JAPANESE CIRCULATION JOURNAL
Online ISSN : 1347-4839
Print ISSN : 0047-1828
ISSN-L : 0047-1828
Volume 49, Issue 1
Displaying 1-15 of 15 articles from this issue
  • MOTOOMI NAKAMURA
    1985 Volume 49 Issue 1 Pages 1-12
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    1. As one of the cause of acute myocardial-ischemia, coronary vasospasm has attracted attention increasingly in clinical cardiology. We developed animal model of coronary vasospasm associated with transient myocardial ischemia by administration of histamine or serotonin in atherosclerotic miniature swine. 2. Early systolic dysfunction as well as subendocardial NADH production of the ischemic region occurred within 10 sec after coronary occlusion, but ST segment started to elevate around 30 sec after occlusion in the isolated rat heart. 3. As the important determinant factors of myocardial infarct size, the preocclusive perfusion area as well as collateral flow area could be measured quantitatively by use of double isotopes autoradiograms, and the close correlation was found between the salvaged area and collateral flow area in dogs. An importance of advancement in basic cardiology and development of new research techniques have been emphasized.
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  • MIRON WEILFELDT
    1985 Volume 49 Issue 1 Pages 13-24
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
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  • TADASHI MATSUMURA
    1985 Volume 49 Issue 1 Pages 25-37
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    Analytical models of the analog computers simulation method of radiocardiogram (RCG) were revised to obtain quantitative hemodynamic evaluations in patent ductus arteriosus (PDA). The theoretical and technical aspects are herein outlined, and the effects of clinical application discussed. Twenty-six patients with a left-to-right PDA shunt were studied by the revised RCG models, and the results were compared with oxymetric or echocardiographic data. Between RCG and oxymetry, the systemic blood flow (SBF) findings agreed well (r=0.91), but in oxymetry, the pulmonary blood flow (PBF) findings were generally seen greater than in RCG (r-0.81), and the oxymetric shunts appeared larger than in RCG (r=0.75). This is because oxymetry cannot avoid the direct effects of the uneven partition of shunt flow to the lungs, whereas RCG can, in addition, measure the mean PBFs and SBFs. RCG may thus be said to be superior to oxymetry in assessing PDA shunts. Furthermore, RCG can estimate the mean left and right heart volumes (LHV and RHV) at the same time; the RCG LHV was found to correspond to the echocardiographic left ventricular end-diastolic volume (LVEDV) (r=0.89). Moreover, the obtained relation between the RHV/LHV (Y) and the shunt ratio (X) proved to be the same that calculated theoretically (Y=-X+1.0) in uncomplicated patients. Patients not presenting this relation may be assumed to suffer some condition complicating the PDA. In effect, the analog computer simulation method of RCG is a unique non-invasive means of obtaining quantitative analyses in PDA and in other congenital shunt diseases as well.
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  • MICHIYOSHI YAJIMA, SHUZO NOMURA, KENICHI NAMBA, MASAAKI SEKINE, TOSHIA ...
    1985 Volume 49 Issue 1 Pages 38-45
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    Plasma prostanoids and levels of cyclic nucleotides were studied in forty-nine outpatients with precordial pains and subjected to the treadmill exercise test. Blood samples were drawn before, immediately after and 30 minutes after exercise, from antecubital veins. Plasma TXB2, 6-keto PGF, cyclic AMP and cyclic GMP levels were measured by radioimmunoassay. The results of exercise tests were evaluated according to the treadmill exercise score (TES) of Hollenberg et al. Patients were divided into two groups; those with TES (+) with normal exercise response. There were no differences in TXB2 levels between the two groups before exercise. Immediately after exercise statistically significant differences in TXB2 levels were present between the two groups. There were increased levels in the TES(-) group and decreased levels in the TES(+) group (p<0.01). Although the 6-keto PGF levels were the same between the two groups before exercise, 6-keto PGF levels in the TES(+) group increased significantly immediately after exercise. Similar changes were noted in the case of cyclic nucleotides, and the differences increased immediately after exercise. We conclude that high responses of cyclic nucleotides and PGI2 are required to counteract increases in levels of TXA2 and diminution of these responses may be an important phenomenon involved in the physiological status of ischemic heart disease.
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  • HIROSHI SHIONOIRI, EIJI GOTOH, NAOMICHI MIYAZAKI, GEN YASUDA, NOBUYOSH ...
