Japanese Heart Journal
Online ISSN : 1348-673X
Print ISSN : 0021-4868
ISSN-L : 0021-4868
19 巻, 1 号
選択された号の論文の16件中1~16を表示しています
  • Iraj H. NAZARIAN, Iraj ARYANPUR
    1978 年 19 巻 1 号 p. 1-11
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    Sixty-two consecutive surgically removed chronic rheumatic mitral valves were classified and tabulated according to their pathological features in relation to age and sex of the patients. The pathological features of the valves are quite different from the cases seen in Western hemisphere. Three types of gross pathological features are described.
    First is fibrous stenotic type which has very thick cusps and extremely short chordae tendineae. It is the most frequent rheumatic vavle seen in children, and majority of the valves show pure stenosis, for which probably open commissurotomy is the procedure of choice. Those which have a combination of stenosis and insufficiency usually require valve replacement.
    The second is the elastic insufficient type, which has a unique gross pathological feature, consisting of a remarkable elasticity and moderately thickened cusps. A valve replacement or valve repair when feasible is the treatment of choice for this type.
    The third is the calcific stenotic type. In this type the cusps are moderately thickened, with short chordae tendineae with various degrees of calcification. This type is seen usually in the 4th decades of life and is more frequent in males. This type of valve must be treated either by open commissurotomy in order to eliminate the risk of embolization of calcific material or with valve replacement.
  • Determination of the Region of the Delayed Activation within the Right Ventricle
    Junichi SUGENOYA
    1978 年 19 巻 1 号 p. 12-27
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    Body surface isopotential maps were produced by computer processing of the 85 electrocardiograms obtained from the entire thorax of 28 patients with complete or incomplete right bundle branch block (RBBB).
    We divided the map patterns into the following 3 groups. Type I map pattern (10 cases): at the early stage of QRS, the maximum was located in the left chest. It shifted to the left from the normal position; at the instant of 44 msec, on the average, after the onset of QRS breakthrough minimum appeared over the left chest. Its appearance was delayed and its site shifted to the left as compared with the normal; at the late stage, the positive zone covered extensively the right chest and the right back; terminally, the maximum was positioned along the right parasternum. Type II map pattern (13 cases): at the early stage of QRS, the maximum was in the left chest as in Type I; breakthrough minimum appeared at 38 msec on the average, later than in the normal, but the site of breakthrough minimum varied from the left chest as in Type I to the midsternal region as in the normal; at the late stage, the positive zone covered the upper part of the right chest and the right back, less extensively than in Type I; the terminal maximum was in the upper sternal region. Type III map pattern (5 cases): the map pattern passed normally until the late stage, but thereafter a small positive zone survived over the upper sternal region.
    In Type I the delayed activation was presumed to occur all over the right ventricle, in Type II mainly over the smaller area of the right anterior free wall, and in Type III over the localized area of the outflow tract.
    Patients with complete RBBB showed Type I pattern. Patients with incomplete RBBB showed Type II or Type III pattern, although electrocardiograms failed to differentiate Type II patients from Type III patients. These findings suggest that the electrocardiographic pattern of incomplete RBBB probably arises from the various mechanisms.
  • Kazuo YAMADA, Junji TOYAMA, Junichi SUGENOYA, Masatoshi WADA, Satoru S ...
    1978 年 19 巻 1 号 p. 28-45
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    This paper is a review of recent work relating body surface isopotential maps to the detection of the site and extent of myocardial infarction in cases which are either indetectable or difficult to diagnose through the use of standard 12 lead ECGs. According to the difference of the site and extent of myocardial infarction, the characteristic maps are obtained. Through the use of body surface isopotential maps, the significant clinical information may be obtained in a number of cases, and we can do better with mapping than without it in the evaluation of patients with myocardial infarction.
  • Junichi YOSHIKAWA, Takane OWAKI, Hiroshi KATO, Koji YANAGIHARA, Yoshih ...
    1978 年 19 巻 1 号 p. 46-57
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    Two cases of anomalous origin of the left coronary artery from the pulmonary artery with and without marked dilatation of the right coronary artery were studied by M-mode echocardiography and cross-sectional echocardiography. The M-mode echocardiogram obtained from the case with the dilated right coronary artery demonstrated an abnormal structure anterior to the aortic root. The cross-sectional echocardiogram of the same case visualized the origin of the dilated right coronary artery. In addition, echocardiographic abnormalities suggesting the ischemia of the left ventricle were observed in both cases. Although many of the ultrasonic features are nonspecific, the combination of ultrasonic technique provides useful clues to the diagnosis of anomalous origin of the left coronary artery from the pulmonary artery.
