CIRCULATIONVOLUME XLVII

January-June 1973

No. 1 (January)EDITORIALS:

Hypertension: A Challenge in Preventive Cardiology. Edward D. Freis 1Bacterial Endocarditis and Prosthetic Valves. Jesse E. Edwards ... 3Excitation-Contraction Coupling and Digitolis. Harry A. Fozzard .. 5

ORIGINAL ARTICLES:Normal Blood Supply to the Human His Bundle and Proximal Bundle Branches. Richard J. Frink

and Thomas N. James ........................... ............................................ 8Accelerated Angina Pectoris: Clinical, Hemodynamic, Arteriographic, and Therapeutic Experience

in 85 Patients. Patrick J. Scanlon, Rimgaudas Nemickas, John F. Moran, James V. Talano, FirouzAmirparviz, and Roque Pifarre ............. 19

Geometry of Left Ventricular Contraction in the Systolic Click Syndrome: Characterization of aSegmental Myocardial Abnormality. A. James Liedtke, James H. Gault, David M. Leaman, andMelvin S. Blumenthal ... ............ 27

Long-Term- Observations in Patients with Angina and Normal Coronary Arteriograms. Carl R.Bemiller, Carl J. Pepine, and Albert K. Rogers ..36

Ventricular Ectopic Rhythms following Vagal Stimulation in Dogs with Acute Myocardial Inforc-tion. Jay Kerzner, Marshall Wolf, Bernard .D. Kosowsky, and Bernard Lown ..44

Coronary Artery Occlusion in the Conscious Dog: Effects of Alterations in Arterial Pressure Pro-uced by Nitroglycerin, Hemorrhage, and Alpha-Adrenergic Agonists on the Degree of Myocardiallschemia. Eldon R. Smith, David R. Redwood, William E. McCarron, and Stephen E. Epstein 51

Myocordial Inforction as a Complication of Coronary Bypass Surgery. David L. Brewer, Robert H.Bilbro, and Alan G. Bartel .................................................................. 58

Correlation between Effects of Ouaboin on the Canine Electrocardiogram and Transmembrane Poten-tiols of Isolated Purkinje Fibers. Michael R. Rosen, Henry Gelband, and Brian F. Hoffman.. 65

Hypertension in the Inner City: 1. Analysis of Clinic Dropouts. Frank A. Finnerty, Jr., Edward C. Mat-tie, and Francis A. Finnerty, III ..73

Hypertension in the Inner City: 11. Detection and Follow-up. Frank A. Finnerty, Jr., Lawrence W.Shaw, and Clifton K. Himmelsbach ..76

Feasibility and Effectiveness of Low-Energy Catheter Defibrillation in Man. M. Mirowski, Morton M.Mower, Vincent L. Gott, and Robert K. Brawley ..79

Premature Atrial Stimulation as a Key to the Understanding of Sinoatrial Conduction in Man: Pre-sentation of Data and Critical Review of the Literature. Harold C. Strauss, Alan L. Saroff, J. T. Big-ger, Jr., and Elsa Grace V. Giardina .................................. 86

Effect of Breathing Oxygen in Patients with Severe Pulmonary Vascular Obstructive Disease. EhudKrongrad, H. Frederic Helmholz, Jr., and Donald G. Ritter

.................................... 94Determination of Systemic Vascular Resistance by a Noninvasive Technic. Miltiadis A. Stefadouros,

Michael J. Dougherty, William Grossman, and Ernest Craige .... .. ..................... 101Echocardiography in the Normal Neonate. Robert Solinger, Francisco Elbl, and Kareem Minhas 108Prognosis of Surgicolly Corrected Coarctation of the Aorta: A 20-Year Postoperative Appraisal.

Barry J. Maron, J. O'Neal Humphries, Richard D. Rowe, and E. David Mellits ................... 119Constriction of the Fetal Ductus Arteriosus Induced by Oxygen, Acetylcholine, and Norepinephrine

in Normal Dogs and those Genetically Predisposed to Persistent Patency. David H. Knight, DonaldF. Patterson, and Julius Melbin ........................ 127

Coronary Arterial-Right Heart Fistulae: Long-Term Observations in Seven Patients. Richard B. Jaffe,D. Luke Glancy, Stephen E. Epstein, B. Gregory Brown, and Andrew G. Morrow ..133

Right Ventricular Volume Determinations in Children: Normal Values and Observations with Vol-ume or Pressure Overload. Thomas P. Graham, Jr., Jay M. Jarmakani, Gerald F. Atwood, and RamonV. Canent, Jr. ................................................................. 144

