Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Volume 66 , Issue 7
Showing 1-20 articles out of 20 articles from the selected issue
Clinical Investigation
  • Unilateral Presentation Is Not Rare
    Hyun-Suk Choi, Hyunah Choi, Seungsuk Han, Hae-sung Kim, Changuk Lee, Y ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 623-626
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    Information regarding pulmonary edema in obstetric patients is limited, especially its natural history as most cases are from tertiary care centers. The incidence, etiology, and course of pulmonary edema in all obstetric patients at a primary - secondary care center was studied prospectively among 29,621 obstetric cases in the past 3.5 years. Pulmonary edema developed in 18 cases (0.06%) of all obstetric patients that were associated with pre-eclampsia - eclampsia and tocolysis with β-mimetics. The onset of pulmonary edema was 1-8 days postpartum in 12 patients, 1 day antepartum in 3 patients, and 26-32 gestational weeks in 3 patients. The cause was mainly cardiogenic, and the mean time taken for resolution was 2.2 days. Unilateral pulmonary edema occurred in 4 patients and there was delayed resolution compared with bilateral pulmonary edema because of delayed treatment. Pulmonary edema associated with pregnancy developed in 0.06% of cases, mainly during the peripartum, and resolved rapidly. Unilateral pulmonary edema was not uncommon. (Circ J 2002; 66: 623 - 626)
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  • Close Correlation of Tumor Necrosis Factor-α With Systemic and Local Production of Nitric Oxide
    Takashi Sugamori, Yutaka Ishibashi, Toshio Shimada, Nobuyuki Takahashi ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 627-632
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    Recent studies have demonstrated that proinflammatory cytokines induce large amounts of nitric oxide (NO) and that the amount increases in patients with congestive heart failure (CHF). There are, however, few reports regarding the relationships between NO production, cytokines and the severity of heart failure, so the plasma concentrations of nitrite and nitrate (NOx), tumor necrosis factor-α (TNF-α) and brain natriuretic peptide (BNP) were measured in 43 patients with CHF caused by dilated cardiomyopathy and 26 age- and sex-matched normal control subjects. Forearm blood flow (FBF) was measured using plethysmography during infusions of acetylcholine and nitroglycerin and after the administration of the NO synthesis inhibitor L-NMMA (NG-monomethyl-L-arginine). Plasma concentrations of both NOx and TNF-α were significantly higher in the patient group than in the control group (p<0.001) and correlated closely with BNP concentrations (p<0.001). There was a positive relationship between NOx and TNF-α concentrations (r=0.80, p<0.001). Administration of L-NMMA significantly reduced FBF in both groups, and the percent change in FBF from baseline correlated significantly with TNF-α concentrations (r=0.63, p<0.001). The FBF response to acetylcholine was depressed in the patient group and correlated inversely with TNF-α concentrations. The FBF response to nitroglycerin did not correlate with TNF-α concentrations. The findings indicate that the concentrations of NO and TNF-α in patients with CHF increase in proportion to the severity of heart failure, and that TNF-α plays a role in the enhanced systemic and local production of NO. (Circ J 2002; 66: 627 - 632)
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  • Shoichi Miyamoto, Masatoshi Fujita, Kinzo Ueda, Shun-ichi Tamaki, Koji ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 633-638
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    It is controversial whether newly created channels made by transmyocardial laser revascularization are functionally significant, so the present study evaluated the shunt flow from the left ventricular (LV) cavity to the ischemic myocardium in 51 patients with acute myocardial infarction (AMI) caused by complete occlusion of the proximal left anterior descending coronary artery. All patients underwent left heart catheterization within 24 h of onset and all underwent successful coronary reperfusion using primary coronary angioplasty with no angiographic restenosis on follow-up coronary angiography (CAG). The presence of the LV shunt flow was evaluated by selective left CAG after successful reperfusion. The LV global ejection fraction (EF) and regional function (centerline method) were analyzed by ventriculography in both the acute and chronic phases. The patients were divided into the 3 groups (Group A, no LV shunt without collaterals, n=20; Group B, no LV shunt with collaterals, n=24; Group C, LV shunt with collaterals, n=7). There was no difference in the grade of collateral circulation between Groups B and C. The improvements in LVEF and regional function from the acute phase to the chronic phase were significantly greater in Group C than in Groups A and B. Not only collateral circulation but also LV shunt contributes to the functional recovery of infarct myocardium in patients with AMI. (Circ J 2002; 66: 633 - 638)
