Japanese Heart Journal
Online ISSN : 1348-673X
Print ISSN : 0021-4868
ISSN-L : 0021-4868
Volume 32, Issue 1
Displaying 1-14 of 14 articles from this issue
  • Analysis of 28 Necropsy Cases
    Nobuteru MAEHASHI, Yoshiyuki YOKOTA, Akira TAKARADA, Seiichiro USUKI, ...
    1991 Volume 32 Issue 1 Pages 1-15
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    The hearts of 28 necropsy cases with DCM and 10 control cases were analysed to elucidate the role of myocarditis and fibrosis in dilated cardiomyopathy (DCM). The extent of fibrosis and myocyte diameter were measured in the transverse sections of the left ventricle. The degree and pattern of fibrosis varied widely from case to case. The DCM cases were then classified into 3 groups: 1) Group la, 8 cases with mild diffuse fibrosis; 2) Group Ib, 9 cases with severe diffuse fibrosis and 3) Group II, 11 cases with segmental fibrosis.
    Myocardial fibrosis and hypertrophy were significantly more prominent in Groups Ib and II than in the control group (p<0.01), but no differences were observed between Group la and the control group. Thus, it is reasonable to attribute the chronic CHF and LV dilatation in Groups Ib and II to the extensive myocardial fibrosis. In contrast, it is not reasonable to attribute the chronic CHF and LV dilatation in Group la to myocardial fibrosis.
    Focal lymphoid cell infiltration was graded to assess inflammatory changes. Group II showed more prominent inflammatory changes than the other 2 groups (p<0.05). Thus, it is possible that myocarditis is an etiologic factor for DCM with a segmental pattern of fibrosis.
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  • Hiroshi IKENOUCHI, Masahiko IIZUKA, Hiroshi SATO, Shin-ichi MOMOMURA, ...
    1991 Volume 32 Issue 1 Pages 17-34
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    The distensibility of the forearm veins in 24 patients with congestive heart failure was studied by occlusion plethysmography. Relationships between forearm venous distensibility and symptoms, hemodynamic data obtained by right heart catheterization and plasma levels of vasoactive hormones were evaluated. Forearm venous pressure (VP) and volume change (ΔV) were measured simultaneously by the venous occlusion technique with strain gauge plethysmography. The relationship between venous pressure and volume change was fitted by the equation VP=c∗exp.(k∗ΔV) (r=0.98±0.01) and the venous stiffness constant (k) was calculated. Venous volume change at a venous pressure of 20mmHg (V20) was also measured as another index of venous compliance. The pressure-volume curve of the peripheral veins shifted leftward on the volume axis and the stiffness constant (k) increased as the New York Heart Association functional class grade increased. Mean pulmonary arterial pressure and pulmonary vascular resistance were closely related to k (r=0.74, p<0.001; r=0.73, p<0.001, respectively), and less closely to V20 (r=-0.56, p<0.004; r=-0.59, p<0.002, respectively). K and V20 were also related to stroke index (r=-0.57, p<0.004; r=0.44, p<0.03, respectively) and stroke work index (r=-0.47, p<0.02; r=0.45, p<0.03, respectively). K was also related to heart rate (r=0.55, p<0.007), pulmonary capillary wedge pressure (r=0.54, p<0.02), right atrial pressure (r=0.51, p<0.02), cardiac index (r=-0.45, p<0.03), and systemic vascular resistance (r=0.45, p<0.03). Both indexes were related to the plasma level of norepinephrine (r=0.64, p<O.008; r=-0.52, p<0.04, respectively). We concluded that the venous tone was related to the severity of heart failure, especially to the symptoms, pulmonary arterial pressure and plasma concentration of norepinephrine, and that the venous stiffness constant, k, was a better parameter with which to assess peripheral venous tone.
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  • Yoshiyu TAKEDA, Junichiro MIFUNE, Kuniaki TAGA, Senshu HIFUMI, Yoshifu ...
