Mitral annular velocity in early diastole(E') gradually decreases following exacerbation of left ventricular(LV) diastolic dysfunction. Patients with an E'≤5cm/s may have LV diastolic dysfunction similar to those with the ratio of the mitral E velocity to E'(E/E')≥15. An E/A>1 obtained by Doppler evaluation of transmitral inflow is considered to indicate greater LV diastolic dysfunction, if E' is low. This study was designed to investigate whether echocardiographic Doppler studies predict the development of heart failure(HF). The present study group comprised 159 subjects of 2040 underwent echocardiographic studies who had an E'≤5cm/s, normal systolic function and sinus rhythm. Subjects were divided into 2 groups based on whether they had evidence of heart failure during 18 months follow-up(HF group and non-HF group). Eleven percent of the subjects were in HF group. Twenty five percent of the subjects with an E/E'≥15 were in HF group, as were 32% of those with an E/A>1. Furthermore, subjects with an E/E'≥15 and an E/A>1 had a higher incidence(5 of 11 patients, 45%) of heart failure. Tissue Doppler and pulse Doppler studies may provide useful information about whether patients with preserved LV systolic function are susceptible to developing heart failure in the elderies.

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　　マグネシウム(Mg)配合輸液が待機的冠動脈形成術(e-PCI)後の血清電解質，腎機能および心機能に与える影響を検討した．対象は e-PCI を施行した 40 例で，施行前に Mg 配合輸液(Mg 群)と Mg 非配合輸液(C 群)の 2 群に分けた．e-PCI 前後で血清 Mg 濃度は Mg 群で変化を認めず，C 群で前値 2.4±0.3mg/dl から 2.2±0.3mg/dl へ有意に減少した(p<0.0001)．血清クレアチニンは両群で有意差を認めず，平均尿量は Mg 群 1,455.0ml が C 群 1,135.5ml より有意に多かった(p=0.049)．両群の不整脈や血圧に有意な差はなかった．Mg 配合輸液は e-PCI の輸液療法において血清 Mg 濃度を維持し，尿量を増加した．Mg 配合輸液は e-PCI 時の合併症予防に有用であると考えられた．

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Left ventricular free wall rupture is usually sudden and fatal. We report our experience with impending blowout rupture diagnosed by Computed Tomography(CT) and treated by sutureless repair. A 70-year-old female was admitted with a diagnosis of acute myocardial infarction. An echocardiography confirmed cardiac rupture of oozing type. However, meticulous examination of CT revealed impending blowout rupture with left ventricular defect. Then, she underwent emergency sutureless repair with cardiac arrest using cardiopulmonary bypass. Her postoperative course was uneventful.

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