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Kwan-Lih HSU, Fu-Tien CHIANG, Huey-Ming Lo, Chang-Her TSAI, Chuen-Den ...
1997 Volume 38 Issue 4 Pages
463-471
Published: 1997
Released on J-STAGE: December 09, 2008
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The relation between left ventricular (LV) endsystolic wall stress (σes) and rate-corrected velocity of circumferential fiber shortening (Vcf
c), which is independent of heart rate (HR) and loading conditions has previously been used to assess cardiac contractility in insulin dependent diabetes mellitus (IDDM). This study is the first report in which this relation has been utilized with data obtained by echocardiography in addition to the traditional indices, to evaluate the cardiac function in asymptomatic, middle-aged patients with noninsulin dependent diabetes mellitus (NIDDM) at baseline and during dobutamine stimulation.
There were 16 NIDDM patients in our study and these patients were classified into 2 groups. Group 1 consisted of 11 patients without microvascular complications. Group 2 consisted of the remaining 5 patients with microvascular complications. Ten age- and sex-matched normal subjects were enrolled as a control group. At baseline, diabetic patients tended to have a faster HR and a greater LV enddiastolic dimension, though these values were not significantly different from the normal subjects. Ejection fraction (EF) in group 1 was significantly higher than that of the normal controls (73±2% vs 65±2%,
p<0.005). Mitral inflow pattern was normal (E/A>1) in the normal subjects (1.11±0.06), but reversed in group 1 (0.87±0.07) and group 2 (0.95±0.12). Isovolumic relaxation time corrected for HR (IVRTc) and the slope of relation between σes and Vcf
c were similar among the 3 groups. Comparing Vcf
c, at 50g/cm
2 of σes, it tended to increase from the normal subjects (0.883±0.057circ/sec) to 0.969±0.048 in group 1 and 1.034±0.101 in group 2, though this result was not statistically significant.
During dobutamine stimulation, EF increased and IVRTc shortened significantly only in the normal subjects. E/A became normalized in both diabetic groups. The increment in Vcf
c representing cardiac reserve of contractility was significantly lower in the diabetics (0.110±0.040 in group 1 and 0.057±0.043 in group 2) than in normal subjects (0.244±0.044).
In conclusion, using the index of relation between σes and Vcf
c, the cardiac contractility of NIDDM was not impaired at baseline, and even had a tendency to increase. However, during dobutamine stimulation, the inadequate reserve of contractility was exposed, especially in those patients who had microvascular complications. These results indicate the importance of controlling diabetes, not only to prevent the development of microvascular complications but also to preserve cardiac function. (Jpn Heart J 1997; 38: 463-471)
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Yung-Zu TSENG
1997 Volume 38 Issue 4 Pages
473-485
Published: 1997
Released on J-STAGE: December 09, 2008
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To date most published studies on normal basic data of the potential distribution of cardiac activity have been restricted to ventricular depolarization. Only a few papers have dealt with ventricular repolarization in normal subjects. This is an attempt to establish the basic data of the body surface potential maps (BSPM) of ventricular repolarization in normal adults.
BSPM of ventricular repolarization utilizing 87 electrodes through the heart potential map system designed by Toyama et al. were studied in 50 normal Chinese male adults.
The following information on BSPMs was obtained: (1) In the initial phase of ventricular repolarization, the potential maximum was located on the precordial area and the potential minimum appeared on the right-superior portion of the back; (2) The movement of potentials was counterclockwise and stable during the later portion of the T loop; (3) The magnitudes of the potentials changed in a spindle pattern with the drifting of ventricular repolarization. They first increased and then decreased with the largest value being around the peak period of the T wave; (4) The absolute value was greater in the potential maximum than the potential minimum throughout ventricular repolarization.There was no "reversal" potential distribution pattern. This parameter may be of importance clinically; (5) There were usually multiple potential maxima and multiple potential minima during the ST segment and early phase of the T wave; (6) The largest potential maximum and potential minimum were 0.93±0.28mV and 0.35±0.19mV, respectively. The potential maximum and potential minimum at the peak T wave were 0.91±0.23mV and 0.35±0.17mV, respectively.