    1991 Volume 32 Issue 1 Pages 35-43
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    Two hundred twenty five anginal symptomatic patients (37-75 years) undergoing selective coronary angiography were studied to clarify the importance of risk factors for coronary artery disease (CAD). Serum lipids, apolipoproteins, fasting blood glucose, hemoglobin A1 and A1c, serum insulin levels, hypertension, smoking and obesity were examined as coronary risk factors in 64 newly diagnosed non-insulin dependent diabetic patients (60±1(±SE)yr), 88 impaired glucose tolerant (IGT) patients (58±1yr) and 73 non-diabetic patients (62±1yr). Diabetic and IGT patients showed significantly higher coronary atherosclerosis indices than non-diabetic patients (p<0.05). In the diabetic and IGT groups, the plasma triglyceride concentrations were significantly higher in the patients with coronary atherosclerosis (CAS) than in either patients without CAS (p<0.05) or non-diabetic patients with CAS (p<0.05). The prevalence of hypertension in the diabetic patients with CAS was higher than in the non-diabetic patients with CAS. These data suggest that hypertriglyceridemia and hypertension might be important as risk factors in the development of coronary atherosclerosis in persons with an abnormal glucose tolerance.
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  • Evaluation of Severity of Hypertension, Efficacy of Treatment and Effects on Nighttime Blood Pressure
    Shigehiro KATAYAMA, Yoshiko MARUNO, Akira ITABASHI, Munemichi INABA, A ...
    1991 Volume 32 Issue 1 Pages 45-55
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    Blood pressure (BP) obtained by the physician in his office and ambulatory BP recorded every hour throughout 24 hours with a noninvasive automated BP monitoring device were compared in 10 normotensives and 162 hypertensives. Casual BPs significantly correlated with averages in ambulatory BPs (ABPs) throughout the whole day, day (7 am-10 pm) and night (0-5 am). However, it was noted that 6 of 10 normotensives and all of the moderate to severe hypertensives had ABPs of more than 150/90mmHg at least once during the 24-hour period. The incidence of ABPs greater than 150/90mmHg among all readings was higher in untreated and treated hypertensives with diastolic BPs in the office of more than 105mmHg, and, when checked along with the clock time, higher not only in the morning but also in the evening. On the other hand, one-third or one-fifth of treated hypertensives with diastolic office BPs less than 90mmHg or between 90 and 105mmHg respectively had ABPs less than 150/90mmHg throughout the whole day. When the effect of nicardipine (60mg, t.i.d.) or slow-release nifedipine (27.3±3.0mg, b.i.d.) on minimum BP during the night was analyzed, long-acting nifedipine decreased BP throughout the night to levels not significantly different from normotensive controls, whereas short-acting nicardipine did not affect nighttime BPs. These results suggest that simple ABP monitoring throughout the day gives us useful information to evaluate the severity of hypertension and the efficacy of anti hypertensive medication as well as to avoid overtreatment with long-acting hypotensive agents resulting in a great fall in BP during sleep.
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  • Hiroyuki SUGA, Yoichi GOTO, Shiho FUTAKI, Osamu KAWAGUCHI, Hitoshi YAK ...
    1991 Volume 32 Issue 1 Pages 57-67
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    We carried out a simulation study to obtain insight into the relation between calcium (Ca2+) transients and energy for handling Ca2+ in excitation-contraction (EC) coupling. The simulation incorporated basic Ca2+ kinetics among total released Ca2+ from sarcoplasmic reticulum (SR), myoplasmic free Ca2+ ion concentration, and troponin (Tn)-Ca complex concentration ([TnCa]). The total Ca2+ released from the SR was arbitrarily set as an impulse and three rate constants were used for Ca2+ binding to Tn, Ca2+ dissociation from Tn, and Ca2+ uptake by SR. The results showed that the peak Ca2+ transient varies widely as a reciprocal of the Ca2+ sensitivity of the contractile machinery, despite constant total released Ca2+ and hence, a constant energy for Ca2+ handling. This result suggests a disproportate relationship between the magnitude of Ca2+ transients and the energy for Ca2+ handling when the Ca2+ sensitivity of contractile machinery changes.
