In this study, the effect of a course of prostaglandin E ( 1 ) (60 microg/d intravenously [i.v.]) or buflomedil (150 mg/d i.v.) treatment on parameters of left ventricular systolic function was investigated by echocardiography in patients of comparatively advanced age with severe peripheral occlusive arterial disease (Fontaine's stage III or IV). The study population was 20 patients, 12 men and 8 women, between 51 and 85 years of age (average age, 73. 7 years), with multiple coexisting medical conditions. These patients were no longer suitable candidates for other forms of interventional or surgical treatment. The patients were treated with prostaglandin E ( 1 ) or buflomedil in the dosages recommended for peripheral occlusive arterial disease for 3 weeks. The following were determined on the 1st, 11th, and 21st day, before and after drug administration: end-diastolic and end-systolic volume, ejection fraction, and pre-ejection period/left ventricular ejection time ratio. The data from all 20 patients were included in the evaluation. There was no evidence of any significant change in the ejection fraction or systolic time intervals, suggesting the safety of the drugs in this special patient population with multiple coexisting conditions.