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RADIOLOGIC NOTES IN CARDIOLOGY:Roentgenogrophic Identification of Starr-Edwards Prostheses. Lawrence I. Bonchek, Jeri L. Dobbs,

Adel F. Matar, Philip Chappel, and Albert Starr ..... ........154CLI NICOPATHOLOGIC CORRELATIONS:

Correlation of the Antemortem Coronary Arteriogrom and the Postmortem Specimen. Zeev Vlodaver,Robert Frech, Robert A. Van Tassel, and Jesse E. Edwards 162

SYMPOSIUM: CARDIAC ARRHYTHMIAS (Part I)Anatomy of the Conduction System. Jack L. Titus ...... 170Ultrastructure of the Atrial, Ventricular, and Purkinje Cell with Special Reference to the Genesis

of Arrhythmias. Marianne J. Legato 178Genesis of Cardiac Arrhythmias. Paul F. Cranefield, Andrew L. Wit, and Brian F. Hoffman 190

BOOKS REVIEWS 205LETTERS TO THE EDITOR:

Classification of Chordae Tendineae. William D. Towne .. ... 209Acquired Right Bundle-Branch Block and Left Anterior Hemiblock in Ostium Primum Atrial Septal

Defect. Antonio Pedraza .. .. 209Sinoatrial Node Entrance Block. Peter Fleischmann ......................................... 210Of Toads and Flowers. James E. Doherty 212

CORRECTION ..18NEWS FROM THE AMERICAN HEART ASSOCIATION

Report of the Inter-Society Commission for Heart Disease Resources: Unanswered Questions A-341

No. 2 (February)EDITORIALS:

Jeopardized, Blighted, and Necrotic Myocardium. Burton E. Sobel and William E. Shell 215Hypotension, Nitroglycerin, and Acute Myocardial Inforction. Stephen E. Epstein 217Venography. William J. Williams 220A Retrospective Look at A-V Nodal Rhythms. Albert L. Waldo and Thomas N. James 222

ORIGINAL ARTICLES:Asymetric Septal Hypertrophy: Echocardiographic Identification of the Pathognomonic Anatomic

Abnormality of IHSS. Walter L. Henry, Chester E. Clark, and Stephen E. Epstein ...... 225Saphenous Vein Coronary Artery Bypass in Patients with "Preinfarction Angina." D. Craig Miller,

David S. Cannomn, Thomas J. Fogarty, John S. Schroeder, Pat 0. Daily, and Donald C. Harrison .... 234Left Ventricular Performance after Myocardial Infarction Assessed by Rodioisotope Angiocurdiog-

raphy. William J. Kostuk, Ali A. Ehsani, Joel S. Karliner, William L. Ashburn, Kirk L. Peterson, JohnRoss, Jr., and Burton E. Sobel ... ... 242

Inability of the Submaximal Treadmill Stress Test to Predict the Location of Coronary Disease. MarvinA. Kaplan, Clifford N. Harris, Wilbert S. Aronow, David P. Parker, and Myrvin H. Ellestad .. 250

Significance of High Degree Atrioventricular Block in Acute Posterior Myocardial Infarction: The Im-portance of Clinical Setting and Mechanism of Block. Michael Rotman, Galen S. Wagner, andRobert A. Waugh .. ... 257

Importance of Identification of the Myocardial-Specific Isoenzyme of Creatine Phosphokinase (MBForm) in the Diagnosis of Acute Myocardial Infarction. Galen S. Wagner, Charles R. Roe, Lee E.Limbird, Robert A. Rosati, and Andrew C. Wallace ...................................... 263

Systemic Arterial Disease with Myocardial Inforction: Report on Two Infants. Helmar G. Rosenberg .. 270Influence of Direct Myocardial Revascularization on Left Ventricular Asynergy and Function in Pa-

tients with Coronary Heart Disease: With and without Previous Myocardial Infarction. Kanu Chat-terjee, H. J. C. Swan, William W. Parmley, Hector Sustaita, Harold S. Marcus, and Jack Matloff 276

Thirty-Month Follow-up of Maximal Treadmill Stress Test and Double Master's Test in Normal Sub-jects. Wilbert S. Aronow

........................ .........287Electrical Stability of Acutely Ischemic Myocardium: Influences of Heart Rate and Vagal Stimulation.

Kenneth M. Kent, Eldon R. Smith, David R. Redwood, and Stephen E. Epstein ........ 291Ventriculographic Patterns and Hemodynamics in Primary Myocardial Disease. Thomas H. Kreulen,

Richard Gorlin, and Michael V. Herman ... .. .. 299Light-Pen Computer Processing of Video Image for the Determination of Left Ventricular Volume.