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  • Hideyuki Saeki, Mareomi Hamada, Kunio Hiwada
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 639-644
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    Insulin-like growth factor-1 (IGF-1) is important in the hypertrophic response of the myocardium, so the present study was designed to elucidate whether the circulating levels of IGF-1 and its binding proteins (IGFBPs) are related to the disease condition of patients with hypertrophic cardiomyopathy (HCM), in particular the occurrence of congestive heart failure (CHF). The study group comprised 124 patients with HCM and 15 healthy control subjects. The HCM patients were subdivided into 3 groups: 39 with hypertrophic obstructive cardiomyopathy (HOCM), 67 with hypertrophic non-obstructive cardiomyopathy (HNCM), and 18 with HCM and a history of CHF (HF-HCM, n=18). Serum levels of IGF-1 and IGFBPs (IGFBP-1 and -3) were compared between groups. IGF-1 levels were significantly higher in patients with HOCM and HNCM, and lower in patients with HF-HCM than in control subjects (p<0.0001, p<0.005, and p<0.05, respectively). IGFBP-1 levels were significantly higher in patients with HF-HCM than in the other 3 groups (p<0.0001 for all). The findings suggest that circulating levels of IGF-1 and IGFBP-1 are related to the extent of myocardial injury in patients with HCM. (Circ J 2002; 66: 639 - 644)
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  • A Study Using the Head-up Tilt Test
    Satoshi Koyama, Nobuyuki Sato, Kimimoto Nagashima, Hitoshi Aizawa, Yui ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 645-648
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    The effect of peripheral sympathetic block on the autonomic nerve function of the heart was studied using the head-up tilt test (HUTT) and right stellate ganglion block (RSGB). Blood pressure (BP), heart rate (HR) and the parameters of power spectral analysis of HR variability recorded during the HUTT were measured in 8 patients with chronic pain syndrome before and after RSGB. In the control state, the mean HR and the LF/HF component recorded during HUTT significantly increased whereas the HF component markedly decreased. Conversely, the mean HR and LF/HF and HF components during HUTT did not significantly alter after the RSGB procedure. There were no significant differences between the BP values before and after RSGB. These results suggest that RSGB suppresses cardiac sympathetic function without significantly affecting BP and thus may be a safe and effective therapy for the chronic pain syndrome. (Circ J 2002; 66: 645 - 648)
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  • Toshihiko Nanke, Kiyoshi Nakazawa, Mariko Arai, Shounosuke Ryu, Tsuneh ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 649-654
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    A new method of extracting the low-amplitude and high-frequency components (L-HFCs) was developed and this study investigated its usefulness in 86 subjects: 28 normal subjects (group 1) and 58 patients with a previous myocardial infarction (MI). The patients were classified into 3 groups: group 2 with 38 patients without ventricular tachycardia (VT), group 3 with 13 patients with non-sustained VT, and group 4 with 7 patients with sustained VT. The new electrocardiography (ECG) subtraction method, using a mathematical filtering procedure, was used instead of conventional complex filtering. The continuous L-HFCs within the QRS complex were analyzed using a Z-lead recording. The duration of the continuous L-HFCs was significantly longer in group 4 than in groups 1 (p<0.0001), 2 (p<0.0001) or 3 (p<0.05) with all 3 filters. The ECG subtraction method is a powerful and useful new technique for identifying patients at risk for either sustained or non-sustained VT after MI, and overcomes several of the problems with the conventional signal-averaging method. (Circ J 2002; 66: 649 - 654)
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  • Manabu Kinoshita, Yutaka Nakaya, Nagakatsu Harada, Akira Takahashi, Ma ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 655-658