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  • Kouichi TAKEDA, Shigeru YAGI
    1991 Volume 32 Issue 1 Pages 69-89
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    A mathematical formula was derived from an active cross-bridge model to express the changes in the active myocardial force which occurred during systole. Using the formula and the assumption that the energy expenditure for cross-bridge cycling (Um) was a linear function of the force-time integral (FTI), we developed formulae describing the left ventricular Um versus FTI relation, the Um versus force relation, and the Um versus pressure-volume area (PVA) relation. There were strong disagreements between the model predictions and the experimental findings relating oxygen consumption of the heart versus the PVA relation. These differences may have resulted from the oversimplification of important mechanical and/or biochemical properties of the myocardium in the model. However, the model appeared to accurately reproduce the Fenn effect (effect of contraction modes on energy liberation) for the myocardium as well as the effect of catecholamine infusion, hypothermia, and hypothyroidism on the changes in the binding rate of Ca2+ with the regulatory proteins, the myosin ATPase activity, the peak force developed, and the myocardial energy expenditure. We present this work as an intermediate step towards a complete theoretical linkage between the molecular biology, dynamics, and energetics of the human heart.
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  • Tomiyasu KOYAMA, Ming-Yan ZHU, Masataka KINJO, Tsunehisa ARAISO
    1991 Volume 32 Issue 1 Pages 91-100
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    The antioxidative effect of idebenone was studied in isolated mitochondria from the rat heart. Variables for dynamic microstructure, membrane viscosity and wobbling angle of phopholipids, were measured by means of a nanosecond time-resolved fluorometer. Exposure of isolated cardiac mitochondria to oxidative conditions in vitro caused significant alterations in lipid peroxidation, wobbling angle of phospholipids and membrane viscosity. Exposure of mitochondria to oxidative conditions after idebenone pretreatment resulted in no significant alterations in membrane viscosity and wobbling angle of phospholipids. Alterations in these variables seemed to be related to the amount of peroxidized lipid. Protection of phospholipids against peroxidation by antioxidative substances is effective in maintaining nearly normal physical properties in the dynamic microstructure of cardiac mitochondrial membranes.
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  • Shin-ichi MOMOMURA, Takashi SERIZAWA, Yoshi OHTANI, Masahiko IIZUKA, T ...
    1991 Volume 32 Issue 1 Pages 101-110
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    Coenzyme Q10 (10mg/kg/day) or digoxin (2μg/kg/day) was given orally to cardiomyopathic hamsters (BIO 14.6) for 8 weeks from 12 weeks of age. The left ventricular weight per gram of body weight (mg/g) was lower (p<0.01) in the coenzyme Q10 group (3.09±0.13) than in the digoxin (3.32±0.20) and control (3.44±0.14) groups. Left ventricular function was evaluated in isovolumically beating hearts. Left ventricular developed pressure (63±5 vs. 54±10mmHg, p<0.05), +dP/dt (1385±100 vs. 1211±136mmHg/sec, p<0.05), and -dP/dt (1068±126 vs. 896±141mmHg/sec, p<0.05) were greater in the coenzyme Q10 than in the control group. The time constant of left ventricular relaxation was shorter in the coenzyme Q10 group than in the control group (25±3 vs. 28±3 msec, p<0.05). By contrast, in the digoxin group, the indices of left ventricular function did not differ from the control group. These results suggest that coenzyme Q10, but not digoxin, attenuated disease progression and preserved left ventricular function in cardiomyopathic hamsters.
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  • Teruhiko AOYAGI, Shin-ichi MOMOMURA, Hiroshi MATSUI, Takashi SERIZAWA, ...