Edwin L. Alderman, Harold Sandler, Jeff Z. Brooker, William J. Sanders, Carl Simpson, and Donald C.Harrison 309

Relationship between Pulmonary Artery End-Diastolic Pressure and Left Ventricular Filling Pressure inPatients in Shock. Melvin Scheinman, G. Thomas Evans, Alan Weiss, and Elliot Rapaport .. 317

Type 1, Type 11, and Type 111 Gaps in Bundle-Branch Conduction. Abdul S. Agha, Agustin Castellanos,Jr., David Wells, Melvin D. Ross, Benjamin Befeler, and Robert J. Myerburg 325

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Response of Resistant Ventricular Tachycardia to Bretylium: Relotion to Site of Ectopic Focus andLocation of Myocardial Disease. H. C. Cohen, E. G. Gozo, Jr., R. Langendorf, B. M. Kaplan, A. Chan,

A. Pick, and G. Glick .33............................ .... ... ..... 331Serum Digitalis and Arrhythmia in Patients Undergoing Cardiopulmonary Bypass. John Morrison and

Thomas Killip ...........................3.....4............1............ 341Intravascular Platelet Aggregotion in the Heort Induced by Stress. Jacob I. Haft and Kazem Fani .. 353Racial Frequencies in Congenital Heart Disease. Barry J. Maron, Judith M. Applefeld, and L. Jerome

Krovetz ........................................................ 359SPECIAL ARTICLE:

Order and Disorder in the Rhythm of the Heart: The Fifth Annual George C. Griffith Lecture. ThomasN. James . ............................. 362

RADIOLOGIC NOTES IN CARDIOLOGY:Radiologic Evaluation of Coronary Artery Surgery. Harold A. Baltaxe .............................. 387

CLINICOPATHOLOGIC CORRELATIONS:Absence of Anatomic Origin from Heart of Pulmonary Arterial Supply. Jesse E. Edwards and Dwight

C. McGoon .. . 393SYMPOSIUM: Cardiac Arrhythmias (Part 2)

Hemodynamic Sequelae of Cardiac Arrhythmias. Philip Samet .................. ................. 399Relation of Electrolyte Disturbances to Cardiac Arrhythmias. Charles Fisch ...... ................... 408How to Approach an Arrhythmia. Leo Schamroth ... .............................................. 420

BOOK REVIEWS .... ............. 427LETTERS TO THE EDITOR:

Atropine and Acute Myocardial Infarction. Jaok Han ......... ..................................... 429Echocordiographic Pattern of Right Ventricular Diastolic Volume Overload in Children. James C. Dillon 431Wolff-Parkinson-White Syndrome. Koen J. J. Bruyneel ........................................... 433

CORRECTION .................................................................................... 219NEWS FROM THE AMERICAN HEART ASSOCIATION ......................................... Page 1

No. 3 (March)EDITORIALS:On the Assessment of Cardiac Inotropic State. John Ross, Jr., and Kirk L. Peterson .435Computers Can Change Cardiology. Andrew G. Wallace and Robert A. Rosati .. 439A Comparison of Beta-Blocking Agents. Robert E. Goldstein .443

ORIGINAL ARTICLES:Experimental Acute Myocardial Infarction: Characterization and.Treatment of the Malignant Pre-

mature Ventricular Contraction. Stephen E. Epstein, G. David Beiser, Douglas R. Rosing, James V.Talano, and Richard B. Karsh .................... .............................................. 446

Progression of Coronary Artery Disease: A Clinical Arteriographic Study. Charles E. Bemis, RichardGorlin, Harvey G. Kemp, and Michael V. Herman.455

Sequential Circulatory Changes following Acute Myocardial Infarction in Man: Determination of Op-timal Heart Rate at Each Stage of the Infarction by Atrial Pacing. W. Glenn Friesen .465

Variant Angina of Prinzmetal with Normal Coronary Arteriograms: A Variant of the Variant. Tsung0. Cheng, Tali Bashour, George A. Kelser, Jr., Lowell Weiss, and James Bacos .476

Identification of Ischemic Area of Left Ventricle by Visualization of 43K Myocardial Deposition.Robert E. Botti, William J. MacIntyre, and Walter H. Pritchard ....... 486

Electrocardiographic Evidence of Left Atrial Hypertension in Acute Myocardial Infarction. PremindraA. N. Chandraratna and Morrison Hodges ........ ............................... 493

Effects of Nitroglycerin on Responses of the Systolic Time Intervals to Exercise. Willard S. Harris,Neset Aytan, and Jean M. Pouget .. .. ... .. ........ ......... ... .. .... .. 499

