Journal of cardiography. Supplement最新文献

{"title":"[Asymmetric septal hypertrophy of sporadic form with abnormal thallium perfusion and myocardial enzymes].","authors":"S Nagata,&nbsp;T Minamikawa,&nbsp;Y D Park,&nbsp;T Nishimura,&nbsp;C Yutani,&nbsp;F Ohmori,&nbsp;H Sakakibara,&nbsp;Y Nimura","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Asymmetric septal hypertrophy with abnormal thallium scintigram and elevated cardiac enzymes were observed in five patients and were studied with special reference to the clinical significance of their clinicopathological features. They were not familial cardiomyopathy patients. Two of the five patients (Cases 1 and 2) exhibited the clinical features characteristic of hypertrophic cardiomyopathy without abnormal thallium perfusion and serum cardiac enzyme levels. A right endomyocardial biopsy for Case 1 disclosed myocardial fibrosis in addition to hypertrophy and disarray of myocardial fibers. The left ventricular cavities of two other patients (Cases 4 and 5) tended to be dilated with signs of impaired systolic function and asymmetric septal hypertrophy. A regional area of reduced thickness was observed in the medial portion of the left ventricular posterior wall of Case 4. The remaining case (Case 3) exhibited left ventricular dilatation and reduced left ventricular systolic function, disproportionate hypertrophy, and had clinical signs of congestive heart failure. Necropsy disclosed massive fibrosis and diffuse disarray of myocardial fibers. Some patients with familial hypertrophic cardiomyopathy progress to exhibit clinical features of dilated cardiomyopathy in the terminal stages, and have massive fibrosis of the myocardium histologically. Thallium scintigraphic abnormalities and elevated serum levels of cardiac enzymes, especially the LDH1 isoenzyme, in patients with hypertrophic cardiomyopathy may be a meaningful indicator of such progression in its early stages. The five patients in the present study exhibited a variety of clinical and histological features which may comprise a spectrum of clinical conditions during the progression from hypertrophic cardiomyopathy to a condition like dilated cardiomyopathy, similar to that in familial patients. This progression and the factors promoting it should be studied further in the near future.</p>","PeriodicalId":77861,"journal":{"name":"Journal of cardiography. Supplement","volume":" 9","pages":"57-65"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14879645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical problems in mitral valve prolapse: an electrocardiographic review].","authors":"J Fujii","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Electrocardiographic signs of mitral valve prolapse are essentially non-specific. Diagnosis must be based on the other methods, but whenever the diagnosis was established, the electrocardiographic abnormalities may have a certain significance to predict the natural course and prognosis. The reported results and those of our series of 111 cases were compared in detail. Resting and exercise electrocardiography of our series revealed no definite tendency of ST-T changes, arrhythmias and other abnormalities in cases with prolapse except a few signs. When the abnormalities were present, they were not related to the severity of prolapse, but premature ventricular contractions were more frequently observed in severe cases. Atrial fibrillation was observed in higher frequency in cases with mitral regurgitation. The other abnormalities were not conclusive to verify previous studies. When compared to 19 cases with neurocirculatory asthenia comfirmed by clinical tests including angiography, the similarity of electrocardiographic abnormalities was observed in many aspects, but arrhythmias were much more common in cases with mitral valve prolapse. On the other hand, exercise test was positive more frequently in cases with neurocirculatory asthenia. No conclusion was established as to the sites of prolapse and electrocardiographic abnormalities.</p>","PeriodicalId":77861,"journal":{"name":"Journal of cardiography. Supplement","volume":" 11","pages":"57-72"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14801393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The effects of medical treatment on the long-term prognosis of variant angina pectoris].","authors":"T Aizawa,&nbsp;J Fujii,&nbsp;K Ogasawara,&nbsp;K Nishimura,&nbsp;K Kato","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To investigate the changing aspect of the long-term prognosis of patients with medically-treated variant angina, we studied 253 consecutive patients treated from January 1963 to August 1984. The patients were categorized into two groups according to the year of first admission to our hospital; 88 patients hospitalized before January 1975 and mainly treated with nitrates (group I), and 165 patients admitted thereafter and treated with calcium antagonists (group II). The average follow-up period was 63.1 months (ranged from one to 136) in the group I, and 32.4 months (ranged from one to 116) in the group II. Coronary arteriography was performed in 146 patients of the group II. In 82 patients (56%), no fixed coronary artery stenosis of greater than or equal to 75% of the luminal diameter was present; 47 patients (32%) had one-vessel disease, and 17 (12%) had multi-vessel involvement. Seventy-eight patients having both rest and effort angina showed a higher prevalence of fixed coronary artery stenoses (50 of 78 