JAPANESE CIRCULATION JOURNAL
Online ISSN : 1347-4839
Print ISSN : 0047-1828
ISSN-L : 0047-1828
Volume 62 , Issue 5
Showing 1-13 articles out of 13 articles from the selected issue
Special Article
  • Mitsuaki Isobe, Jun-ichi Suzuki
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 315-327
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    There are still many problems to be faced in the field of heart transplantation. Acute and chronic rejection are still the major medical obstacles. In this review, we describe recent research in this field undertaken in our laboratory. The induced intercellular adhesion molecule-1 (ICAM-1) and MHC class II antigen resulting from rejection can be visualized in vivo by radioimmunoscintigraphy. This non-invasive method is sensitive for detecting early rejection and allows quantitative assessment of rejection. Short-term administration of monoclonal antibodies to ICAM-1 and leukocyte function-associated antigen-1 (LFA-1) results in an indefinite acceptance of cardiac allografts by induction of antigen-specific tolerance, as evidenced by acceptance of the secondary skin allografts. The characteristics and possible mechanisms of this tolerance induction are discussed. Immunohistopathologic features of graft coronary arteriopathy are shown. Adhesion molecules, cytokines, and growth factors are associated with intimal hyperplasia and phenotypic. transformation of smooth muscle cells in the allograft coronary arteries. Dramatic reduction in this intimal hyperplasia was demonstrated by antisense gene therapy targeting cyclin-dependent kinase 2 kinase. We hope that these investigations will contribute to the improvement of the management of patients who undergo heart trans-plantation. (Jpn Circ J 1998; 62: 315 - 327)
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Review Article
  • Yoshiji Yamada, Mitsuhiro Yokota
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 328-335
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    Platelet-activating factor (PAF) mediates a variety of physiologic and pathologic events by activating platelets, neutrophils, monocytes, macrophages, and smooth muscle cells. A strongly oxidizing environment induces fragmentation of the polyunsaturated fatty acids of membrane phospholipids, and the resulting oxidized phospholipids are structurally similar to PAF and mimic its biologic actions. The effects of PAF and oxidized phospholipids are abolished by hydrolysis of the sn-2 residue, a reaction catalyzed by PAF acetylhydrolase. Plasma and intracellular forms of PAF acetylhydrolase have been purified and characterized. The plasma form binds with high affinity to lipoproteins in plasma. Furthermore, changes in the activity of this enzyme are associated with various human diseases and animal models of human pathology, suggesting that it may play important roles in their pathogenesis. Studies that have defined the properties of this enzyme and its roles in physiologic and pathologic processes are reviewed. Such studies have provided insight into the functions of PAF and oxidized phospholipids as well as into the etiology of allergic, inflammatory, and atherosclerotic diseases. (Jpn Circ J 1998; 62: 328 - 335)
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Clinical Study
  • Toshiaki Shiigi, Yuhji Furutani, Yasuma Nakamura, Hiroshi Nakamura, Ma ...
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 336-340
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    The aim of the study was to assess the relationship between changes in heart rate variability (HRV) and parameters of neuroendocrine activation in patients with various levels of left ventricular dysfunction. Measurements of HRV, plasma norepinephrine (PNE), and plasma atrial natriuretic peptide (ANP) were performed in 17 age- and gender-matched control subjects (group C) and in 39 patients with ischemic heart disease or cardiomyopathy who were subdivided into 3 equal groups according to their left ventricular ejection fraction: group N (normal); group M (mildly impaired); and group S (severely impaired). Spectral analysis of HRV (from 10-min electrocardiograms) was analyzed by the method of coarse-graining spectral analysis. PNE and ANP were significantly elevated in group S only (p<0.05). Log low-frequency power and log total power for group M were significantly lower than for group N (p<0.05). Log high-frequency power was significantly lower for group M than for group C (p<0.05). Thus, assessment of changes in HRV, which were observed earlier in the progress of left ventricular dysfunction than changes in neuroendocrine factors, may be a useful non-invasive method for the early detection of autonomic abnormality in patients with left ventricular dysfunction. (Jpn Circ J 1998; 62: 336 - 340)
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  • Kazuhiko Tanabe, Akiko Yamamoto, Noriyuki Suzuki, Naohiko Osada, Yasuh ...