Angina Pectoris in Men: Prognostic Significance of Selected Medical Factors. Charles W. Frank, EveWeinblatt, and Sam Shapiro ............................ . 509

Prosthetic Replacement of the Mitral Valve: Continuing Assessments of the 100 Patients Operatedupon during 1961-1965. Frederick H. Levine, Jack G. Copeland, and Andrew G. Morrow .518

Left Ventricular Ejection Time in Valvular Aortic Stenosis. Robert J. Bache, Yang Wang, and JosephGreenfield, Jr. 527

Functional 2:1 A-V Block within the His-Purkinje System: Simulotion of Type 11 Second-Degree A-VBlock. Anthony N. Damato, P. Jacob Varghese, Anthony R. Caracta. Masood Akhtar, and Sun H. Lau 534

Paradoxic Phenomenon of Premoture Beats with Narrow QRS in the Presence of Bundle-Branch Block.Rashid A. Massumi, General Hilliard, Anthony DeMaria, Ramon Fabregas, Alan E. Lindsay, EzraAmsterdam, and Dean T. Mason ................ ...... 543

Effect of Aspirin on Brachial Artery Occlusion following Brachial Arteriotomy for Coronary Arteri-ogrophy. Kieran M. Hynes, Gerald T. Gau, Barry D. Rutherford, Francis J. Kazmier, and Robert L. Frye 554

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Hypolipoproteinemia: Prevalence in a Free-Living Population in Albany, New York. D. F. Brown andK. Daudiss ...... ... 558

Quantitative Assessment of Left Ventricular Diastolic Stiffness in Man. William Grossman, Miltiadis A.Stefadouros, Lambert P. McLaurin, Ellis L. Rolett, and Daniel T. Young .567

Congenital Polyvalvular Disease. Saroja Bharati and Maurice Lev ..... . 575Cardiac Manifestations of Marfan Syndrome in Infancy and Childhood. Charlie Phornphutkul, Amnon

Rosenthal, and Alexander S. Nadas ... 587Echocardiography in the Diagnosis of Ebstein's Anomaly of the Tricuspid Valve. Nils-Rune Lundstrom 597

SPECIAL ARTICLE:Pediatric Congenital Cardiac becomes a Postoperative Adult: The Changing Population of Congenital

Heart Disease. Joseph K. Perloff ....................................................... 606CLIN ICOPATHOLOGIC CORRELATIONS:

Juxtaposition of the Atrial Appendages. Yzhar Charuzi, Panayiotis K. Spanos, Kurt Amplatz, andJesseE. Edwards ................. .......................... . 620

RADIOLOGIC NOTES IN CARDIOLOGY:Radiologic Appearance of the Azygos Vein in Cardiovascular Disease. E. Robert Heitzman .... 628

SYMPOSIUM: Cardiac Arrhythmias (Part 3)The Sick Sinus Syndrome. M. Irene Ferrer ............................... ...... ... .635Refractory Supraventricular Tachycardias. Andres R. Ticzon and Robert W.Whalen ................. 642Junctional Tachycardia: Mechanisms, Diagnosis, Differential Diagnosis, and Management. Kenneth M.

Rosen ..... ..... 654BOOK REVIEWS ................................ 665

LETTERS TO THE EDITOR:An Indirect Method for Evoluation of Left Ventricular Function in Acute MyocardialInforction. P. D.Verdouw and J. D. Laird ... ................ ................................ 667AtrialVentricular Conduction System in Left Bundle-Branch Block with Normal QRS Axis. Thomas A.

Preston ....... 669CORRECTION ...... 464NEWS FROM THE AMERICAN HEART ASSOCIATION

The Relevance of IrrelevanceRemarks on Receiving the James B. Herrick Award, American Heart Association. Howard B.Burchell .....Page 1

Time for ReflectionInternational Lecture, American Heart Association Scientifc Sessions. Reginald E. B. Hudson .... Page 7

No. 4 (April)EDITORIALS:

Theory and Practice of Minidose Heparin in Surgical Patients: A Status Report. Stanford Wessleran E. Thye Yin 671

Physical Training and Intrinsic Cardiac Adaptations. James Scheuer................................ 677ORIGINAL ARTICLES:

Mechanisms of Digitalis Toxicity: Effects of Ouaboin on Phase Four of Canine Purkinje Fiber Trons-membrane Potentials. Michael R. Rosen, Henry Gelband, Charles Merker, and Brian F. Hoffman ... 681

Myocardial Blood Flow in Coronary Artery Disease: Effect of Right Atrial Pacing and Nitroglycerin.Suzanne B. Knoebel, Paul L. McHenry, Anthony J. Bonner, and John F. Phillips ................. 690

