[Does captopril possess antianginal actions? An evaluation of its effects on myocardial ischemia by stress tests in patients with stable angina and normal ventricular function]. / Posee el captopril acciones antianginosas? Valoración de sus efectos sobre la isquemia miocárdica mediante pruebas de esfuerzo en enfermos con angina estable y función ventricular normal.

INTRODUCTION: We have studied the effects of captopril on myocardial ischaemia in normotensive and hypertensive patients with coronary artery disease and stable effort-induced angina. STUDY DESIGN: A maximal treadmill effort test (Bruce modified) was obtained before and after 60 min administration of 25 mg. p.o. of captopril. In a first open pilot essay, 12 patients were studied. In a double-blind randomized, placebo-controlled, without crossover, 20 patients with the same characteristics and methodology were divided in two groups (10 in placebo and 10 in captopril group) and compared in a maximal treadmill effort test. RESULTS: In the pilot essay, the second test don't showed increments in heart rate, systolic and diastolic blood pressure showed a significant reduction at rest (p < 0.01) and at 1 mV ST segment depression (p < 0.01). Captopril increased exercise duration at 1 mV ST segment depression, time to angina and total exercise time (p < 0.01). In double-blind essay, captopril group results were similar to the pilot essay. In comparing results between placebo and captopril groups the most relevant differences were: significant increment in the time to 0.1 mV ST segment depression (p < 0.01), to angor (p < 0.05) and total exercise duration (p < 0.01). Maximal work-load sustained increased significantly with captopril (7.43 +/- 2.1 to 10.34 +/- 1.8 METS) (p < 0.01). CONCLUSIONS: We conclude that captopril used in monotherapy in patients with chronic stable angina, seems to reduce clinical and electric ischemia and to ameliorate maximal exercise duration and work-load.

[The double-orifice mitral valve. An evaluation by two-dimensional echocardiography and color echo-Doppler]. / Doble orificio de la válvula mitral. Valoración con ecocardiografía bidimensional y eco-Doppler color.

Double-orifice mitral valve is an uncommon congenital heart defect. The isolated occurrence of this anomaly is exceptional and, more often, is encountered in association with other congenital cardiac abnormalities. Principal among these are the partial and complete forms of the atrioventricular canal. In this paper, we present two cases of double-orifice mitral valve. Our first case is associated with subaortic stenosis and coarctation of aorta. The second case is an isolated one resembling a severe mitral stenosis. As we know, the diagnosis of this rare anomaly by color-Doppler technique has not been previously reported. We believe this technique provides definite anatomical and functional information about double-orifice mitral valve.