Ischemic heart disease 1630 INDEX

Patient Population. The proband of the B family, T.B., was referred to the Lipid Research Clinic at The Johns Hopkins Hospital at the age of five years because of hypercholesterolemia of 900 mg/100 ml. She had multiple planar xanthomas that had first appeared at three years of age. The patient was free of symptoms of ischemic heart disease. The index lipoprotein pattern was type lib (57), with marked hypercholesterolemia, hyperbeta-lipoproteinemia, a mild hyperprebetalipoproteinemia and hypertriglyceridemia. None of the relatives of T.B. had xanthomas or corneal arcus one (J.S.) developed signs of premature coronary atherosclerosis at the age of 43 years. Increased total plasma and LDL cholesterol levels were transmitted over three generations on both maternal and paternal sides of the family (Fig. I). The parents of the proband, S.B. and K.B., had endogenous hypertriglyceridemia as well. Two normolipidemic members of this family (S.B., Jr. and E.B.), were also studied. 

The hemodynamic effects of dofetilide 500 micrograms bd and sotalol 160 mg bd for 3-5 days have been studied in 12 patients with ischemic heart disease and sustained ventricular tachycardia (56). There were significant reductions in heart rate, mean systemic pressure, and cardiac index (-13%) with sotalol, but cardiac index increased significantly with dofetilide (11%) with no effect on heart rate or systemic blood pressure. The authors suggested that oral dofetilide could be useful in patients with ventricular tachydysrhythmias associated with impaired left ventricular function. One patient taking dofetilide reported mild dizziness and there were no cardiac dysrhythmias. 

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