Comparison of Methyllidocaine and Lidocaine on Arrhythmias Produced by Coronory Occlusion in theDog. Richard A. Gillis, Frederick H. Levine, Harold Thibodeaux, Arthur Raines, and Frank G. Standaert 697

Blood-Gas and Hemodynomic Responses to Oxygen in Acute Myocardial Infarction. Robert M. David-son, Barry W. Ramo, Andrew G. Wallace, Robert E. Whalen, and C. Franklin Starmer .. .. 704

Relationship between Ventricular Premature Contractions on Routine Electrocardiography and Subse-quent Sudden Death from Coronary Heart Disease. F. David Fisher and Herman A. Tyroler 712

Assessment of Ventricular Function after Acute Myocardial Inforction by Plasma Volume Expansion.Henry S. Loeb, Shahbudin H. Rahimtoola, Kenneth M. Rosen, M. Ziad Sinno, Ruben Chiquimia, and RolfM. Gunnar .. 720

Use of Phentolamine in Acute Myocardial Inforction Associated with Hypertension and Left VentricularFailure. David T. Kelly, Cesar E. Delgado, Dean R. Taylor, Bertram Pitt, and Richard S. Ross 729

Saliva Calcium and Potassium Concentrotions in the Detection of Digitalis Toxicity. Margo Swanson,Larry Cacace, George Chun, and Masashi Itano 736

Plasma Concentration and Urinary Excretion Kinetics of Acetyl Strophanthidin. Richard Selden,Michael D. Klein, and Thomas W. Smith 744

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Manifest and Concealed Reentry: A Mechenism of A-V Nodal Wenckebach in Man. John J. Gallagher,Anthony N. Damato, P. Jacob Varghese, and Sun H. Lau 752

Effect of Extrasystoles on Idioventricular Rhythm: Clinical and Electrophysiologic Correlation. Herman0. Klein, Robert Lebson, Paul F. Cranefield, and Brian F. Hoffman ... 758

Immediate and Remote Prognostic Significance of Fascicular Block during Acute Myocardial Infarction.Robert A. Waugh, Galen S. Wagner, Thomas L. Haney, Robert A. Rosati, and James J. Morris, Jr. 765

Conduction Intervals and Conduction Velocity in the Human Cardiac Conduction System: Studiesduring Open-Heart Surgery. Joel Kupersmith, Ehud Krongrad, and Albert L. Waldo ... 776

Intrarenal Blood Flow in Congestive Heart Failure. Margaret M. Kilcoyne, Donald H. Schmidt, and Paul J.Cannon ...........................6.. ................................ 786

Left Ventricular Function, Metabolism, and Blood Flow in Chronic Cor Pulmonale. Martin J. Frank, AllenB. Weisse, Christos B. Moschos, and Gilbert E. Levinson. ................... ......... 798

Thirty-Month Follow-Up of Resting and Postexercise Apexcardiogram in Normal Subjects. Wilbert S.Aronow. 807

Echocardiogram in Ebstein's Anomaly with Wolff-Parkinson-White Preexcitation Syndrome, Type B.Abdul J. Tajik, Gerald T. Gau, Emilio R. Giuliani, Donald G. Ritter, and Thomas T. Schattenberg .. 813

Pediatric Radiocardioangiography: Shunt Diagnosis. F. P. Stocker, J. Kinser, J. W. Weber, and H. Rosler 819SPECIAL ARTICLES:

Asymmetric Septal Hypertrophy (ASH): The Unifying Link in the IHSS Disease Spectrum: Obser-vations Regarding its Pathogenesis, Pathophysiology, and Course. Walter L. Henry, Chester E.Clark, and Stephen E. Epstein 827

Newer Aspects of Echocardiography. Harvey Feigenbaum ......................................... 833Cardiac Ultrasonography: Cross-Sectional Ultrasonic Imaging of the Heart. Donald Latham King 843

CLINICOPATHOLOGIC CORRELATIONS:Spontaneous Laceration of Ascending Aorta. Charles A. Murray and Jesse E. Edwards ... 848

RADIOLOGIC NOTES IN CARDIOLOGY:Lung Changes in Left Heart Failure. William T. Meszaros . . .859

SYMPOSIUM: Cardiac Arrhythmias (Part 4)Wolff-Parkinson-White Syndrome: A Review. Onkar S. Narula .. .. 872Digitalis Intoxication in Patients with Atrial Fibrillation. John A. Kastor 888The His Bundle Electrogram. Jacob I. Haft ....897

BOOK REVIEWS ......................................................................... 912LETTERS TO THE EDITOR:

Coronary Arteriography. L. A. lannone ...913Atrial Standstill Secondary to Atrial Inexcitability. Samuel Epstein .... ... 913

CORRECTIONS......... . . .680NEWS FROM THE AMERICAN HEART ASSOCIATION ..........................Page 1

No. 5 (May)EDITORIALS:

Ethyl Alcohol and Myocardial Metabolism. Arthur F. Whereat and Joseph K. Perloff .. 915What ECG Computer Program to Choose for Clinical Application: The Need for Consumer Protection.