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    The contraction of muscle enhances the release of bradykinin (BK) and improves glucose uptake by the muscle. Angiotensin-converting enzyme inhibitor (ACEI) slows the breakdown of BK, thus the effect of BK is augmented in the presence of ACEI. The present study investigated whether the combination of exercise (increased production of BK) and ACEI (delay in breakdown of BK) might further improve insulin sensitivity in hypertensive patients with insulin resistance (HOMA-R >1.8). Patients were assigned either to increased walking distance (Walking group) or taking 2 mg temocapril, an ACEI, daily (ACEI group) for 8 weeks. Then both interventions were given to all patients for 8 weeks (ACEI+Walking group). Blood concentrations of triglycerides were slightly lower in the ACEI+Walking group than at baseline, although there were no significant differences in total cholesterol or high density lipoprotein-cholesterol among the 2 groups. Blood glucose was not significantly different with each treatment, but blood concentrations of insulin and HOMA-R were significantly lower in the Walking and ACEI groups compared with the Control group. The combination of walking and ACEI further lowered blood concentrations of insulin and HOMA-R, which suggests that this treatment is beneficial for hypertensive patients with insulin resistance. (Circ J 2002; 66: 655 - 658)
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  • Evaluation Based on the Thickness of the Ablated Intima and Media
    Yoshihiko Oishi, Mitsunori Okamoto, Takashi Sueda, Masaki Hashimoto, S ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 659-664
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    The effect of guidewire bias on angled-lesion ablation by rotational atherectomy (RA) was assessed by measuring the changes in vertical lumen diameter, horizontal lumen diameter and the intima - media thickness of the coronary artery, using intravascular ultrasound in 10 lesions with an angle greater than 10°. The vertical and horizontal diameters significantly increased after RA. The intima - media thickness at the 4 orthogonal sites significantly decreased. There was a significant positive correlation between vertical diameter change and angle (r=0.642, p=0.045), but none between horizontal diameter change and angle. There was no correlation between intima - media thickness change at 0° and angle; however, at 180° there was a tendency to correlation with angle (r=0.602, p=0.066). These data suggest that in cases of angled lesions, the increase in vertical lumen diameter is caused more by ablation of the 180° wall than by that of the 0° wall, which is brought about by guidewire bias toward the vascular wall at 180°. (Circ J 2002; 66: 659 - 664)
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  • Analysis Using Quantitative Parameters
    Yoshimi Hiraumi, Ken Watanabe, Hideshi Tomita, Ken-ichi Kurosaki, Akih ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 665-667
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    Functional pulmonary atresia must be distinguished from anatomical atresia, which has an intact ventricular septum, to avoid inappropriate treatment, but there is a paucity of data regarding the echocardiographic features that differentiate these conditions. Echocardiographic findings in 5 neonates with functional atresia were compared to those in 5 with anatomical atresia. The left and right ventricular end-diastolic dimensions (LVDd, RVDd), percent of normal predicted LVDd, RVDd/LVDd, tricuspid valve ring diameter (TVD), percent of normal predicted TVD, grade of tricuspid regurgitation (TR), peak TR velocity, pulmonary valve ring diameter (PVD), percent of normal predicted PVD, the minimum diameter of the ductus and the peak velocity through it (PDA velocity) were measured. In addition, systolic pulmonary (PAp) and right ventricular pressure (RVp) from either PDA velocity or TR velocity, and calculated PAp/RVp were also estimated. There were significant differences in RVDd/LVDd, %TVD, and peak TR velocity between the 2 groups. All functional patients showed RVDd/LVDd >0.6, %TVD >100%, estimated RVp <50 mmHg, PAp/RVp >0.85, and peak TR velocity <4 m/s, whereas the findings in anatomical atresia patients were completely the opposite. In conclusion, a large RVDd/LVDd, TVD, PAp/RVp, low RVp and small TR velocity all suggest functional rather than anatomical pulmonary atresia, although there may be some exceptions such as severe Ebstein anomaly. (Circ J 2002; 66: 665 - 667)
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  • Katsuhiko Matsuyama, Masahiko Matsumoto, Takaaki Sugita, Junichiro Nis ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 668-670