  • Junichi YOSHIKAWA, Kiyoshi YOSHIDA, Takane OWAKI, Hiroshi KATO, Koji Y ...
    1978 年 19 巻 1 号 p. 58-65
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    Eight patients with congenital pulmonary regurgitation documented by cardiac catheterization and angiography were studied by echocardiography. Echocardiographic features of the pulmonary valve observed in this condition included a) diastolic fluttering (5 cases), b) diastolic separation (2 cases), and c) increase of posterior motion during atrial systole (a wave). Maximum a wave depth exceeded the upper limit of the normal value in 2 cases and averaged 6.1±0.7 (standard error of the mean) mm. In addition, d) diastolic fluttering of the anterior tricuspid valve was seen in 5 cases and e) abnormal interventricular septal motion in 2 cases (one, paradoxical and the other, flat). Of these findings, the diastolic fluttering of the pulmonary valve, which results from the turbulent stream of blood in the outflow of the right ventricle striking the pulmonary valve, is pathognomonic for pulmonary regurgitation. Although the other findings are nonspecific, all patients had at least 1 of these 5 findings. Echocardiography, therefore, provides useful clues to the diagnosis of pulmonary regurgitation. Furthermore, echocardiography should be of use in differentiating congenital from functional pulmonary regurgitation and from aortic regurgitation.
  • Senichi TANAKA, Akira TAKESHITA, Hitonobu TOMOIKE, Motoomi NAKAMURA
    1978 年 19 巻 1 号 p. 66-73
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    The role of autonomic nervous system and non-autonomic components in hemodynamic abnormalities of young patients with borderline hypertension was examined by comparing the effects of sequential pharmacological autonomic blockade on hemodynamics between 8 patients with borderline hypertension (mean age 20.0±0.2) and 10 normotensive subjects (mean age 19.3±0.2). Propranolol (0.2mg/Kg), atropine (0.04mg/Kg), and phentolamine (10 or 15mg) were given intravenously in that order to produce "total" autonomic blockade. Increased cardiac index, heart rate, and mean arterial blood pressure with normal peripheral vascular resistance were noted at rest in patients with borderline hypertension. Cardiac index and heart rate in patients with borderline hypertension were normalized by propranolol, but after "total" autonomic blockade mean arterial blood pressure and peripheral vascular resistance were higher in patients with borderline hypertension as compared to those in normotensive subjects. These results suggest that, although autonomic nervous system control of circulation is abnormal, non-autonomic components play an important role in maintaining increased peripheral vascular resistance in borderline hypertension in young men.
  • Haruo TOMODA
    1978 年 19 巻 1 号 p. 74-83
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    Left ventricular myocardial stiffness was calculated in clinical cases. Thirty patients who underwent diagnostic cardiac catheterization were studied.
    Left ventricular cineangiograms and simultaneously recorded left ventricular pressure tracings were analyzed. The left ventricular stiffness constant k, was computed by substituting the left ventricular myocardial stress (σ) and strain (ε) throughout the period between the end of rapid ventricular filling and the beginning of atrial contraction, in the equation σ=b•eκ·ε.
    Left ventricular myocardial stiffness was measured as follows: Group I (normal): 9.6±4.3, Group II (mitral stenosis): 10.7±4.0, Group III (left ventricular volume overload): 12.1±4.2, Group IV (coronary artery disease without myocardial infarction): 8.6±2.5, and Group V (myocardial infarction): 23.6±7.4.
    All of the normal cases showed stiffness constants of less than 15 and maxVcf of more than 2.0circ/sec, and all the patients with histories of heart failure in Groups III to V showed stiffness constants of more than 15 and maxVcf of less than 1.0circ/sec. For the rest of the patients, measurements of the stiffness constant were valuable for the assessment of patients' clinical status, especially when combined with contractility.
  • Kozo SUMA, Takayuki Tsuji
    1978 年 19 巻 1 号 p. 84-93
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    The concept of a maximum tolerable afterload and an afterload reserve was proposed for evaluating ventricular function. A maximum tolerable afterload was defined as the systolic ventricular pressure during gradual proximal arterial obstruction, at the point where a distal arterial pressure or flow began to fall. An afterload reserve was defined as the difference between a maximum tolerable afterload and a basal afterload.