Hubert V. Pipberger and Jerome Cornfield ................................................ 918Shock Lung: A Distinctive Nonentity. Alfred P. Fishman .......................................... 921

ORIGINAL ARTICLES:Assessment of Left Ventricular Performance in Man: Instantaneous Tension-Velocity-Length Relations

Obtained with the Aid of an Electromagnetic Velocity Catheter in the Ascending Aorta. Kirk L. Peter-son, John B. Uther, Ralph Shabetai, and Eugene Braunwald ....................................... 924

Clinical Course of Patients with Normal, and Slightly or Moderately Abnormal Coronary Arteriogroms:A Follow-up Study on 500 Patients. Albert V. G. Bruschke, William L. Proudfit, and F. Mason Sones, Jr. 936

Angina Pectoris at Rest with Preservation of Exercise Capacity: Prinzmetal's Variant Angina. Rex N.MacAlpin, Albert A. Kattus, and Anthony B. Alvaro 946

Prognostic Significance of Ventricular Ectopic Beats with Respect to Sudden Death in the Late Postin-farction Period. Morris N. Kotler, Bernard Tabatznik, Morton M. Mower, and Suketami Tominaga ... 959

Natural History of Cardiac Arrhythmias and their Prevention with Quinidine in Patients with AcuteCoronary Insufficiency. Saul S. Bloomfield, Donald W. Romhilt, Te-Chuan Chou, and Noble 0. Fowler 967

Deleterious Effects of Bretylium in Cats with Digitalis-induced Ventricular Tachycardia. Richard A.Gillis, Margaret M. Clancy, and Rebecca J. Anderson...... 974

Blood Lidocaine Levels and Kinetics following High-Dose Intramuscular Administration. Julian C.Zener, Richard E. Kerber, Alfred P. Spivack, and Donald C. Harrison .... 984

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Abnormol Mitral Valve Motion in Patients with Elevated Left Ventricular Diastolic Pressures. Lee L.Konecke, Harvey Feigenbaum, Sonia Chang, Betty C. Corya, and John C. Fischer 989

Echocardiographic Detection of Regional Myocardiol Infarction: An Experimentol Study. Richard E.Kerber and Francois M. Abboud ................................................ 997

Temporal Relation of the First Heart Sound to Closure of the Mitral Valve. Shlomo Laniado, Edward L.Yellin, Hyman Miller, and Robert W. M. Frater .. ....................... .... 1006

Baroreceptor Activity in Normotensive and Hypertensive Uremic Patients. J. M. Lazarus, C. L. Hampers,E. G. Lowrie, and J. P. Merrill ................................................................ 1015

Left Ventricular Function and Hypertrophy in Cardiomyopothy with Depressed Ejection Fraction.Bolling J. Feild, William A. Baxley, Richard 0. Russell, Jr., William P. Hood, Jr., John H. Holt, John T.Dowling, and Charles E. Rackley .. 1022

Repair of Transposition of the Great Arteries in 123 Pediatric Patients: Early and Long-Term Results.Gerard L. Champsaur, David M. Sokol, George A. Trusler, and William T. Mustard 1032

Symptomatic Atrial Septal Defect in Infancy. Carl E. Hunt and Russell V. Lucas, Jr. 1042Quantitative Radionuclide Angiocardiography: Determination of Qp:Qs in Children. David L. Maltz

and S. Treves .. ....... 1049Ventricular Septal Defect Associated with Aortic Insufficiency: Anatomic Classification and Method

of Operation. Yasunaru Kawashima, Michiaki Danno, Yukihiko Shimizu, Hikaru Matsuda, TakeshiMiyamoto, Tsuyoshi Fujita, Takahiro Kozuka, and Hisao Manabe ..... .. ... 1057

Hemodynamic Abnormalities in Response to Mild and Intense Upright Exercise following OperativeCorrection of an Atrial Septal Defect or Tetralogy of Fallot. Stephen E. Epstein, G. David Beiser,Robert E. Goldstein, Douglas R. Rosing, David R. Redwood, and Andrew G. Morrow ..1065

SPECIAL ARTICLE:Biochemical "Defect" in the Hypertrophied and Failing Heart: Deleterious or Compensatory? Arnold