    1985 Volume 49 Issue 1 Pages 46-51
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    The antihypertensive effect of a non-sulfhydryl, long acting ACE (angiotensin converting enzyme) inhibitor, MK-421, was evaluated by administering a single does of 10 mg to 13 patients with mild to moderate essential hypertension. The pharmacokinetic profile of MK-421 and its potent active metabolite, MK-422, was also assessed, together with the effect on the various components of the renin-angiotensin system. A single does of MK-421 produced a significant fall in MBP from 2 to 24 hours post-drug. As could be expected, plasma ACE activity was suppressed up to 24 hours after MK-421. The half-like of MK-422, Cmax and [AUC]240 of MK-421 and MK-422 were measured. No significant change in plasma bradykinin or urinary excretion rate of kallikrein was observed, whereas a slight increase was observed in the urinary excretion rate of kinins after MK-421 in 8 patients. Significant correlations were observed between pretreatment PRA levels and the maximum fall in MBP.
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  • RYO KATORI, MASAHIRO TASHI, MAKOTO OHNO, TOSHIHIRO OOGAI, MASATAKA MOR ...
    1985 Volume 49 Issue 1 Pages 52-60
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    The symptom limited maximal exercise was performed by a supine bicycle ergometer before and 12 weeks after oral carteolol therapy in 10 patients with essential hypertension of WHO Stage 1 and 2. At rest, arterial blood pressure (BP) and venous pressure (VP) significantly declined after therapy, while heart rate (HR), cardiac index (CI), stroke index (SI) and systemic vascular resistance (SVR) were not significantly changed. The maximal exercise work of post-therapy was similar to that of pre-therapy in 9 patients and increased in one. When compared with the pre-therapy values at each work load of exercise, carteolol caused significant decreases in systolic BP, mean BP, HR and CI, and a significant increase in SVR, while SI and VP were not significantly changed. Plasma levels of renin activity, aldosterone, and catecholamines were not altered by carteolol throughout the study at rest and with exercise. It may be concluded that the inhibition of HR increase by carteolol results in a reduced cardiac output during moderate and severe exercise and then suppresses the elevation of BP, so that carteolol makes it possible to achieve more exercise with less cardiac work.
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  • EIICHI SENNARI
    1985 Volume 49 Issue 1 Pages 61-67
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    This report describes racial differences in the morphology of ventricular septal defects associated with coarctation or interruption of the aortic arch. Twenty-three heart specimens with obstruction of the aortic arch associated with ventricular septal defects collected in southern Japan were studied. Six specimens had an interrupted aortic arch and the remaining 17 cases had coarctation of the aorta. Fifteen cases (65.2% of the total) had malalignment defects with posterior deviation of the conal and/or truncal septum. In contrast to Anderson's report, only one case of perimembranous defect with aortic overriding was seen in our series. These anatomical findings suggest that the majority of ventricular septal defects associated with coarctation or interruption among Japanese is a malalignment defect with left ventricular outflow tract obstruction.
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  • GAKUJI NOMURA, SHOJI SAKAI, MICHIMASA SUMIE, HIROMI TASHIRO, HIRONORI ...
    1985 Volume 49 Issue 1 Pages 68-74
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    Serum N-acetyl-β-D-glucosaminidase (NAG) levels were measured in 1080 residents in Tanushimaru, Fukuoka, aged 20 to 84 years old, during a periodical epidemiological survey performed in 1982. thirteen pregnant women were excluded from this study. Serum NAG levels showed an increase with age, but were not different between sexes. We found high serum NAG values in those with high blood pressure, high serum total cholesterol, low serum HDL-cholesterol, or reduced creatinine clearance rate, and women with high serum uric acid, increased skinfold thickness, or high hematocrit. Multiple regression equation was as follows: NAG = 3.53+0.07 (age) + 0.14 (hematocrit) + 0.03 (total skinfold thickness) + 0.04 (systolic blood pressure) - 0.03 (HDL-cholesterol) - 0.04 (mean blood pressure) - 0.04 (mean blood pressure) -0.01 (creatinine clearance). The multiple correlation coefficient was 0.37 (F=24.4). We suggest that NAG may be a useful index in screening cardiovascular impairment and for cardiovascular risk factors.
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  • YOSHIO KOHDA, RYUJI TOMINAGA, YASUTAKA UENO, HIROMI ANDOH, EIICHI NAKA ...
