Le remplacement valvulaire aortique au stade d'insuffisance cardiaque.

80 adult patients with isolated aortic valvulopathy and cardiac insufficiency have been investigated. Among 10 non operated patients, there has been 9 deaths during a three years follow-up. Among 70 operated patients early mortality is not higher than among patients without cardiac failure, but late mortality is significantly higher (27, 1 p. 100), bacterial endocarditis and sudden deaths being particularly frequent. Subjective improvement is constant among survivors but cardiomegaly and left ventricular hypertrophy do not change much. The authors think aortic valve replacement is beneficial even in patients with cardiac failure

The actions of nifedipine and nisoldipine on the contractile activity of human coronary arteries and human cardiac tissue in vitro.

We have studied the action of nifedipine and nisoldipine on the contractile activity of human isolated coronary arteries and human isolated auricular and ventricular muscles. Nisoldipine depressed dose dependently the spontaneous rhythmic contractions displayed by the coronary artery preparations and at 1 nM abolished these contractions. Nisoldipine was twenty times more potent than nifedipine as an inhibitor of increase in tone induced by depolarization (100 mM K+). The rhythmic activity induced by serotonin (10 microM) was about five times more sensitive to nisoldipine than to nifedipine. In both auricular and ventricular preparations, isoprenaline evoked an increase in the rate of force development and in the rate of relaxation. Nifedipine was five times (ventricular muscles) and ten times (auricular muscles) more potent than nisoldipine as a negative inotropic agent. The present observations in human isolated preparations indicate that nisoldipine shows a higher vascular selectivity than nifedipine