patients) compared with the patients without effort angina (14 of 68 patients) (p less than 0.001). The group II showed a significantly good long-term efficacy of medical treatment for anginal attacks (124 of 165 patients compared with 54 of 88 group I patients: p less than 0.05). Complete remission over three months or more occurred in 56% of the group II compared with 45% of the group I. Fourteen patients (16%) of the group I suffered from myocardial infarction (10 were within six months of onset of angina); whereas, only five (3%) of the group II developed myocardial infarction (two were within six months of initial anginal attack) (p less than 0.001). Cardiac death occurred in five patients (6%) of the group I in contrast to four patients (2%) of the group II. The patients having significantly effective medical treatment for anginal attack were 80%, 62% and 64% in those without significant stenosis, with one-vessel disease, and with multi-vessel disease, respectively. Myocardial infarction occurred in two of 17 patients with multi-vessel disease. Spontaneous remission of angina over at least three years without medical treatment occurred in seven of 32 patients who were followed for more than 10 years. It was concluded that the long-term prognosis of patients with variant angina who received calcium antagonists was reasonably improved compared with patients treated with nitrates.(ABSTRACT TRUNCATED AT 400 WORDS)</p>","PeriodicalId":77861,"journal":{"name":"Journal of cardiography. Supplement","volume":" 10","pages":"3-12"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14706941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Right ventricular function assessed by scintigraphy using continuous infusion of krypton-81 m].","authors":"A Miyamoto,&nbsp;I Sakuma,&nbsp;K Kanamori,&nbsp;T Kobayashi,&nbsp;H Yasuda","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Scintigraphy using continuous infusion of krypton-81m, (81mKr) is a reproducible, noninvasive method for determining right ventricular ejection fraction (RVEF). Radionuclide determinations of RVEF by 81mKr scintigraphy were compared with those by the technetium-99m (99mTc) first-pass technique in 25 patients; the results obtained by both methods correlated well (r = 0.86, p less than 0.005). In 20 additional patients, the RVEF determined by 81mKr was compared with the RVEF as measured by multislice ECG-gated cardiac X-ray computed tomography, and there was good correlation between RVEFs obtained by the two methods (r = 0.76, p less than 0.005). Furthermore, the RVEF by the 81mKr technique and the LVEF by the 99mTc gated blood pool technique were compared with hemodynamic measurements. There was a significant inverse correlation between RVEF and pulmonary artery pressure or total pulmonary resistance. Other determinants of right ventricular systolic function were the presence of proximal right coronary artery disease, reduced left ventricular function and associated tricuspid regurgitation.</p>","PeriodicalId":77861,"journal":{"name":"Journal of cardiography. Supplement","volume":" 8","pages":"53-62"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14842350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Panel discussion: diagnostic criteria of mitral valve prolapse].","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77861,"journal":{"name":"Journal of cardiography. Supplement","volume":" 11","pages":"113-6"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14801387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Progressive left ventricular dilatation in a child with hypertrophic cardiomyopathy: a case report].","authors":"S Nagata,&nbsp;Y D Park,&nbsp;H Sakakibara,&nbsp;C Yutani,&nbsp;Y Nimura,&nbsp;S Mimasu,&nbsp;T Kuniya,&nbsp;S Harada,&nbsp;K Yoshida","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Clinical pictures of a patient with progression from hypertrophic cardiomyopathy to dilated cardiomyopathy features in the end stage was described. Echocardiography performed at the age of five years revealed septal hypertrophy without systolic anterior motion (SAM). At 7 years of age, it revealed ventricular septal thickness of 18 mm, left ventricular posterior wall thickness of 24 mm, and marked SAM. Echocardiography at 14 years of age revealed left ventricular dilatation (52 mm in diastole) with poor contraction. Ventricular septal thickness was 18 mm and left ventricular posterior wall thickness was 16 mm. The SAM was no longer present. At autopsy, the heart weighed 590 g, and there was moderate dilatation of the right and left ventricular cavities. Histologically, there were massive fibrosis and myocardial disarray in the right and left ventricular walls.