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Volume 28 (1987)
- Issue 6 Pages 813-
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Volume 28, Issue 6
Displaying 1-14 of 14 articles from this issue
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A Study by Holter Electrocardiographic Monitoring during HemodialysisRafique AHMED, Fumihiro KIYA, Koei KITANO, Hiroyuki TAKAGI, Kunitake H ...1987 Volume 28 Issue 6 Pages 813-828
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSHolier electrocardiographic recordings were performed for 24 hours in 20 patients on chronic hemodialysis to evaluate the effect of changes in serum calcium and potassium during a 5-hour hemodialysis period on the QT interval. Hemodialysis caused an acute increase in serum calcium from a predialysis value of 9.6±1.3mg/dl to 11.5±.2 mg/dl and a decrease in serum potassium from 4.9±0.6mEq/L to 3.5±0.4mEq/L. The Q oTc interval shortened from a predialysis value of 0.240±0.023 sec to a minimum of 0.215±0.022 sec during the 5th hour of hemodialysis. This Q oTc interval shortening was correlated strongly with an increase in serum calcium and was statistically significant only in subjects showing an increase in serum calcium of more than 2mg/dl (p<0.05). The Q-eTc interval increased from a predialysis value of 0.392±0.030 sec to 0.414±0.024 sec during the 4th hour of hemodialysis. This Q-eTc interval prolongation was correlated with a decrease in serum potassium. It was concluded that increased serum calcium during hemodialysis caused shortening of the Q-oTc interval, that the degree of shortening was proportional to the magnitude of increase in serum calcium, and that changes in serum calcium and the Q oTc interval were concurrent. It was also concluded that hemodialysis resulted in prolongation of the Q eTc interval. This change was possibly caused by a decrease in the level of serum potassium during the procedure.View full abstractDownload PDF (890K) -
Hikaru HOSHI, Isao KUBOTA, Kozue IKEDA, Kai TSUIKI, Shoji YASUI1987 Volume 28 Issue 6 Pages 829-839
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSTo estimate the hypertrophic sites of the left ventricle by body surface mapping (MAP), we performed MAP in 55 patients with hypertension and compared the MAP data with echocardiographic findings. MAP data were analyzed using the departure map technique reported by Flowers et al. The mean and standard deviation (SD) of the normal control were obtained from 40 normal volunteers. We constructed departure maps at 20, 30, 40, 50 and 60msec from the onset of the QRS. Each map indicates the area of abnormally increased potential outside the normal range at the time.
Subjects were classified into 5 groups according to the appearance time of the abnormal positive area. Septal thickness was significantly increased in groups that had an abnormal positive area at 20msec, and left ventricular posterior wall thickness was significantly increased in the groups that had an abnormal positive area at 60msec. We postulate that the increased electrical potential due to hypertrophy of the interventricular septum is represented by the abnormal positive area at 20msec, and the increased potential of the left ventricular posterior wall by the abnormal positive area at 60msec.
MAP, especially the departure map technique, is a useful method to detect the abnormal electrical potential distribution in patients with left ventricular hvnertronhv.View full abstractDownload PDF (536K) -
Kensuke EGASHIRA, Yutaka KIKUCHI, Tomohiko SAGARA, Masayoshi SUGIHARA, ...1987 Volume 28 Issue 6 Pages 841-849
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSLong-term prognosis of 90 patients with vasospastic angina without significant coronary artery disease (less than 50% reduction in luminal diameter) was examined for a mean follow-up period of 4 years. All patients had episodes of angina at rest and were treated with calcium antagonists. One patient developed myocardial infarction and 2 died suddenly during the follow-up period. In the patient with myocardial infarction, there was an abrupt worsening of angina prior to the infarction despite therapy with a calcium antagonist. One of the sudden death patients discontinued his calcium antagonist before his death. Of the sudden death patients, one had ventricular tachycardia and the other had a complete atrioventricular block during an anginal attack. The incidence of such serious arrhythmias was higher (p<0.01) in sudden death patients (2/2) than that in survivors (6/88). The treatment with calcium antagonists reduced the severity and frequency of angina in all patients. These results suggest that long-term prognosis of vasospastic angina without significant coronary artery disease is good as characterized by the low incidence of myocardial infarction and death and the favorable response to treatment with calcium antagonists.View full abstractDownload PDF (513K) -