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 341-346
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    We have previously reported that chronic sleep deprivation causes a deficiency of intracellular magnesium (Mg) and decreased exercise tolerance. The aim of this study was to clarify whether oral administration of Mg could be effective in restoring the exercise tolerance that is decreased by chronic sleep deprivation. A bicycle ergometer cardiopulmonary exercise test was performed by 16 healthy volunteers (mean age 21.9 years). They were divided into 2 groups: 8 received doses of 100 mg of Mg orally per day for 1 month (Mg group) and the remaining 8 received no Mg and served as the control group. The study conditions were designed as follows: (1) the usual state (good sleep); and (2) the sleep-deprived state (sleeping time up to 60% Iess than the usual state for 1 month). The ratio of intracellular Mg content of the sleep-deprived state to the usual sleep state was significantly higher in the Mg group (p <0.05) than the untreated control group. There was no difference between the sleep-deprived state and the usual state with regard to anaerobic threshold and peak oxygen uptake in the Mg group, whereas both of these decreased in the sleep-deprived state in the control group. These results indicate that decreased exercise tolerance observed in the sleep-deprived state could be improved by oral Mg administration. (Jpn Circ J 1998; 62: 341-346)
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  • Studies in Patients in Whom No Effective Pharmacologic Therapy Could be Determined by Electrophysiologic Study
    Shinichi Niwano, Hiroshi Furushima, Koji Taneda, Akira Abe, Koji Ohira ...
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 347-352
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    The usefulness of Holter monitoring (HM) in selecting pharmacologic therapy for patients with sustained monomorphic ventricular tachycardia (VT) was evaluated in patients in whom no effective pharmacologic therapy could be determined in an electrophysiologic study (EPS). The study population consisted of 49 consecutive patients with sustained VT who were receiving long-term pharmacologic therapy despite the fact that no pharmacologic therapy had been found to be effective in the EPS. The efficacy of the pharmacologic therapies was assessed by HM. A reduction in frequent (10/h) premature ventricular contractions (PVCs) was used as an index of treatment efficacy, with therapies achieving substantial PVC suppression (>70% of all PVCs) being considered to be effective (HM effective group). When no therapy was found to be effective when assessed by HM, a drug with any other beneficial effect, eg, reduction in VT rate, was chosen (HM ineffective group). VT recurrence and survival were compared between groups. During the follow-up period of 31±28 months, VT recurrence was observed in a total of 25/49 patients: 3/17 patients in the HM effective group, in 18/25 in the HM ineffective group, and in 4/7 in the HM undetermined group (p=0.0487). Sudden cardiac death occurred in a total 7/49 patients: 2/17 patients in the HM effective group, 4/25 patients in the HM ineffective group, and 1/7 patient in the HM undetermined group (p=0.2828). Among patients in whom no effective therapy could be determined by EPS, the VT recurrence rate was significantly lower in the group in whom treatment was effective as assessed by HM than among those in whom treatment was assessed by HM to be ineffective. Sudden cardiac death rate was also lowest in the HM effective group, although the difference was not statistically significant. HM assessment was considered useful in selection of pharmacologic therapy for patients in whom no effective therapy could be determined in the EPS. (Jpn Circ J 1998; 62: 347 - 352)
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  • Hideki Watanabe, Masaaki Kakihana, Sadanori Ohtsuka, Yasuro Sugishita
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 353-358
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    This study was designed to investigate the effect of angiotensin-converting enzyme (ACE) inhibitors with and without a sulfhydryl group on intracellular production of cGMP, forearm blood flow, and neurohormonal factors during continuous transdermal application of nitroglycerin in patients with chronic heart failure. Platelet cGMP level and forearm blood flow were measured before and 5 min after sublingual administration of nitroglycerin (NTG) in 20 patients with chronic heart failure during the following 4 phases: (1) baseline phase; (2) NTG phase (1 week after NTG tape 10 mg/day); (3) CPT phase (1 week after both captopril 37.5 mg/day and NTG tape 10 mg/day); and (4) ENL phase (1 week after both enalapril 5 mg/day and NTG tape 10 mg/day). The platelet GMP level before sublingual NTG and forearm blood flow were significantly higher during the 3 phases with NTG tape than during the control phase. The percent increases in platelet cGMP level and forearm blood flow after sublingual NTG were significantly lower during the NTG phase than during the baseline phase. In contrast, concomitant application of ACE inhibitors maintained the percent increase in platelet cGMP level and forearm blood flow. These results indicate that concomitant therapy with ACE inhibitors may be helpful in preventing the attenuation of intracellular cGMP production in patients with chronic heart failure during continuous transdermal application of NTG. (Jpn Circ J 1998; 62: 353 - 358)
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  • Relation to the Original Site on Previous Coronary Angiography
    Taro Saito, Haruhiko Date, Izumi Taniguchi, Shouta Nakamura, Hideki Ok ...