Obviously, this study offers valuable basic data on the BSPM in normal adults and will be helpful to our understanding of the BSPM in various heart diseases.
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Effects of Left Atrial Appendage Function
Kazuyo MANABE, Takashi OKI, Tomotsugu TABATA, Hirotsugu YAMADA, Kazuyo ...
1997 Volume 38 Issue 4 Pages
487-495
Published: 1997
Released on J-STAGE: December 09, 2008
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Left atrial appendage (LAA) flow velocities prior to electrical cardioversion were recorded using transesophageal pulsed Doppler echocardiography to predict initially successful cardioversion of isolated atrial fibrillation (AF). Patients with AF were placed into either a success group (19 patients) in which sinus rhythm was maintained for at least 2 days or a failure group (12 patients). The duration of AF was shorter in the success group. The maximum left atrial diameter was the same for the two groups. The maximum LAA area was smaller in the success group. The maximum forward and backward LAA velocities were greater in the success group, as were the mean forward and backward LAA velocities. In the patients with mean LAA flow velocities greater than 19cm/sec, the success of cardioversion could be predicted with high sensitivity (80%) and specificity (88%). We conclude that the duration of AF, the maximum LAA area, and LAA flow velocities prior to cardioversion predict the initial recovery of sinus rhythm for isolated AF.
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Akm ISCAN, M. Ramazan YIGITOGLU, Aydm ECE, Zeki ARI, Muhittin AKYILDIZ
1997 Volume 38 Issue 4 Pages
497-502
Published: 1997
Released on J-STAGE: December 09, 2008
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We examined the relationship between maternal smoking during pregnancy and serum lipid, lipoprotein and apolipoprotein levels in newborns. Serum concentrations of total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, apolipoprotein A-1, apolipoprotein B and lipoprotein (a) were assesed in blood samples from 38 mothers who were smokers and their newborns obtained at delivery and compared to blood sample from 42 nonsmokers and their newborns. As compared with newborns of nonsmoker mothers, newborns of smoker mothers showed a lower mean level of high density lipoprotein cholesterol (21 versus 26mg/d
l,
p<0.01), a higher total cholesterol to high density lipoprotein cholesterol (4.7 versus 3.7,
p<0.01), a higher low density lipoprotein cholesterol to high density lipoprotein cholesterol ratios (3.2 versus 2.3,
p<0.05), a lower mean level of apolipoprotein A-1 (105 versus 129mg/d
l,
p<0.01) and a higher apolipoprotein B to apolipoprotein A-1 ratio (0.44 versus 0.3,
p<0.01). These paremeters were also different between smoker and nonsmoker mothers. There were no significant differences in TC, TG, LDL-C, Apo B and Lp (a) values between the two newborn groups. These data suggest that maternal smoking during pregnancy markedly affects lipid metabolism in the fetus.
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Takuya WATANABE, Toshikuni YANAGISHITA, Noburu KONNO, Eiichi GESHI, Ta ...
1997 Volume 38 Issue 4 Pages
503-514
Published: 1997
Released on J-STAGE: December 09, 2008
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We evaluated the effects of angiotensin-converting enzyme (ACE) inhibition on metabolic changes in myocardial organelles, myocardial hypertrophy, and interstitial fibrosis in the early stage of hypertension. An ACE inhibitor, imidapril (2.5mg/kg per day), a calcium-channel blocker, diltiazem (30mg/kg per day), or vehicle was given to spontaneously hypertensive rats (SHRs) from 10 to 18 weeks of age. Single myocytes were isolated enzymatically from the left ventricles of these SHRs and normotensive Wistar-Kyoto (WKY) controls at 18 weeks of age. In single ventricular myocytes, enzyme activities in the sarcoplasmic reticulum (SR) and the sarcolemma (SL) and the mitochondrial respiratory control ratio (RCR) were determined. In 18-week-old SHRs receiving vehicle, myocardial hypertrophy and interstitial fibrosis developed, and SR Ca
2+ ATPase activity and the mitochondrial RCR were significantly lower and SL Na
+, K
+-ATPase activity was significantly higher than in age-matched WKYs. However, compared with diltiazem, imidapril was better able to prevent the development of myocardial hypertrophy and interstitial fibrosis, to improve SR Ca
2+-ATPase activity and the mitochondrial RCR, and to increase SL Na
+, K
+-ATPase activity. These results suggest that ACE inhibition can prevent the development of morphologic changes associated with hypertension-induced left ventricular remodeling, such as myocardial hypertrophy and interstitial fibrosis, and can counteract ongoing dysfunction of organelle metabolism early in the development of hypertension.