Toshiro TANIZAKI, Katsuya KOBAYASHI, Hisashi FUKUZAKI1987 Volume 28 Issue 6 Pages 851-862
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSTo clarify the clinical significance and therapeutic implication of exercise-induced ST elevation at the infarcted area in old myocardial infarction (OMI), 30 patients with exercise-induced ST elevation underwent treadmill exercise testing. The patients with transient perfusion defects at the infarcted area on thallium-201 stress myocardial scintigraphy (group I:n=12) revealed a decreased rate of ST elevation expressed as ΔST/ΔHR×102 after 10mg of isosorbide dinitrate (ISDN), compared to the results of treadmill exercise testing under no medication (3.1±2.5 vs. 4.7±2.6, p<0.001). Exercise capacity and anginal threshold were improved after ISDN in group I. In contrast, the patients without transient perfusion defects (group II:n=18) revealed an increased rate of ST elevation after ISDN (2.4±1.1 vs. 2.0±0.8, p<0.05). It is concluded from the above results that if exercise-induced ST elevation at the infarcted area reflects transient myocardial ischemia, ISDN can decrease it by its antianginal effect. Additionally, treadmill exercise testing with ISDN is a useful means of clarifying the underlying pathophysiology and management in OMI cases with this effect on exercise-induced ST elevation at the infarcted area.View full abstractDownload PDF (636K) -
Ryo KATORI, Kinji ISHIKAWA, Ken KANAMASA, Masataka MORISHITA, Makoto O ...1987 Volume 28 Issue 6 Pages 863-872
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSThe effectiveness of coronary thrombolysis with urokinase (UK) on short- and long-term outcome after acute myocardial infarction was studied by comparison of 120 patients treated with UK and 124 with conventional therapy followed up for a period of 20 months. UK was administered to patients within 6hours of the onset of chest pain, by the intracoronary route (20, 000U/min, at a mean dose of 698, 000U) in 46 patients, intravenously (960, 000 to 1, 920, 000U in 15 or 30min, at a mean dose of 1, 293, 000U) in 56 patients and by the combined route (at a mean dose of 2, 333, 000U) in 18 patients. Complete occlusion or 99% stenosis with severe delay of the contrast medium was found in 72.5% and recanalization by UK was achieved in 68.0%. Cumulative mortality rate was significantly reduced in the UK group (9.2% vs. 29.0%). Cardiac death from recurrent MI was also significantly reduced (2.5% vs. 10.5%). The reduction in mortality rate was demonstrated even in older patients as well as in those cases graded as severe according to the Killip and Forrester classifications. Thus, it is concluded that coronary thrombolysis with UK therapy improves the prognosis of acute myocardial infarction.View full abstractDownload PDF (541K) -
Two-Dimensional Echocardiographic StudyYukiko OKA, Takashi ITO, Shinsaku MATSUMOTO, Hiroyuki SUEMATSU, Etsuro ...1987 Volume 28 Issue 6 Pages 873-882
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSTo examine the prevalence of mitral valve prolapse (MVP) and to define the mechanisms of its development in patients with anorexia nervosa, we studied the cardiac function of 23 patients with anorexia nervosa by two-dimensional (2-D) echocardiography. MVP was present in 19 of 23 patients (82.6%), 10 having double MVP in both the anterior and posterior mitral leaflets and 9 having a single MVP in the anterior leaflet. There was no difference in echocardiographic parameters between the MVP(+) and MVP(-) groups. The heart rate was lower in the double MVP group (46.3±8.1; mean±SD) than in the non MVP group (64.0±6.3; p<0.01) and the single MVP group (55.9±10.9; p<0.05). The presence of bradycardia in these patients suggests an increase in vagal tone. The present study suggests that the incidence of MVP in anorexia nervosa is among the highest compared with its incidence in association with any other disorders, and an increase in vagal tone may be responsible for the development of MVP in patients with anorexia nervosa.View full abstractDownload PDF (907K) -
Ryoko MIYAMORI, Yoshiro NAKAMURA, Hidezo MORI, Toshihisa MIYAZAKI, Sho ...1987 Volume 28 Issue 6 Pages 883-889