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    There are no guidelines for the optimal therapeutic range of anticoagulant therapy in Japanese patients with mechanical heart valves. A total of 214 patients were followed retrospectively after mitral mechanical valve replacement (mean duration of follow-up, 4.8 years; total duration of follow-up, 1,027 patient-years). The target range of the international normalized ratio (INR) for oral anticoagulation was between 1.5 and 2.5. For all patients 10,416 measurements of the INR were obtained during the follow-up period and approximately 76% of the intensity measurements were within the target range. Thromboembolism occurred in 8 patients (0.8 per 100 patient-years) and major bleeding in 5 patients (0.5 per 100 patient-years). There was no correlation between the distribution of the INR and the occurrence of thromboembolic or bleeding complications. In the univariate analysis of the various risk factors, patients who had a tilting valve or did not receive antiplatelet therapy had an increased risk of thromboembolism. However, there were no risk factors with respect to bleeding complications. A target range of 1.5 to 2.5 INR appears to be the optimal range and is safe for thromboembolism or bleeding complications. Thromboembolism may be reduced by additional antiplatelet therapy, and a tilting valve needs more intense anticoagulation. (Circ J 2002; 66: 668 - 670)
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  • Tetsuo Sasano, Kenzo Hirao, Kei Yano, Mihoko Kawabata, Kaoru Okishige, ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 671-676
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    The cause and duration of the thrombogenesis provoked by radiofrequency catheter ablation (RF-CA) was investigated by measuring the thrombin - antithrombin III complex (TAT) in 43 patients who underwent RF-CA and in 20 control subjects who underwent an electrophysiologic study. Blood samples were collected at 7 different times: before introducing the sheaths, during the ablation procedure and at 30 min, 6 and 24 h, and 3 and 6 days after the procedure. Hepatocyte growth factor (HGF) was simultaneously measured in the ablation group. Plasma TAT concentration exhibited a double peaked pattern in the ablation group: the first peak occurred during the ablation procedure (42.8±15.5 ng/ml), and the second peak 3 days later. Plasma TAT at 3 days after the procedure was significantly higher than that of the control group (21.3±19.0 vs 2.5±1.4, p=0.0003). The first peak significantly correlated with the procedure time prior to the administration of heparin (r=0.669), but the second peak did not (r=0.132). A subgroup with a serum HGF >0.40 ng/ml at 6 h after the procedure exhibited a significantly high second peak. The thrombogenesis caused by RF-CA has 2 phases; in the acute phase, there is hemostasis during placement of the catheters, and in the delayed phase thrombogenesis is the result of endothelial damage from the RF current. (Circ J 2002; 66: 671 - 676)
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  • Yoshio Ichihara, Jun Ohno, Masayuki Suzuki, Takafumi Anno, Mikio Sugin ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 677-684
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    Of 2,722 people (1,876 men, mean age: 51.3±10.3 years; 846 women, mean age: 51.4±11.1) who underwent the fitness check program at Aichi Prefectural Center for Health Care, the concentration of C-reactive protein (CRP) and the white blood cell count (WBC) were investigated in relation to the number of coronary risk factors, maximum oxygen uptake (VO2max) quartiles and physical fitness score. CRP was measured by conventional latex immunoturbidimetric assay. Both CRP and WBC were higher in those who had more risk factors. In men the lowest mean CRP was 0.07 mg/dl in those with only one risk factor (RF1) and the highest was 0.29 mg/dl in RF6 (p<0.0001). The lowest mean WBC was 4,868/mm 3 in RF1 and the highest was 7,096/mm3 in RF6 (p<0.0001). In women the lowest mean CRP was 0.073 mg/dl in those with no risk factors (RF0) and the highest was 0.22 mg/dl in RF5 (p=0.0379). The lowest mean WBC was 5,065/mm3 in RF1, and the highest was 6,792/mm3 in RF4 (p=0.0001). A similar relationship was noticed when the groups were analyzed by VO2max quartile or fitness score. CRP and WBC both showed a stepwise increase or decrease in men, but was generally in order in women in accordance with the number of risk factors, VO 2max level or fitness score. In apparently healthy Japanese subjects, elevated inflammatory indices (ie, higher CRP and WBC) were associated with more coronary risk factors and poorer physical fitness. Therefore, high-risk coronary subjects might be screened by conventional measurement of CRP. (Circ J 2002; 66: 677 - 684)
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  • Tadamichi Sakuma, Takenori Okada, Yasuhiko Hayashi, Masaya Otsuka, Yuu ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 685-690