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Shuji MUKAE, Toshikuni YANAGISHITA, Eiichi GESHI, Kazuhiko UMETSU, Mas ...
1997 Volume 38 Issue 4 Pages
515-529
Published: 1997
Released on J-STAGE: December 09, 2008
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The impairment of mitochondria in non-infarcted myocardium under cardiogenic shock complicated by acute myocardial infarction was studied.
We induced acute myocardial infarction in dogs by ligating the circumflex branch of the left coronary artery (LCX). On basis of left ventricular systolic pressure (LVPs) after 60 minutes, we divided the dogs into two groups: a group in which LVPs fell to below 70% of the pre-LCX ligation level, and a Control group in which LVPs remained more than 90%. The former group was further divided into four subgroups, depending on infusion of dopamine, dobutamine, amrinone or saline after 90 minutes. Mitochondria were prepared and mitochondrial respiratory activity determined.
In the Saline group, hemodynamics became reduced to less than 70% of the preligation level after 120 minutes, however, in the Dopamine and Dobutamine groups, hemodynamics became restored to the preligation level. In the Amrinone group, LVPs decreased slightly, while cardiac output, LV Max. dp/dt and myocardial blood flow increased. In the Saline group, mitochondria in the non-infarcted myocardium functioned at a lower level of activity than that of the Control group. However, in the Dopamine, Dobutamine, and Amrinone groups, the mitochondria functioned at a higher level. Electron microscopy revealed mitochondrial damage in the Saline group only.
The results indicate that an energy production disorder in the noninfarcted myocardium may have pathogenetic implications in cardiogenic shock associated with acute myocardial infarction, while dopamine, dobutamine, and amrinone improve mitochondrial function, and ultimately improve cardiac function.
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Po-Hsien CHU, Wei-Jan CHEN, Pyng-Jing LIN, Wer-Ber LIAO, Cheng-Wen CHI ...
1997 Volume 38 Issue 4 Pages
531-534
Published: 1997
Released on J-STAGE: December 09, 2008
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Left ventricular thrombus is one source of cardiogenic embolism. The protruding, mobile type is the highest risk subgroup but is rarely encountered. Thrombectomy is one choice of therapy, and variously recommended based primarily on the experience with myocardial infarction. We report a rare case of successful left ventricular thrombectomy for two protruding, mobile thrombi in a patient with idiopathic dilated cardiomyopathy in order to prevent repeat embolizaion.
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Haruhiko ABE, Yasuyo IWAMI, Yasuhide NAKASHIMA, Kiyotaka KOHSHI, Akio ...
1997 Volume 38 Issue 4 Pages
535-539
Published: 1997
Released on J-STAGE: December 09, 2008
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We describe a 16-year-old female referred for evaluation of syncope associated with competitive long distance running. She had experienced 4 episodes of syncope during competitive long distance racing. The syncope associated with marked bradycardia and asystole was demonstrated by head-up tilt testing without isoproterenol infusion. Oral propranolol therapy failed to prevent the syncope. Oral disopyramide therapy, however, prevented the syncope induced by both head-up tilt testing and competitive long distance racing. Caution should be urged in evaluating athletes with syncope, especially in the pediatric age group, because the cause of the syncope may result from life-threatening disorders such as cardiomyopathy, long QT syndrome, or exercise-induced arrhythmias. The head-up tilt test is an important diagnostic tool for the evaluation of exercise-associated syncope.