    1985 Volume 49 Issue 1 Pages 75-80
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    Isolated rat heart preparations were used to determine the effect of cardioplegia on myocardial metabolism during profound hypothermic (15°C) ischemia. The hearts were grouped according to the components of cardioplegia and the mode of administration. The six groups were normokalemic (GI), calcium-containing hyperkalemic (GII), calcium-free hyperkalemic (GIII) and single does (A), multidose (B). Following 120 min of ischemia, tissue ATP decreased from 25.4±2.2 to 10.3±2.7, 3.9±2.4, 4.1±1.2, 15.5±3.2, 14.5±2.4 and 20.0±2.7 (I-A vs II-A p<0.005, I-A vs III-A p<0.005, I-B vs III-B p<0.05, II-B vs III-B p<0.005), and tissue lactate increased from 9.6±1.5 to 163.4±12.2, 174.1±13.5, 166.8±21.3, 99.1±8.3, 102.6±12.2 and 83.5±9.3 (I-B vs III-B p<0.02, II-B vs III-B p<0.02) μmol/dry wt g, in GI-A, GII-A, GIII-A, GI-B, GII-B and GIII-B, respectively. The results of this study suggests that (1) potassium cardioplegia in a single dose does not prevent degradation of high energy phosphate (HEP) in the hypothermic arrested heart, (2) though multidoes cardioplegia is effective in preserving HEP during ischemia, the extent of its effects varies with the composition, and (3) the omission of calcium is beneficial in GIK cardioplegia in terms of preserving HEP at the end of ischemia.
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  • KAZUO HAZE, TETSUYA SUMIYOSHI, KENICHI FUKAMI, SATOSHI ICHIDA, MINEYAS ...
    1985 Volume 49 Issue 1 Pages 82-93
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    We studied the clinical characteristics of I 53 patients with angina pectoris associated with coronary artery spasm (CAS). The study was designed to investigate the relationship of CAS to ST segment deviation and to the site of fixed stenosis, and hemodynamic alteration during a spastic event. Analysis of coronary arteriograms and multilead electrocardiograms obtained simultaneously from 170 events of CAS by the use ofradioluscent carbon-fiber electrodes resulted in 58 events with ST elevation which were related to total occlusion of major coronary arteries due to CAS; another 54 events with ST depression, in which the affected coronary arteries demonstrated severe but incomplete occlusion, or total occlusion but were visualized via collateral vessels; and remaining 58 events without ST deviation showing mild occlusion. The results indicate a close correlation between magnitude of CAS and ST segment deviation. CAS occurred at the site of pre-existing fixed stenosis including minor plaque defect in 133 patients and at apparently normal site in 20 patients. In the former group, only four patients had triple vessel disease, while 95 had nonsignificant fixed lesion. In the latter group, 10 patients had minor lesion distant from the site of CAS. Thus, CAS is closely related to fixed stenosis, which may have but a limited role as a cause of CAS. Hemodynamic measurements during spastic events were obtained from 49 patients including 41 events with spasm of the left anterior descending artery (LAD) and 21 events with spasm of the right coronary artery (RCA). The onset of an increase in left ventricular (LV) filling pressure and a reduction in LV dP/dt preceded ST segment deviation in all events. The first hemodynamic variable manifested in the spastic event was the reduction of LV contraction dP/dt in the majority of patients. The increase of LV filling pressure was greater in LAD spasm than RCA spasm (116 mmHg vs 74 mmHg, P < 0.0125) and in events with ST elevation than with ST depression (115 mmHg vs 65 mmHg, p < 0.001). Right ventricular functional impairment was mild in most patients during CAS. The study indicates that mechanical impairment precedes electrical impairment during CAS and that LAD spasm with ST elevation represents the most severe LV dysfunction.
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  • KEN-ICHI KAWASAKI, KATSUMI SEKI, ISAO MIYAZAWA, NAOHIRO MATSUMOTO, NOR ...
    1985 Volume 49 Issue 1 Pages 94-100
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    The role of atherosclerosis in coronary artery spasm was studied by morphometrical examinations of isolated postmortem human coronary arteries that were used for the observation of spontaneous periodic contractions. Isometric tension of coronary ring segments from seventy-six cadavers was recorded in a bath containing physiological saline solution. According to the degree of atherosclerosis, the segments were classified into three groups: minimum intimal lesion (Group I), moderate intimal lesion (Group II) and severe atherosclerotic lesion (Group III). Results were analyzed by a chi-square test. The incidence of the spontaneous periodic contractions was 45% in the proximal portion. Of the segments in which the contractions occurred, 83% were in Group Ii. There were significant differences in the incidence between Group I and II (33% vs 80%; p<0.02) and Group II and III (80% vs 25%, p<0.001), respectively. According to the characteristics of the atherosclerosis, there were significant differences in incidence of the contractions between circumferential thickening and eccentric thickening in Group II (63% vs 28%; p<0.001). In conclusion, the spontaneous periodic contractions occur most frequently in the segments in which (1) the degree of atherosclerosis is moderate rather than minimum or severe and )2) the characteristics of atherosclerosis is circumferential thickening instead of eccentric thickening.