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 359-363
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    Culprit lesions in acute coronary syndrome [acute myocardial infarction (AMI) and unstable angina pectoris (UAP)] were examined angiographically in 222 patients who had previously undergone coronary angiography (CAG). The observation period lasted 5 years after primary CAG in medically treated patients (group M, 127 cases) and after final follow-up CAG in patients treated by percutaneous transluminal coronary angioplasty (PTCA) (group B, 95 cases). There were 33 AMIs, including 5 deaths (22/127, 17.3%, in group M vs 11/95, 11.6%, in group B; p<0.01) and 189 UAPs (105/127, 82.7%, in group M vs 84/95, 88.4%, in group B; NS). High-grade stenoses (>75%) were found in 76 (59.8%) patients in group M, of which 41 lesions (54%) resulted in acute coronary syndromes (ACSs). In group M, ACSs resulted from insignificant stenosis (≤50%) in 67 (53%) patients and from significant stenosis (>50%) in 60 (47%) patients. In group B, ACSs resulted from insignificant stenosis in 78 (82%) patients and from significant stenosis in 17 (18%) patients. Out of 95 PTCA sites, high-grade restenosis occurred in 3 lesions and ACSs (2 AMI, 14 UAP) in 16 (16.8%). We conclude that ACSs are more likely to develop from insignificant lesions than from significant lesions. Highgrade stenoses are prone to become occlusive lesions and PTCA reduces this potential risk. Most target sites of PTCA that escaped restenosis were stable in the long term. (Jpn Circ J 1998; 62: 359 - 363)
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Experimental Study
  • Ken Shinmura, Masato Tani, Yukako Suganuma, Hiroshi Hasegawa, Yoko Hay ...
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 364-370
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    Iodine-123-labeled 15-(p-iodophenyl)-3-(R,S)-methyl pentadecanoic acid (123I-BMIPP) is widely used to detect myocardial metabolic changes, but the preferred energy substrates in the myocardium would be expected to be altered in the presence of metabolic disorders such as diabetes mellitus (DM). We investigated the metabolism of branched-chain fatty acids in the myocardium of rats with DM. Streptozotocin-induced DM rats were examined 48 h (acute; AD) and 6 weeks (chronic; CD) after injection of streptozotocin. Hearts were excised 15 min or 60 min after injection of 0.185 MBq of 125I-BMIPP, followed by homogenization in an EDTA-Tris buffer. The homogenates were subjected to differential centrifugation to obtain the mitochondrial (MF) and cytoplasmic (CF) fractions. Myocardial 125I uptake tended to increase in the AD group, but the change was not significant. Myocardial 125I uptake at 15 min was significantly lower in the CD group than in the control group, even in the insulin-treated rats [control (CC), 4.4±0.4; not treated (CDN), 3.3±0.5; insulin-treated (CDI), 3.4±0.4×104 cpm/g, p<0.05 in each case]. The 125I count value corrected for the blood count (counts/min (cpm) per g of protein divided by blood cpm) in the MF decreased by 40% at 60min in the CC group, but increased by 60% in the CDN group. The results of the present study suggest that the myocardial uptake of branched-chain fatty acids is decreased in rats with chronic diabetes, probably as a result of mitochondrial dysfunction. (Jpn Circ J 1998; 62: 364-370)
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  • A Study of the Role of Endogenous Adenosine in Anesthetized, Open-Chest Dogs
    Shinji Tayama, Ken Okumura, Toshiro Matsunaga, Ryusuke Tsunoda, Toshif ...
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 371-378
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    The effect of chronic inhibition of endothelium-derived nitric oxide (NO) synthesis on the regulation of coronary blood flow (CBF) is yet to be elucidated. A chronic canine model of inhibited NO synthesis was created and the role of adenosine in the regulation of coronary blood flow in this model was examined. Dogs were fed a diet supplemented with 40 mg/kg per day NG-nitro-L-arginine methyl ester (L-NAME group, n=8) or a regular diet without L-NAME supplementation (control group, n=8) for 4 weeks. The experiments were performed in an anesthetized, open-chest state and the results were compared in the L-NAME and control groups. Chronic L-NAME treatment significantly increased arterial pressure. Neither basal CBF in the left anterior descending artery nor heart rate differed between the L-NAME and control groups. In the L-NAME group, the response of CBF to intracoronary acetylcholine and adenosine was blunted, but that to glyceryl trinitrate was not. In addition, myocardial reactive hyperemia following 20 sec coronary occlusion was blunted in the L-NAME group. During atrial pacing at a rate 60 beats/min faster than the sinus rate, CBF increased to a similar degree in the L-NAME and control groups, and systolic wall thickening (SWT) changed similarly in both groups. Intracoronary 8-phenyltheophylline (8-PT), an adenosine receptor blocker, decreased basal CBF in the L-NAME group but not in the control group. In the L-NAME group, pacing-induced increase in CBF was abolished and SWT deteriorated after 8-PT administration. Basal myocardial adenosine release was significantly increased in the L-NAME group compared with the control group. It is concluded that in anesthetized, open-chest dogs with chronic inhibition of NO synthesis, adenosine may play a compensatory role in the regulation of coronary blood flow, as concomitant blockade of adenosine causes deterioration of coronary circulation and cardiac function. (Jpn Circ J 1998; 62: 371 - 378)
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Case Report
  • Hirofumi Fujii, Motohiko Osako, Hajime Otani, Hiroji Imamura, Katsumas ...