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSRegional effects of intracoronary administration of nicardipine, a dihydropyridine derivative with calcium blocking activity, were studied in 13 open-chest dogs. Hypoxic, constant-flow perfusion was done in the area supplied by the distal left anterior descending artery. The 5-min regional hypoxic perfusion did not result in significant alterations in either heart rate or aortic pressure in 6 control dogs perfused with original Krebs-Henseleit solution (KHS), which was deoxygenized by mixed gas (95%N2 and 5%CO2), and in 7 dogs perfused with nicardipine-containing (0.2mg/ dl) KHS. A transmural biopsy after 5min of perfusion revealed a less severe metabolic deterioration in nicardipine-treated dogs than in control dogs, as indicated by a higher ATP content (2.84±0.43 vs. 2.23±0.45μmol/g, wet weight). The sequence of regional contractile deterioration was not different between the 2 groups. In conclusion, regional nicardipine administration showed a myocardial protective effect which was not mediated by afterload reduction in the whole heart.View full abstractDownload PDF (422K) -
Yoshifusa AIZAWA, Masahito SATOH, Masami AIZAWA, Toshikazu FUNAZAKI, S ...1987 Volume 28 Issue 6 Pages 891-898
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSUsing anesthetized dogs, the coronary vascular effects of neuropeptide Y (NPY) were studied and the action of alpha- or serotonergic receptor blockade on the action of NPY was evaluated. To demonstrate the biological significance of the action of NPY, the vasoconstrictor potencies of NPY and norepinephrine were compared. One to 5 nmol of intracoronary NPY reduced coronary flow in a dose-dependent manner. The action started rather gradually and lasted for 10min or more. Since perfusion pressure and central venous pressure were unchanged, the decrease in coronary flow should be a result of coronary vasoconstriction. Intracoronary norepinephrine infusion caused vasodilatation but when dogs were pretreated with 0.5 to 1.0mg/kg of systemic propranolol, a vasoconstrictor effect was observed at a 5times higher dose than with NPY. Furthermore, the action of NE was only transient, lasting for 30sec or less. The vasoconstrictor action of NPY was not antagonized by phentolamine or by ketanserin. Since NPY is an endogenous polypeptide found in the sympathetic nerve terminals around coronary arteries, it may participate in the regulation of coronary flow.View full abstractDownload PDF (420K) -
Katsusuke YANO, Masanobu HIRATA, Yoriaki MATSUMOTO, Mitsuhiro MORI, Os ...1987 Volume 28 Issue 6 Pages 899-911
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSElectrophysiologic properties of the left ventricle, vulnerability to ventricular arrhythmias and regional myocardial blood flow (RMBF) of the left ventricle were examined during superposition of acute ischemia on a healed myocardial infarction. The left circumflex coronary artery (LCX) was ligated in 13 dogs with a 28-day-old anteroapical infarction. Six (46%) of 13 dogs had reproducible ventricular tachycardia in response to programmed ventricular stimulation before LCX ligation. Ventricular fibrillation could be induced in 2 of these 6 dogs. After LCX ligation, 11 (85%) of 13 dogs had ventricular arrhythmias induced by ventricular stimulation. Nine of 13 dogs had ventricular tachycardia and 7 of 13 dogs had ventricular fibrillation. The heterogeneity of the effective refractory period (ΔERP) and the local intraventricular conduction time (LIVCT) in the border and the infarct zones of the left ventricle increased significantly after LCX ligation. RMBF in the border and the infarct zones were markedly decreased by LCX ligation. The magnitude of reduction of RMBF was correlated significantly with the prolongation of LIVCT. In conclusion, acute critical reduction of the collateral blood supply causes a more heterogeneous refractory period and conduction delay in the preexisting ischemic area of the heart, increasing the vulnerability to lethal ventricular arrhythmias.View full abstractDownload PDF (694K) -
Yasuyuki FURUKAWA, Kimiaki SAEGUSA, Yasuhiro OGIWARA, Masayoshi TAKEDA ...1987 Volume 28 Issue 6 Pages 913-922