    By using right heart bypass preparations in dogs, a maximum tolerable afterload and an afterload reserve were compared with the ventricular function curve. An improved ventricular function curve was always associated with a greater maximum tolerable afterload and a greater afterload reserve, whereas a depressed function curve with a smaller maximum tolerable afterload and a smaller afterload reserve.
  • I. Comparison of the Effects of Physiological Saline and 5% Glucose Solution
    Masahito NAGASAKA, Katsunori HONDA, Takashi KINOUCHI, Kazumichi NAKAMU ...
    1978 年 19 巻 1 号 p. 94-102
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    Dogs were subjected to volume expansion with physiological saline and 5% glucose solution. During the infusion Na excretion was significantly increased only when saline was given. Maintenance of the volume expansion with 5% glucose solution immediately following saline infusion was ineffective in preventing the decline of Na excretion rate after the cessation of saline loading. Although the indices of hemodilution such as plasma total protein concentration and peripheral venous hematocrit were reduced along with natriuresis, these values also correlated with the total amount of Na retained during saline infusion. And this amount of retained Na has also a good correlation with the natriuresis. It is concluded that hemodilution is not the essential cause of natriuresis in the present volume expansion experiments, and that the amount of Na retained during saline loading determines the Na excretion rate in some unknown manner. The implication of regression coefficient between Na retention and Na excretion is discussed as a characteristic value in the Na homeostatic mechanism of the organism.
  • Satoshi TAKEO, Fumio TAKENAKA
    1978 年 19 巻 1 号 p. 103-111
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    Effects of catecholamines and iodoacetamide on lipase activity (pH6.8) and triglyceride mobilization were investigated in adipose tissue, myocardial slice and isolated perfused heart preparation of the rat. Epinephrine and isoproterenol did not enhance myocardial lipase activity in vitro and in perfused hearts. No detectable amount of fatty acid was released from myocardial slice by epinephrine in vitro. Epinephrine, however, induced an increase in lipase activity and in the amount of fatty acid released from the adipose tissue. The results suggest a difference in properties of lipase present in the myocardium and in the adipose tissue. Iodoacetamide decreased lipase activity in vitro both in the myocardium and in the adipose tissue. Triglyceride content in the perfused heart receiving iodoacetamide at 30 min of perfusion was higher than that of the control. However, there was no correlation between triglyceride mobilization and lipase activity in these 2 tissues.
  • Yasumi UCHIDA, Nobuo YOSHIMOTO, Satoru MURAO
    1978 年 19 巻 1 号 p. 112-124
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    The effect of a new chemical agent, SG 75, on coronary blood flow of anesthetized dogs has been examined. Intravenous administrations of this agent in a dose of 10μg/Kg or over caused a significant increase in blood flow of non-constricted coronary artery. Percent increases in flow were 40 (10μg/Kg), 95 (50μg/Kg), 145 (100μg/Kg), and 195 (250μg/Kg). The increases were significantly larger than those caused by the same doses of diltiazem, verapamil, nitroglycerin, isosolbide dinitrate, and papaverine. The durations of the increase in flow were 12 (10μg/Kg), 23 (50μg/Kg), 28 (100μg/Kg), and 46 min (250μg/Kg), and they were longer than those caused by diltiazem and verapamil. A slight reduction in left ventricular tension and an increase in aortic blood flow were also observed following the administrations of SG 75 in a dose of over 50μg/Kg. A decrease in heart rate was produced with a dose of over 500μg/Kg. However, PQ interval of electrocardiogram became shorter. Intravenous administrations of SG 75 in doses of 50 and 150μg/Kg caused an increase in blood flow of the constricted coronary artery, while nitroglycerin (10 and 30μg/Kg) and nifedipine (1 and 3μg/Kg) reduced it. The results indicate that SG 75 is a potent and long-acting coronary vasodilating agent and it causes an increase in blood flow of constricted as well as non-constricted coronary artery.
  • Stewart C. HARVEY
    1978 年 19 巻 1 号 p. 125-135
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    The patterns of distribution of histamine and norepinephrine among the 4 chambers of the heart of rats, guinea pigs, and rabbits and among 15 portions of the dog heart were quite similar, except for the coronary ring of the dog, which was disproportionately high in histamine. In whole mouse hearts the separate chambers were not assayed; in the whole heart, the contents of the 2 amines did not correlate. The subcellular distribution of histamine in the rat and guinea pig heart was different from that of norepinephrine. Histamine was mostly associated with mast cell-like granules. Toluidine blue-staining granules of 2 widely different densities were found.