M. Katz .. ... .... 1076RADIOLOGIC NOTES IN CARDIOLOGY:

Angiocardiographic Evaluation of the Right Ventricular Outflow Tract in Tetralogy of Fallot. Kent Ellis 1080CLINICOPATHOLOGIC CORRELATIONS:

Aneurysmlike Formations in Relation to Membraneous Ventricular Septum. Rajendra Tandon and JesseE. Edwards ...................................... 1089

SYMPOSIUM: Cardiac Arrhythmias (Part 5):Disturbances in Cardiac Conduction and their Management. John Merideth and Raymond D. Pruitt 1098Artificial Pacemakers: Indications and Management. Kinsman E. Wright, Jr., and Henry D. McIntosh 1108Types of Pacemakers and their Complications. Doris J. W. Escher ........ 1119

BOOK REVIEWS 1132LETTERS TO THE EDITOR:

Request to Rat Colony Curators. Thomas G. Coleman .. 1133H-V Intervols in LBBB. Agustin Castellanos, Jr. ... 1133Implanted Standby Defibrillators. Arthur J. Moss; M. Mirowski, Morton M. Mower, and Albert I.

Mendeloff ... ... 1135Effect of Procaine Amide on Canine Purkinje Fibers. John M. Bete ... ... 1136Abnormalities in Ventricular Function following Ml. Richard L. Popp .. 1137

NEWS FROM THE AMERICAN HEART ASSOCIATION..........................................Page 1

No. 6 (June)EDITORIALS:

Clinical Pathologic Correlations in Coronary Artery Disease. Herrman L. Blumgart and Paul M. Zoll 1139Dilemmas in Potassium Therapy. Howard B. Burchell ... . .1144

ORIGINAL ARTICLES:Progress Study of 590 Consecutive Nonsurgical Cases of Coronary Disease Followed 5-9 Years: 1.

Arteriographic Correlations. Albert V. G. Bruschke, William L. Proudfit, and F. Mason Sones ... 1147Pragress Study of 590 Consecutive Nonsurgical Cases of Coronary Disease Followed 5-9 Years: it.

Ventriculographic and Other Correlations. Albert V. G. Bruschke, William L. Proudfit, and F. MasonSones, Jr. ....... ... . ............... 1154

Changes in Maximal Exercise Performance in the Evaluation of Saphenous Vein Bypass Surgery. EugeneS. Lapin, John A. Murray, Robert A. Bruce, and Loren Winterscheid ..1164

Left Ventricular Size after Acute Myocardial Infarction: Serial Changes and their Prognostic Signifi-conce. William J. Kostuk, Thomas M. Kazamias, Martin P. Gander, Allan L. Simon, and John Ross, Jr. 1174

Influence of Atropine and of Vagally Mediated Bradycardia on the Occurrence of Ventricular Arrhyth-mias following Acute Coronary Occlusion in Closed-Chest Dogs. Robert E. Goldstein, Richard B. Karsh,Eldon R. Smith, Michael Orlando, Douglas Norman, Gary Farnham, David R. Redwood, and Stephen E.Epstein .. ... 1180

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lntraaortic Balloon Pumping for Ventricular Septal Defect or Mitral Regurgitation Complicating AcuteMyocardial Infarction. Herman K. Gold, Robert C. Leinbach, Charles A. Sanders, Mortimer J. Buckley,Eldred D. Mundth, and W. Gerald Austen .... 1191

lntraaortic Balloon Pumping for Control of Recurrent Myocardial lschemia. Herman K. Gold, Robert C.Leinbach, Charles A. Sanders, Mortimer J. Buckley, Eldred D. Mundth, and W. G-erald Austen ... 1197

Long-Term Use of Procaine Amide following Acute Myocardial Infarction. Bernard D. Kosowsky, JackTaylor, Bernard Lown, and Robert F. Ritchie .................................................... 1204

Occlusion of Coronary Arteries after Vein Bypass. M. R. Malinow, E. Louise Kremkau, F. E. Kloster, L. I.Bonchek, and J. Rosch .... ........................... .. ... ............ ........... 1211

Diastolic Heart Sounds during Static (Handgrip) Exercise in Patients with Chest Pain. Peter F. Cohn,Peter Thompson, James Todd, Warren Strauss, and Richard Gorlin ......... ..... 1217

A Study of Ventricular Arrhythmias Associated with Acute Myocardial Infarction in the Canine Heart.Albert L. Waldo and Gerard A. Kaiser ........................................................... 1222