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  • HITONOBU TOMOIKE
    1985 Volume 49 Issue 1 Pages 101-107
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    An animal model of coronary spasm was designed 1) to reproduce coronary spasm similar to that seen in patients with variant angina, 2) to determine whether hypercontraction of the vascular smooth muscle occurs at the site of the spasm, 3) to document the relationship between functional and structural changes of the vascular wall and 4) to characterize the pathophysiological features of coronary spasm. After balloon de-endothelialization and feeding of a high cholesterol diet in mongrel dogs and Gottingen miniature pigs, there was evidence of vascular hypercontraction associated with arteriosclerotic changes. Coronary spasm of more than 75% narrowing of the artery was provoked with ischemic signs in miniature swine. These events could be repeatedly provoked by an intra-coronary injection of histamine following pretreatment with cimetidine. The site of hypercontraction corresponded well with the site of the de-endothelialization, an area where the basal vascular tone was increased and was related to histamine activity. Thus, the present animal model will shed light on mechanism involved in vasoactive angina pectoris and aid in clarifying the pathophysiology of vascular smooth muscle.
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  • MASAAKI KAKIHANA, HIROSHI NODA, SADANORI OHTSUKA, YASURO SUGISHITA, IW ...
    1985 Volume 49 Issue 1 Pages 108-118
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    Ergnovine, methoxamine and clonidine were administered intravenously in order to clarify the mechanism of coronary artery spasm in canine experiments. After these administrations, 27.5% of the dogs treated with ergonovine, 59.5% of the dogs treated with methoxamine and 72.7% of the dogs treated with clonidine showed ST segment elevation. The combined application of propranolol with ergonovine or methoxamine could more easily induce ST segment elevation than a single application of ergonovine or methoxamine. Most cases of elevated ST segment returned to the normal after the administration of nitroglycerin and phentolamine. Yohimbine was completely effective for the restoration of normal ST segment. Plasma norepinephrine decreased to 20±8.0% of the control when ST segment elevation was induced. This is a significantly greater decrease than that seen without ST segment elevation (p<0.001). Concomitant with the restoration of normal ST segment, plasma norepinephrine increased after the administration of yohimbine. Methoxamine and clonidine increased (p<0.01) and yohimbine decreased (p<0.01) and yohimbine decreased (p<0.01) coronary vascular resistance. Coronary spasm was visualized on coronary arteriogram after the application of clonidine; also coronary vascodilation was visualized after the administration of yohimbine. These results confirm the hypothesis that coronary artery spasm is mediated by pre- and postsynapic 2-adrenoceptors.
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  • FUJIO NUMANO, TADANORI AIZAWA, SHUZO NOMURA, MICHIYOSHI YAJIMA, JUN-IC ...
    1985 Volume 49 Issue 1 Pages 119-127
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
    To elucidate the contribution of prostanoids in coronary spasm, plasma levels of thromboxane B2 (TXB20) and 6-keto PGF at the coronary sinus and ascending aorta in 21 patients with variant angina were measured, as compared with findings in 20 with effort angina and 13 subjects with normal coronaries. In the coronary sinus blood, plasma TXB2 in patients with effort angina exhibited statistically significant high levels, as compared with data in the controls. On the contrary, the data obtained from patients with variant angina were not statistically significant. However, eight patients whose coronary angiogram revealed more than 50% of coronary stenoses had statistically significant high levels of TXB2 and other patients with normal coronaries or less than 50% of narrowing showed almost the same levels of TXB2 as the controls. In contrast to TXB2, the plasma levels of 6-keto PGF in patients with variant angina were very low in both groups with variant angina. These data suggest that high levels of TXB2 observed in patients with atherosclerotic coronaries may be an accelerating factor while low levels of prostacyclin may be an essential factor leading to spasm. HLA analysis of 23 patients with variant angina was performed to search for genetic factors, under the hypothesis that such may contribute to the low levels in prostacyclin. This preliminary study revealed statistically significant high frequencies of Bw52 and B-40 in the patients, as compared with frequencies among 152 normal Japanese. Genetic studies are ongoing in our clinic.
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  • YASUMI UCHIDA
    1985 Volume 49 Issue 1 Pages 128-139
    Published: January 20, 1985
    Released on J-STAGE: April 14, 2008
    JOURNAL FREE ACCESS
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