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Po-Hsien CHU, Wei-Jan CHEN, Cheng-Wen CHIANG, Ying-Shiung LEE
1997 Volume 38 Issue 4 Pages
541-545
Published: 1997
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Lovastatin is a popular drug for the treatment of hypercholesterolemia. Few serious complications are associated with its use although rhabdomyolysis with renal failure has been reported when lovastatin is combined with cyclosporine or other drugs following transplantation. We report the case of a patient who developed hepatopathy and rhabdomyolysis accompanied by acute renal failure after 4 weeks of lovastatin monotherapy. The pathogenesis and treatment of these complications are also discussed.
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Lessons from Rodent Models
Suzanne Oparil
1997 Volume 38 Issue 4 Pages
555-556
Published: 1997
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Ah-Mee Park, Masahiko Ikeda, Masaki Tabuchi, Hideya Mizuno, Takako Tom ...
1997 Volume 38 Issue 4 Pages
557
Published: 1997
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Takanori Noguchi, Yasuto Sasaki, Junji Seki, Junichiro Yamamoto
1997 Volume 38 Issue 4 Pages
558
Published: 1997
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Shinichi Hatta, Norihito Amemiya, Hiroko Togashi, Mitsuhiro Yoshioka, ...
1997 Volume 38 Issue 4 Pages
559
Published: 1997
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Shiko Chichibu, Yoshio Ohta, Tsuneyuki Suzuki
1997 Volume 38 Issue 4 Pages
560
Published: 1997
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Masae Tanaka, Jean L. Olson, Olga Schmidlin, Sai-Li Yi, R. Curtis Morr ...
1997 Volume 38 Issue 4 Pages
561
Published: 1997
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Masae Tanaka, Olga Schmidlin, Sai-Li Yi, R. Curtis Morris
1997 Volume 38 Issue 4 Pages
562
Published: 1997
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Masahisa Goto, Masashi Mukoyama, Issei Tanaka, Tsunekazu Matsumoto, Ma ...
1997 Volume 38 Issue 4 Pages
563
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Kenji Yoshino, Masataka Kazama, Tae Hitoto, Aiko Matsui, Yoichiro Mats ...
1997 Volume 38 Issue 4 Pages
564
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Ken-ichi Okugawa, Miho Terada, Mari Kondo, Takashi Fujiwara
1997 Volume 38 Issue 4 Pages
565
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Hideaki Higashino, Morihiko Hishida, Aritomo Suzuki
1997 Volume 38 Issue 4 Pages
566
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Azharul I. Khan, Johji Kato, Kazuo Kitamura, Kenji Kangawa, Tanenao Et ...
1997 Volume 38 Issue 4 Pages
567
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Masahiko Hirafuji, Takashi Ebihara, Fumito Kawahara, Yukitatsu Kanai, ...
1997 Volume 38 Issue 4 Pages
568
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Norihisa Ono, Tetsuya Oshima, Nobuo Sasaki, Yukiko Nakano, Mitsuisa Yo ...
1997 Volume 38 Issue 4 Pages
569
Published: 1997
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Yoh Hamada, Naoko Ito, Youko Kouhei, Tetsuo Murakami
1997 Volume 38 Issue 4 Pages
570
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Yoshio Ohta, Taka-aki Chikugo, Tsuneyuki Suzuki
1997 Volume 38 Issue 4 Pages
571
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Norikazu Yamaguchi, Takeshi Fujii, Kazuko Fujimoto, Koichiro Kawashima
1997 Volume 38 Issue 4 Pages
572
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Hideo Kataoka, Kazuo Gotoh, Fumitada Hazama
1997 Volume 38 Issue 4 Pages
573
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Toshio Kumai, Masami Tanaka, Tomonori Tateishi, Minoru Watanabe, Hiron ...