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    The objective of this study was to determine the optimal time to assess microvascular integrity within the risk area for myocardial infarction in order to predict unfavorable left ventricular remodeling (LVR) after successful primary coronary angioplasty. Fifty-three patients who underwent myocardial contrast echocardiography (MCE) just before recanalization, shortly after and 1 day (Day 2) and 3 weeks after recanalization were studied. The no- and low-reflow ratio (LR ratio) was analyzed at each stage. The wall-thinning ratio within the risk area was determined using magnetic resonance imaging performed 3-4 weeks after the recanalization. Thirteen of the 53 patients showed LVR 3-8 months after recanalization. The optimal time to predict LVR was found to be Day 2 based on the receiver operating characteristic curves. The LR ratio on Day 2 (χ2=7.39, p=0.007) and the collateral circulation before recanalization (χ2=4.57, p=0.03) were chosen as independent variables for predicting LVR. Patients with greater than 0.43 in the LR ratio on Day 2 showed a lower wall-thinning ratio (58±19% vs 72±20%, p=0.05). This study shows that the optimal time to estimate the microvascular integrity for predicting LVR is 1 day after recanalization, which is neither shortly after recanalization nor during the convalescent stage. (Circ J 2002; 66: 685 - 690)
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  • Hiroshi Suzuki, Hitoshi Matsubara, Shinji Koba, Mikitaka Murakami, You ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 691-695
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    Arteriosclerosis of the small arteries is one of the main causes of microvascular angina, and although some reports have shown favorable prognoses, there is progressive reduction in left ventricular function. The present study evaluated the prognosis of microvascular angina in 86 Japanese patients (51 women, 35 men; average age, 59±9 years) who had ischemic ST segment depression, normal coronary angiograms and small artery sclerosis confirmed by endomyocardial biopsies. The mean follow-up period was 7.2±3.4 years. Questionnaires regarding their symptoms, cardiac medication, and new events were sent to all patients. Eighty-five patients (98.9%) were still alive at the end of the follow-up period. Chest pain remained in 35.3%; the degree of pain was unchanged in 18.8%, and had lessened in 11.8%. None of the patients died of cardiac events or suffered from a myocardial infarction. At the end of the follow-up period, calcium antagonist was used in 63.5% of patients. Seventeen patients (20.0%) were free of antianginal medication. The prognosis of microvascular angina diagnosed by strict criteria was favorable. (Circ J 2002; 66: 691 - 695)
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Experimental Investigation
  • Possible Involvement of Neurotransmitters From Autonomic Nervous System
    Atsushi Sugiyama, Yoshioki Satoh, Yuko Ishida, Masahiko Yoneyama, Hiro ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 696-701
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    Catheter ablation of the atrioventricular node (AVN) with radiofrequency current is closely associated with the short-term onset of a junctional rhythm. The origin of this rhythm was analyzed in Beagle dogs which were anesthetized with pentobarbital sodium. Atrioventricular (AV) conduction block was induced first using a standard catheter ablation technique for the AVN, so that the sinus automaticity could not override the junctional ectopy during the following energy delivery. The ablation catheter was kept in the initial position and the delivery of radiofrequency energy was repeated. The pattern of ECG changes suggests that the dominant pacemaker may shift from the distal portion of the AV junctional area to the proximal portion during the energy delivery. This enhanced junctional automaticity was suppressed by the β-blocker esmolol, but was not affected by M-antagonist atropine. Moreover, the β-agonist isoproterenol did not induce the same type of junctional tachycardia, but the pacemaker shift was induced by the increased sympathetic tone after transient asystole by ventricular overdrive pacing or acetylcholine administration. These results suggest that proximal portion of the AV junctional area has extremely slow pacemaker activity, but responds to locally released norepinephrine with an abrupt rise and fall in rate, resulting in a typical pattern of junctional tachycardia during the ablation of the AVN. (Circ J 2002; 66: 696 - 701)
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Case Report
  • Jun-ichi Kotani, Shinsuke Nanto, Masafumi Kitakaze, Tomoki Ohara, Taka ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 702-704