Effect of Digitalis on Atrioventricular Conduction and Circus-Movement Tachycordias in Patients withthe Wolff-Parkinson-White Syndrome. Hein J. Wellens and Dick Durrer .. 1229

Electrophysiologic Properties of Diphenylhydantoin. Anthony N. Damato, Mark E. Josephson, Michael A.Ricciutti, John J. Gallagher, and Sun H. Lau ........................... 1234

Nonrheumatic Subvalvular Mitral Regurgitation: Etiology and Clinical Aspects. Philip K. Caves, GeorgeC. Sutton, and Matthias Paneth ... .1242

Mechonics of Left Ventricular Contraction in Severe Mitral Regurgitotion. Dwain L. Eckberg, James H.Gault, Richard L. Bouchard, Joel S. Karliner, and John Ross, Jr. ... .. 1252

Infra-His Bundle Origin of Bidirectional Tachycardia. Stafford I. Cohen, Albert Deisseroth, and Harvey S.Hecht .. 1260

A-V Nodal Reentrance: An Unexpected Mechanism of Paroxysmal Tachycardia in a Patient with Pre-excitation. Kenneth M. Rosen ............ 1267

Echocardiographic Determination of Mitral Disc Valve Excursion. Michael L. Johnson, Joseph H. Holmes,and Bruce C. Paton .. ... ......1274

Systolic Time Intervals in Infants with Congestive Heart Failure. Sang C. Park, Leonard Steinfeld, andIvan Dimich..... .... .... 1281

A Quantitative Evaluation of Heart Size Measurements from Chest Roentgenograms. Lester Glover,William A. Baxley, and Harold T. Dodge ................................................ 1289

Variations in Arterial Blood Pressure after Kidney Transplantation: Relation to Renal Function, PlasmaRenin Activity, and the Dose of Prednisone. Mordecai M. Popovtzer, Wulf Pinnggera, Fred H. Katz,Jacques Corman, John Robinette, Bernard Lannois, Charles G. Halgrimson, and Thomas F. Starzl 1297

Renal Cortical Blood Flow, Cortical Fraction, and Cortical Blood Volume in Hypertensive Subjects. Alex-ander G. Logan, Manuel T. Velasquez, and Jay N. Cohn 1306

Reduced Red Cell 2,3-Diphosphoglycerote and Adenosine Triphosphote, Hypophosphatemia, and In-creased Hemoglobin-Oxygen Affinity after Cardiac Surgery. Jerald A. Young, Marshall A. Lichtman,and Jules Cohen .131.......................................... 1313

Prosthetic Valvular Endocarditis: A 12-Year Review. Laura Slaughter, James E. Morris, and Albert Starr 1319SPECIAL ARTICLE:

Myocardial Ammonia Metabolism in Patients with Heart Disease as Revealed by Coronary SinusCatheterization Study. Eugene Chazov, V. N. Smirnov, A. V. Mazaev, G. B. Asafov, D. U. Gukowski, andV. T. Krikov .137.. .. .......... ......................... 1327

RADIOLOGIC NOTES IN CARDIOLOGY:Postoperative Roentgen Evaluation of Total Correction of Tetralogy of Fallot. Kent Ellis 1335

CLINICOPATHOLOGIC CORRELATIONS:Cardiac Malformations Associated with Down's Syndrome. Rajendra Tandon and Jesse E. Edwards 1349

SYMPOSIUM: Cardiac Arrhythmias (Part 6)Present Status of Electroversion in Management of Cardiac Dsyrhythmias. Leon Resnekov .. 1356Ventricular Tachyarrhythmias: Clinical Aspects. Bernard Lown, John V. Temte, and Warren J. Arter 1364Pacemaker Arrhythmias and Electrocordiogrophic Recognition of Pacemakers. Augustin Castellanos,

Jr. and Louis Lemberg.. ..... ....... 1382BOOK REVIEWS .....1392BOOKS RECEIVED .. . . . . ............. ..................................................... 1395LETTERS TO THE EDITOR:

Atropine and Acute Myocardial Infarction. Andrew L. Wit ... . ........... 1397Regional Dyssynergy in Postinforct Patients. Ernest L. Fallen..... .................... 1400

POSTSCRIPT. Ephraim Donoso. .......................... .... 1402NEWS FROM THE AMERICAN HEART ASSOCIATION

President's Page: Community Program for Journals. Paul N. Yu . Page 1In Memorium: Louis N. Katz. Page 3Report of the Inter-Society Commission for Heart Disease Resources: Clinical Performance Criteria -

Defibrillation.. A-359VOLUME AUTHOR INDEX .1403VOLUME SUBJECT INDEX........ 1407

Circulation, Volume XLVII, June 1973

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