1997 Volume 38 Issue 4 Pages
574
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Shigeyuki Miki, Kazuo Takeda, Hiroshi Fujita, Masahiro Kiyama, Tsuguru ...
1997 Volume 38 Issue 4 Pages
575
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Ishii Toshiaki, Otsuka Yuji, Akimoto Hideo, Yokokoji Kiyoshi, Abeta Hi ...
1997 Volume 38 Issue 4 Pages
576
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Nobuaki Nakano, Athushi Moriguchi, Ryuichi Morishita, Jithuo Higaki, K ...
1997 Volume 38 Issue 4 Pages
577
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Hideya Mizuno, Masahiko Ikeda, Ah-Mee Park, Takako Tomita
1997 Volume 38 Issue 4 Pages
578
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Tatsuhiko Mori, Masakuni Ueyama, Jiro Kubota, Keishiro Kawamura
1997 Volume 38 Issue 4 Pages
579
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Masato Mizukoshi, Takuzo Hano, Osamu Satani, Yasuhito Sakai, Akira Bab ...
1997 Volume 38 Issue 4 Pages
580
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Yoshio Ohta, Tsuneyuki Suzuki, Atsushi Chiba, Shiko Chichibu
1997 Volume 38 Issue 4 Pages
581
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Noboru Saito, Yoshie Doi, Hitoshi Aomi, Seiji Nakayama, Miki Kamitani, ...
1997 Volume 38 Issue 4 Pages
582
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Tetsuo Murakami, Yoko Kouhei, Norifumi Shirasaka, Hajime Yoshizumi, Yo ...
1997 Volume 38 Issue 4 Pages
583
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Keiichi Shimamura, Kazuo Yamamoto, Kyoko Matsuda, Li-Bo Zou, Fumiko Se ...
1997 Volume 38 Issue 4 Pages
584
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Li-Bo Zou, Keiichi Shimamura, Kazuo Yamamoto, Kyoko Matsuda, Fumiko Se ...
1997 Volume 38 Issue 4 Pages
585
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Masahiro Ishikawa, Yoshihiko Saito, Yoshihiro Miyamoto, Osamu Nakagawa ...
1997 Volume 38 Issue 4 Pages
586
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Keiichi Kazihara, Takeshi Tsutsumi, Yutaka Shimizu, Hirofumi Osada, Sa ...
1997 Volume 38 Issue 4 Pages
587
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Yoshitaka Nishimura, Aritomo Suzuki
1997 Volume 38 Issue 4 Pages
588
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Akiko Ohira, Juro Yamamoto, Mitsumasa Ohyanagi, Tadaaki Iwasaki
1997 Volume 38 Issue 4 Pages
589
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Fumiko Sekiguchi, Kazuo Yamamoto, Keiichi Shimamura, Satoru Sunano
1997 Volume 38 Issue 4 Pages
590
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Junko Hiraoka, Kiminori Hosoda, Yoshihiro Ogawa, Katsumi Ikeda, Yasuo ...
1997 Volume 38 Issue 4 Pages
591
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Kazuto Shiegmatsu, Akira Mishima, Akihiko Himeno, Toru Nabika, Yuji Is ...
1997 Volume 38 Issue 4 Pages
592
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Masato Nishimura, Akira Nanbu, Ken Otsuka, Hakuo Takahashi, Manabu Yos ...
1997 Volume 38 Issue 4 Pages
593
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Masashi Sekimoto, Takashi Ueyama, Kiyomitsu Nemoto, Haruaki Kageyama, ...
1997 Volume 38 Issue 4 Pages
594
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Kazushi Tsuda, Ichiro Nishio, Yoshiaki Masuyama
1997 Volume 38 Issue 4 Pages
595
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Nori Nakayama, Kazuyoshi Tsukamoto, Toshiyuki Kurihara, Osamu Isogai, ...
1997 Volume 38 Issue 4 Pages
596
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