  • K. PRASAD, A. KAMIYAMA, F. INOUE
    1978 年 19 巻 1 号 p. 136-150
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    Effects of propranolol (10-9 to 10-4Gm/ml) on various electrophysiologic properties of human papillary muscles obtained from patients undergoing corrective open heart surgery were studied to have an insight into the mechanism of its antiarrhythmic activity in man. Propranolol (10-8 to 10-6 Gm/ml) produced significant decreases in the action potential duration, effective refractory period and dv/dt of depolarization phase of action potential without significantly affecting the resting potential and amplitude of action potential. These effects were concentration dependent. High concentration (10-4Gm/ml) of propranolol not only produced greater decreases in the above parameters but also reduced the resting potential and amplitude of action potential. Although propranolol decreased both the action potential duration and effective refractory period, the shortening of the action potential duration was greater than the shortening of the effective refractory period. It shifted the membrane responsiveness curve to the right and down. It produced frequency dependent decreases in the dv/dt of phase 0 of action potential and the rate of repolarization. Propranolol also increased the threshold of stimulation. Propranolol produced electrophysiologic changes in the human myocardium qualitatively similar to those in canine myocardium. The probable mechanism of its antiarrhythmic activity in man has been discussed.
  • Munehito IDEISHI, Masahide TAKII, Tadayuki HIROKI, Kikuo ARAKAWA
    1978 年 19 巻 1 号 p. 151-158
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    A case of accelerated hypertension, which was unique in a resistance to an angiotensin antagonist, and a lack of the elevation of plasma renin activity (PRA) is reported. Non-elevated PRA was coincided with nonmalignant nephrosclerosis in renal histology. The acceleration was attributed to the neurological cause i.e., cerebral hemorrhage in the right hypothalamus which extended to the ventricle and subarachnoid space. The case therefore clinically seemed malignant-like, but it was not malignant hypertension in the sense of Volhard's classical definition. This does not conflict with the usefulness of the determination of PRA in the diagnosis of malignant hypertension with nephrosclerosis.
  • Masayoshi YOKOYAMA, Motokazu HORI, Hisae HAYASHI, Yoshiaki SAITO
    1978 年 19 巻 1 号 p. 159-166
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    A 14-year-old girl has been implanted a cardiac pacemaker with a myocardial electrode since 8 years old. As the first myocardial electrode fractured near its tip, the second one was added. Thus, patient had two pairs of myocardial electrode systems with one demand pacemaker implanted. When she was readmitted to hospital because of light-headedness, EGG monitor revealed the frequent suppression of pacemaker emission on transcutaneous waving of pacemaker unit. Application of the magnet over the generator resulted in no inhibition even on moving the unit. The pacemaker pocket was reopened. Waving the active myocardial electrode or pacemaker unit did not inhibit the demand pacemaker, but manipulation of the inactive lead induced suppression of pacemaker emission. Such manipulation produced high interference waves, which were created probably by motion of the cut end of inactive leads against patient's abdominal muscle. The exchange of the demand pulse generator to a fixed mode was followed by complete disappearance of light-headedness in this case.
  • Ali YAZDANYAR, Mohammad H. SAFAVIAN, Iraj NAZARIAN, Jami G. SHAKIBI
    1978 年 19 巻 1 号 p. 167-173
    発行日: 1978年
    公開日: 2008/12/09
    ジャーナル フリー
    A 9-year-old boy is reported who had tetralogy of Fallot, rudimentary pulmonic valve, and supravalvar pulmonic stenosis. The patient lacked almost all of the clinical findings commonly encountered in this syndrome. Thus he never had signs of a large left-to-right shunt, or congestive heart failure. He had no murmur of pulmonic regurgitation and his pulmonary artery was not large on chest roentgenogram. Angiocardiography revealed moderate main pulmonary arterial dilation. The lack of the usual manifestations of tetralogy of Fallot with absent pulmonic valve was due to supravalvar pulmonic stenosis, acting as a natural pulmonary artery band. A quantitative angiocardiographic study was undertaken in order to find a clue for the diagnosis of these atypical cases. The ratio of the transverse diameters of the main pulmonary artery and the aortic root as measured on lateral angiocardiograms in 31 children with uncom-plicated tetralogy of Fallot was 0.70±0.22, whereas this ratio was 1.70 in this particular patient (p<0.001). It is concluded that a quantitative evaluation of the ratio of the transverse diameter of the main pulmonary artery to the aortic root on lateral angiocardiogram allows differentiation of tetralogy of Fallot with absent pulmonic valve associated with supravalvar pulmonic stenosis from uncomplicated forms of tetralogy of Fallot.
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