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    Radiolucent findings of coronary angiogram are believed to usually represent intracoronary thrombus, but in the present case, were atheromatous plaque with a large lipid core. A 62-year-old man who suffered from an inferior acute myocardial infarction was admitted to hospital 6 h after onset. The first cine angiograms showed TIMI-1 flow in the distal-portion of the right coronary artery, so thrombectomy was initially carried out and TIMI-2 flow achieved. However, the radiolucent lesion did not disappear and so adjunctive mechanical dilatation of the lesion was prformed, which resulted in `no-reflow' (TIMI-0). Finally, aspiration of the material from the stagnated lesion was attempted and immediately obtained TIMI-3 flow. The retrieved materials were macrophages (foam cells) and many cholesterol crystals, both of which are considered to be atheromatous gruel. Therefore, the sudden flow reduction following percutaneous transluminal coronary angioplasty was caused by mechanical disruption of an atheromatous plaque with a large lipid core. (Circ J 2002; 66: 702 - 704)
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  • A Case Report
    Shuji Joho, Hidetsugu Asanoi, Masao Sakabe, Keiko Nakagawa, Tomoki Kam ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 705-706
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    This report describes a long-term survival case of left ventricular free wall rupture treated with percutaneous intrapericardial fibrin-glue fixation therapy. A 82-year-old woman was admitted to the emergency room because of vomiting and syncope diagnosed as acute posterolateral myocardial infarction complicated by cardiac tamponade. After her hemodynamic condition was stabilized by drawing off the bloody pericardial effusion, fibrin-glue was injected into pericardial space with the expectation that the glue would cover the oozing site of the left ventricular epicardium. After this therapy, the patient recovered and did not have any no recurrent cardiac events for 1 year. Serial echocardiographic studies revealed a preserved left ventricular function and no development of left ventricular restriction. This case suggests that percutaneous intrapericardial fibrin-glue fixation therapy is an effective treatment for the oozing type of left ventricular free wall rupture and that there is no risk of left ventricular restriction during long-term follow-up. (Circ J 2002; 66: 705 - 706)
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  • Öcal Berkan, Ílhan Günay
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 707-708
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    There are numerous cases of arterial and venous bullet embolism to the heart. An unusual case of birdshot embolus to the right ventricle from the femoral vein caused diagnostic confusion. Distant migration of the foreign bodies via blood vessels has to be taken into consideration after gunshot wounds. (Circ J 2002; 66: 707 - 708)
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  • Masayuki Teraguchi, Yumiko Ikemoto, Yohnosuke Kobayashi
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 709-711
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    A 14-year-old boy with mid-ventricular hypertrophic obstructive cardiomyopathy (MVHOCM) first presented at the age of 10 years with severe chest pain. Two-dimensional echocardiography disclosed marked hypertrophy at the mid-portion of the ventricular septum, and left ventriculography showed an hourglass appearance at systole. He was initially treated with propranolol, but the chest pain and dyspnea on exertion worsened at the age of 12 years. After disopyramide was started, the chest pain disappeared and the degree of the pressure gradient at the mid-ventricular level was reduced. There was also significant improvement on a 123I β-methyliodophenyl pentadecaonic acid (BMIPP) myocardial scintigram. (Circ J 2002; 66: 709 - 711)
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Rapid Communication
  • A Possible Animal Model of `Tako-Tsubo' Cardiomyopathy
    Takashi Ueyama, Ken Kasamatsu, Takuzo Hano, Katsuhiro Yamamoto, Yoshih ...
    Type: scientific monograph
    Subject area: None
    2002 Volume 66 Issue 7 Pages 712-713
    Published: 2002
    Released: June 25, 2002
    JOURNALS FREE ACCESS
    The etiology of a novel cardiac syndrome `tako-tsubo' cardiomyopathy, otherwise known as `transient left ventricular (LV) apical ballooning' and which mimics acute myocardial infarction, is not clear; however, emotional or physical stress is known to precede the attack. Left ventriculography of rats experiencing emotional stress induced reversible LV apical ballooning, which was normalized by pretreatment with adrenoceptor blockade. Together with results of previous studies, activation of cardiac adrenoceptors in the absence of ischemia-reperfusion is proposed as the primary cause of this syndrome. (Circ J 2002; 66: 712 - 713)
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