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSThe effects of DJ-7141, a new alpha-2 agonist, on an isolated atrial preparation cross-perfused with arterial blood from a support dog were investigated. In the isolated atrium, a selective injection of DJ-7141 (1-100μg) into the sinus node artery induced dose-dependent positive chronotropic and inotropic effects. The positive cardiac effects of DJ-7141 were not only inhibited by propranolol and by imipramine, but reversed to negative effects, whereas the positive cardiac effects of norepinephrine were blocked by propranolol and potentiated by imipramine. Tetrodotoxin (TTX) did not modify the cardiac responses to DJ-7141. After propranolol treatment, the negative chronotropic and inotropic responses to DJ-7141 were not influenced by atropine, which completely blocked acetylcholine-induced cardiac responses. When DJ-7141 was injected into the support dog at a dose of 10-300μg/Kg i.v., it induced a brief increase in femoral arterial blood pressure and a long-lasting decrease in heart rate in the support dog and increases in atrial rate and contractile force in the isolated atrium. These results suggest that the new alpha-2 agonist, DJ-7141, induces indirect positive chronotropic and inotropic effects due to a tyramine-like action and direct negative cardiac effects in the isolated dog heart, and that the tyramine-like effect may be partially responsible for the increase in blood pressure seen with DJ-7141 in in situ dogs.View full abstractDownload PDF (494K) -
Calcium-induced Changes in the Osmotic Fragility of Erythrocytes in HypertensionKazushi TSUDA, Yohsuke MINATOGAWA, Seiko TSUDA, Hiroki SHIMA, Ichiro N ...1987 Volume 28 Issue 6 Pages 923-931
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSTo investigate the sensitivity to calcium of erythrocytes in hypertension, changes in the osmotic fragility of erythrocytes following Ca-loading were observed. Washed erythrocytes were obtained from spontaneously hypertensive rats (SHR, Okamoto and Aoki) and age-matched normotensive Wistar Kyoto rats (WKY). Treatment of erythrocytes with Caionophore A23187 and Ca in the medium caused a reduction in the osmotic fragility which correlated with the Ca-concentration. The degree of alteration in the osmotic fragility of erythrocytes was greater in SHR than in WKY. Oral administration of hydralazine to SHR significantly reduced the blood pressure. However, the alterations in the osmotic fragility of erythrocytes secondary to Ca-loading were not different between hydralazine-treated and untreated SHR.
In the presence of a Ca-antagonist (verapamil or diltiazem) in the medium, the reduction of the osmotic fragility of erythrocytes caused by Ca-loading was inhibited, and the differences between SHR and WKY were abolished by Ca-antagonists.
These results suggest that the greater changes in osmotic fragility of erythrocytes caused by Ca-loading in SHR could be due to a genetic abnormality of Ca-handling by the cell membranes, and that this abnormality might cause an increase in intracellular Ca, which contributes, in part, to the pathogenesis of hypertension.View full abstractDownload PDF (866K) -
Hironori EZAKI, Shin-ichiro OHKAWA, Akihiko MIYAGAWA, Keiji UEDA, Masa ...1987 Volume 28 Issue 6 Pages 933-940
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSElectrophysiologic and histopathologic studies were performed on an 83-year-old man with partial atrial standstill. In the electrophysiologic study, no atrial electrical activity was recorded in the right atrium, but f waves were seen in the coronary sinus electrogram. Although the high right atrium and the atrial septum could not be activated by electrical stimuli of up to 10 V, the low atrium could be stimulated. The pathologic examination showed that there was extensive fatty infiltration into the sinus node and fibrosis in the atrial muscle. In the low right atrium, the musculature was partially preserved.View full abstractDownload PDF (980K) -
A Report of Two Family CasesSeiichi KOIKE, Shigeyuki KAWA, Kouji YABU, Ryohei ENDO, Yasuyuki SASAK ...1987 Volume 28 Issue 6 Pages 941-945
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSTwo familial cases of dilated cardiomyopathy were evaluated by HL-A typing. In the case of the first family, the mode of inheritance is likely to be an autosomal dominant trait. Only the affected individuals carried the identical HL-A haplotype (A2, Bw54, Cwl, DR4, DQw3), while the unaffected members do not share this pattern. In the second family case, the disease is probably inherited by autosomal recessive traits. All of the family members examined shared the identical HL-A haplotype (A24, Bw52, DR2, DQw1), but only the affected individuals were homozygous for this haplotype.View full abstractDownload PDF (258K) -
Fumimaro TAKATSU, Hiroyasu ISHIKAWA, Teruo NAGAYA1987 Volume 28 Issue 6 Pages 947-953
Published: 1987
Released on J-STAGE: December 09, 2008
JOURNAL FREE ACCESSA 54-year-old man developed angina pectoris 18 months after a successful aortocoronary bypass graft. The angiogram demonstrated patent grafts and no significant changes in the native coronary vessels. However, ergonovine maleate provoked spasm in a saphenous vein graft.View full abstractDownload PDF (1697K)
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