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 379-381
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    A 66-year-old woman with a history of mitral valve replacement with a Starr-Edwards ball valve 25 years ago was treated for refractory heart failure but died of right heart failure. At autopsy, primary pulmonary artery sarcoma was found in the right ventricular outflow tract, main pulmonary trunk, and bilateral pulmonary artery, and had invaded the aortic arch. The pathohistologic diagnosis was osteosarcoma. Echocardiography, chest computed tomography and right ventriculography performed 1 year before death did not reveal the presence of a tumor in the pulmonary artery. The history of this patient shows that primary pulmonary artery sarcoma grows rapidly, with, in this case, the patient dying within 1 year of its appearance. (Jpn Circ J 1998; 62: 379 - 381)
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  • Yutaka Igarashi, Hidehiro Kasai, Manabu Hayashi, Hiroshi Inuzuka, Kenj ...
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 382-384
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    A 63-year-old man with left main coronary artery disease underwent aortocoronary bypass surgery using saphenous vein grafts. Less than 1 month later, severe narrowing occurred in the mid-portion of the vein graft to the left anterior descending coronary artery. Preintervention intravascular ultrasonography revealed prominent vein graft shrinkage. Percutaneous transluminal angioplasty failed because the stenotic lesion could not be dilated, even by high-pressure balloon inflation. Saphenous vein graft shrinkage appears to be one of the mechanisms of early saphenous vein graft stenosis, and balloon angioplasty to the vein graft stenosis with prominent shrinkage may be of only limited value. (Jpn Circ J 1998; 62: 382 - 384)
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  • Tomoaki Ohtsuka, Mareomi Hamada, Yuji Hara, Taishi Kuwahara, Koji Koda ...
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 385-388
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    A 57-year-old woman was admitted for examination because of chest discomfort. Transthoracic echocardiography was performed and she was diagnosed as having hypertrophic cardiomyopathy. An echocardiogram also revealed that she had midventricular obstruction with a pressure gradient of 125 mmHg determined by Doppler echocardiography. A phonocardiogram showed an early systolic sound and the beginning of the sound coincided with the time of septal-posterior wall contact. In addition, the timing also corresponded to the sudden obstruction of blood flow in the region of the midventricular narrowing. Furthermore, this sound markedly decreased with the reduction in pressure gradient caused by cibenzoline treatment. Thus, it was concluded that the early systolic sound was associated with midventricular obstruction and produced by a rapid deceleration of the interventricular flow caused by midventricular obstruction. (Jpn Circ J 1998; 62: 385-388)
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Rapid Communication
  • A Multicenter Study in Japan
    Akira Matsumori, Naohiro Ohashi, Koji Hasegawa, Shigetake Sasayama, Ta ...
    Type: None
    Subject area: None
    1998 Volume 62 Issue 5 Pages 389-391
    Published: 1998
    Released: November 25, 2001
    JOURNAL FREE ACCESS
    As a collaborative research project of the Committees for the Study of Idiopathic Cardiomyopathy, a questionnaire was sent out to 19 medical institutions in Japan in order to examine the possible association between hepatitis C virus (HCV) infection and cardiomyopathies. Hepatitis C virus antibody was found in 74 of 697 patients (10.6%) with hypertrophic cardiomyopathy (mean age, 57.7 years) and in 42 of 663 patients (6.3%) with dilated cardiomyopathy (mean age, 56.5 years); these prevalences were significantly higher than that found in volunteer blood donors in Japan (2.4%, 50-59 years of age, each p<0.0001). The prevalence was significantly higher in patients suffering from hypertrophic cardiomyopathy as opposed to those with dilated cardiomyopathy (p<0.01). The presence of HCV antibody was detected in 650 of 11,967 patients (5.4%) patients seeking care in 5 academic hospitals. Various cardiac abnormalities were found among these patients, arrhythmias being the most frequent. These observations suggest that HCV infection is an important cause of a variety of otherwise unexplained heart diseases. (Jpn Circ J 1998; 62: 389 - 391)
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