    1991 Volume 32 Issue 1 Pages 111-130
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    Both myocardial contractility and contraction duration were assessed load-independently in isolated hypertrophic and control rat hearts. Hemodynamic parameters for isolated isovolumically contracting hearts were compared for 7 Wistar rats with DOCA-salt induced hypertrophy (LVH) and 7 controls. Loads were altered by changing the volume of an intraventricular balloon. Myocardial contractility was assessed in terms of the shortening-afterload (Sm-σaft), and the ejection fractionafterload (EF-σaft) relations at common preloads, based upon the systolic myocardial stiffness concept. Indices of contraction duration (time to maximum stiffness, pressure time integral divided by peak pressure and the time required for left ventricular (LV) peak pressure to be reduced by a half) were prolonged in LVH. Multiple regression analyses indicated that the degree of hypertrophy was an independent determinant of the contraction duration. The Sm-σaft and EF-σaft relations at common preloads demonstrated normal contractility in the LVH group. The time constant of the fall in LV pressure and the diastolic myocardial stiffness remained normal in the LVH group. Thus, we introduced the new approach to load-independently assess both the myocardial contractility and the contraction duration in a whole ventricle. A prolonged contraction duration in the presence of normal myocardial contractility was observed in a ventricle with moderate pressure-overload hypertrophy.
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  • Hideaki KAWAGUCHI, Hitoshi SANO, Toshiyuki KUDO, Hisakazu YASUDA
    1991 Volume 32 Issue 1 Pages 131-138
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    We studied the effects of elastase on [3H]thymidine incorporation into aortic smooth muscle cells. When elastase was added to cultured aortic smooth muscle cells, [3H]thymidine incorporation was inhibited in a dose-dependent manner in the presence of fetal bovine serum. Elastase also inhibited this incorporation in cells treated with epidermal growth factor. Epidermal growth factor (50ng/ml) stimulated thymidine incorporation, without elastase, but with the addition of 20units/ml of elastase the incorporation was inhibited 70%. The incorporation of thymidine into cells treated with 50ng/ml epidermal growth factor was also inhibited 50% by a low concentration of elastase (5units/ml). These inhibitory effects on thymidine incorporation were also observed in cells stimulated with platelet-derived growth factor. Platelet-derived growth factor (20units/ml) markedly stimulated thymidine incorporation into cells, and elastase inhibited its activity in a dose-dependent manner. These results suggest that elastase has the potential to prevent the development of atherosclerosis by inhibiting smooth muscle proliferation.
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  • Lesion Mimicking Tricuspid Valve Myxoma
    Süheyla ÖZKUTLU, Muhsin SARAÇLAR, Semra ATALAY, Metin ...
    1991 Volume 32 Issue 1 Pages 139-145
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    Noninfective endocarditis may develop on heart valves in a wide variety of clinical conditions. Various events have been cited as possible etiologic factors.
    These lesions are clinically important because the vegetations frequently embolize and cause arterial obstruction and tissue infarction. Previously, the diagnosis of the disease had been made only at autopsies. Only a single case has been reported to have been diagnosed clinically in childhood. We present a patient with noninfective endocarditis, urgently operated on with the presumptive echocardiographic diagnosis of tricuspid valve myxoma, whose protein C level was found to be very low. It's known that in patients with homozygous congenital protein C deficiency venous thrombosis may develop. We think that the etiologic factor of the thrombosis on the tricuspid valve in the case presented is congenital protein C deficiency. With this case study we further emphasize the specific role of two-dimensional echocardiography in the diagnosis of noninfective endocarditis and recommend that protein C deficiency be investigated as an etiologic factor.
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  • Ilhan PASAOGLU, Riza DOGAN, Aysel ORAM, Filiz ÖZYILMAZ, A. Yü ...
    1991 Volume 32 Issue 1 Pages 147-151
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    A case of a giant blood cyst within the left ventricle of a 34-year-old man is presented with a brief review of the literature and a discussion of the pathogenesis.
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  • Altan ONAT, Tayyar SARIOGLU, Baris ILERIGELEN, Nergiz DOMANIÇ-& ...
    1991 Volume 32 Issue 1 Pages 153-156
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
    The case of a 38-year-old female who suffered a cerebral embolism from a free left atrial thrombus is reported. The clinical picture, including serum enzyme elevations, was consistent with a nontransmural myocardial infarction. Atrial flutter exhibiting very slow (162/min) and tall waves was transiently recorded indicating development of an intraatrial conduction disturbance.
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  • 1991 Volume 32 Issue 1 Pages e1
    Published: 1991
    Released on J-STAGE: December 09, 2008
    JOURNAL FREE ACCESS
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