' Experience With the

Medtronic-Hall Valve. Karl Victor Hall, Sigurd Nitter-1351 Cardiac Arrhythmias in Patients With Surgical Hauge, Michel Abdelnoor

Repair of Ebstein's Anomaly. Jae K. Oh, David R. Holmes, Jr., David L. Hayes, Co-bum J. Porter, DIAGNOSTIC TECHNIQUES Gordon K. Danielson 1422 Osteogenic Sarcomas Mimicking Left Atrial

1358 Fetal Tachycardia and Intramyocardial Tumors. Myxomas: Clinical and Two-Dimensional Stuart E. Birnbaum, John P. McGahan, Gregory G. Echocardiographic Features. Robert J. Mich, Linda D. Janos, Mary Meyers Gillam, Arthur E. Weyman

1362 Intracardiac Undifferentiated Sarcoma in Infancy. 1428 Right Atrial Thrombus Formation After Transvenous Achi Ludomirsky, Thomas A. Vargo, Daniel J. Murphy, Catheter Ablation of the Atrioventricular Node. Mary V. Gresik, David A. Ott, Charles E. Mullins Klaus-Peter Kunze, Michael Schluter, Angelika Costard,

1365 Fetal Hydrops in a Newborn With Hypoplastic Left Christoph A. Nienaber, Karl-Heinz Kuck

Heart Syndrome: Tricuspid Valve "Stopper." Paul 1431 Entrainment of Circus Movement Tachycardia M. Weinberg, Karen Peyser, James R. Hackney Utilizing an Accessory Pathway With Long

REVIEWS Retrograde Conduction Times During Ventricular and Atrial Stimulation. Agustin Castellanos, Bolivar

1370 Diagnosis and Classification of Atrial Septal Portillo, Jose Mejias, Nelly Leon-Portillo, Nadir C. Aneurysm by Two-Dimensional Echocardiography: Saoudi, Liaqat Zaman Report of 80 Consecutive Cases. Peter C. Hanley, A.

ACC NEWS Jamil Tajik, John K. Hynes, William D. Edwards, Guy S. Reeder, Donald J. Hagler, James B. Seward 1438 President's Page. William W. Parmley

REPORTS ON THERAPY 1440 RETRACTION

1383 Curative Surgery for Atrioventricular Junctional INDEXES (" A V Nodal") Reentrant Tachycardia. David L.

1441 Author Index: Volume 6 Ross, David C. Johnson, A. Robert Denniss, Mark J. Cooper, David A. Richards, John B. Uther 1444 Subject Index: Volume 6