volume 114 Number 4, ParI 1 Piroximone in CHF 14. Wilson JR, Schwartz S, St John Sutton M, Ferraro N, 20. Bennotti JR, Grossman W, Braunwald E, Carabello BA. Horowitz LN, Reichek N, Josephson ME. Prognosis in severe Effects of amrinone on myocardial energy metabolism and heart failure: relation to hemodynamic measurements and hemodynamics in patients with severe congestive heart fail- ventricular ectopic activity. J Am Coll Cardiol 1983;2:403- ure due to coronary artery disease. Circulation 1980;62:28- 10. 34. 15. Massie B, Ports T, Chatterjee K, Parmley W, Ostland J, O’Young J, Haughman F. Long-term vasodilator therapy for heart failure: clinical response and its relationship to hemo- dynamic measurements. Circulation 1981;63:269-78. 16. Maskin CS, S&kind SJ, LeJemtel TH. High prevalence of nonsustained ventricular tachycardia in severe congestive heart failure. AM HEART J 1984;107:896-901. 17. Weber KT, Janicki JS, Shroff S, Fishman AP. Contractile mechanics and interaction of the right and left ventricles. Am J Cardiol 1981;47:685-95. 18. Martin JL, Likoff MJ, Janicki JS, Laskey WK, Hirschfeld JW, Weber KT. Myocardial energetics and clinical response to the cardiotonic agent MDL 17,043 in advanced heart failure. J Am Co11 Cardiol 1984;4:875-83. 19. Amin DK, Shah PK, Hulse S, Shellock FG, Swan HJC. Myocardial metabolic and hemodynamic effects of intrave- nous MDL-17,043, a new cardiotonic drug, in patients with chronic, severe heart failure. AM HEART J 1984;108:1285-92. 21. Monrad ES, Bairn DS, Smith HS, Lanone A, Braunwald E, Grossman W. Effects of milrinone on coronary hemodynam- its and myocardial energetics in patients with congestive heart failure. Circulation 1985;71:972-9. 22. Weber KT, Andrews V, Janicki SJ, Wilson JR, Fishman AP. Amrinone and exercise performance in patients with chronic cardiac failure. Am J Cardiol 1981;48:164-9. 23. Likoff MJ, Weber KT, Andrews V, Janicki SJ, St John Sutton M, Wilson H, Rocci ML. Amrinone in the treatment of chronic cardiac failure. J Am Co11 Cardiol 1984;3:1282- 24. kber KT Janicki JS Jain MC. Enoximone (MDL 17 043) for stable, ‘chronic heart failure secondary to ischemic or idiopathic cardiomyopathy. Am J Cardiol 1986;58:589-95. 25. Weber KT, Andrews V, Janicki JS, Likoff MJ, Reichek N. Pirbuterol, an oral beta-adrenergic receptor agonist, in the treatment of chronic cardiac failure. Circulation 1982; 66:1262-7. Biventricular cardiac hypertrophy in essential hypertension Left ventricular hypertrophy (LVH) is the major adaptation of the heart to a prolonged increase in the left ventricular afterload In hypertension. However, the structure and function of the right ventricle have received little attention. The present study was designed to assess right ventricular structural changes in patients with established essential hypertension. To accomplish thls, M-mode echocardlograms were obtained from 15 healthy normotenslve subjects and 35 patlents with essential hypertension- 15 with normal left ventricles and 20 with clear-cut echocardiographlc evidence of LVH. In comparison with the normotensive subjects, right ventricular wall thickness was Increased almost twofold In the hypertensive patients with LVH (7.0 ? 2.1 mm vs 3.7 + 0.8 mm; p < 0.001); there was a significant, direct correlation between right and left ventricular wall thickness In the entire patient population (r = 0.65; p < 0.001). Furthermore, the left atria1 emptying index was significantly reduced in all patients with hypertension regardless of whether LVH was present (p < 0.001) and suggests early diastolic functlonal Involvement of the left ventricle in hypertension. We therefore conclude that right ventricular hypertrophy is associated with LVH in patients with hypertension, although the changes of LVH are frequently more obvious to the clinician. (Am HEART J 1987;114:813.) Boris D. Nunez, M.D., Franz H. Messerli, M.D., Celso Amodeo, M.D., Guillermo E. Garavaglia, M.D., Roland E. Schmieder, M.D., and Edward D. Frohlich, M.D. New Orleans, La. From the Department of Internal Medicine, Section on Hypertensive Diseases, Ochsner Clinic, and the Research Division, Alton Ochsner Hypertrophy is one of the major adaptive adjust- Medical Foundation. merits of the heart to chronologically increased Received for publication Dec. 4, 1986; accepted April 22, 1987. stress of a physiologic overload.1~2 Evidence is abun- Reprint requests: Franz H. Messerli, M.D., Ochsner Clinic, 1514 Jefferson dant supporting the premise that left ventricular Hwy., New Orleans, LA 70121. hypertrophy (LVH) in hypertension is a compensa- 813