</p>","PeriodicalId":77861,"journal":{"name":"Journal of cardiography. Supplement","volume":" 9","pages":"49-55"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14879644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Severity and extent of coronary artery disease and their relationship to left ventricular functional reserve in the chronic disease state].","authors":"K Tsuiki,&nbsp;T Kanaya,&nbsp;M Hayasaka,&nbsp;M Oguma,&nbsp;I Ota,&nbsp;T Kaminishi,&nbsp;S Yamaguchi,&nbsp;N Ohara,&nbsp;I Tonooka,&nbsp;S Yasui","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Our previous observations showed that left ventricular wall motion abnormality (asynergy) induced by stress was observed in the phase response of radionuclide technique, and the severity and extent of coronary artery disease (CAD) assessed by the Pujadas score (PS) correlated well with the maximal phase delay response (delta MPD) but not with the ejection fraction response (delta EF) in patients with CAD without old myocardial infarction (MI). This study evaluated the usefulness of EF, MPD and the first-third filling fraction (FF, divided by the volume accrued throughout diastole) at rest and during stress, using ergometer and first-pass radionuclide angiocardiography (RNA), to determine the severity of CAD, and to evaluate any abnormalities in the systolic and diastolic coupling in left ventricular function during stress. Seventy-four patients with significant CAD, including 41 with previous transmural MI (MI group) and 33 without MI (angina group) were the subjects of this study. EF at rest and during stress inversely correlated, and MPD on stress linearly correlated with PS in angina group with PS greater than 10, while no such correlations were found in MI group. A normal EF response (delta EF greater than or equal to 5%) was accompanied by a greater-than-normal response in FF (delta FF) in both groups. A lower EF response was accompanied by a smaller delta FF in angina group, but by a larger delta FF in MI group. The difference was statistically significant (p less than 0.03), without significant differences by age, PS, peak heart rate, systolic blood pressure, and ischemia on ECG during stress. Resting EF and FF by the RNA method correlated with those by left ventriculography (LVG), respectively. It was suggested that RNA is an accurate method for determining EF and FF, while phase analysis may provide some additional information different from that provided by LVG. We concluded that EF and MPD during stress are as useful as delta MPD with the exception of a few cases in predicting the severity of CAD, and that scar tissue within the ventricular wall in MI may play an important role in determining the ventricular diastolic mechanical property during stress.</p>","PeriodicalId":77861,"journal":{"name":"Journal of cardiography. Supplement","volume":" 8","pages":"15-24"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14842346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Asynchronous wall motion in patients with ischemic heart disease assessed by higher-order harmonics of the Fourier series].","authors":"S Kodama,&nbsp;N Tamaki,&nbsp;T Mukai,&nbsp;Y Yonekura,&nbsp;K Torizuka,&nbsp;Y Suzuki,&nbsp;S Tamaki,&nbsp;R Nohara,&nbsp;H Kambara,&nbsp;C Kawai","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To assess regional cardiac function in patients with ischemic heart disease (IHD), multigated blood-pool studies using higher-order harmonics of the Fourier series were performed for 14 normal persons and 37 patients with IHD. IHD was further divided into IHD (I) (EF greater than or equal to 50%) and IHD (II) (EF less than 50%). A pixel-by-pixel volume curve was simulated using second order harmonics of the Fourier series to create functional images of the following parameters: time to endosystole (TES), peak ejection rate (PER), time to PER (TPE), peak filling rate (PFR), and time to PFR (TPF). TES (SD), TPE (SD), and TPF (SD) were calculated as the standard deviations of left ventricular (LV) histograms of each phase, representing indexes of asynchronous wall motion. An LV volume curve was simulated using third order harmonics to calculate PFR, PFR/PER, and TPF/TPE, representing indexes of diastolic function. TES (SD) was abnormal in 10 cases (50%), and TPE (SD) was abnormal in seven cases (35%) of IHD (II). On the contrary, TPF (SD) was abnormal in three cases (18%) of IHD (I) and 15 cases (75%) of IHD (II), indicating that diastolic asynchronous indexes are more sensitive than systolic asynchronous indexes in detecting IHD. IHD (I) and IHD (II) showed lower PFR (2.32 +/- 0.55, 1.64 +/- 0.46 EDV/sec) and lower PFR/PER (0.84 +/- 0.15, 0.68 +/- 0.26) than those in normals (3.25 +/- 0.98 EDV/sec, 0.99 +/- 0.19), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":77861,"journal":{"name":"Journal of cardiography. Supplement","volume":" 8","pages":"25-32"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14842347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Radionuclide ventriculographic evaluation of left ventricular systolic function in acute myocardial infarction].","authors":"F Ohsuzu,&nbsp;K Hosono,&nbsp;H Nakamura,&nbsp;H W Strauss","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Within 18 hours of acute myocardial infarction, global left ventricular (LV) function was evaluated by radionuclide ventriculography for 127 patients. Ejection fraction (EF) was calculated using a variable region of interest counts method. LV end-diastolic volume index (EDVI) was calculated from the LV outlines in the anterior and LAO projections using the area-length method. To validate the determination of EDV by the area-length method, the radionuclide EDV correlated with that derived from direct contrast angiography in 44 other patients who had both studies within two weeks, with an overall correlation coefficient of 0.84. To minimize any potential problems with the geometric ellipsoid model, the end-systolic volume index (ESVI) was calculated from EF and EDVI. Peak systolic blood pressure (PSP) was recorded with a cuff during imaging and the PSP/ESV calculated as a measure of LV contractile function. The regional wall motion of five segments in both the anterior and LAO projections were each scored on a scale, from 4 (= normal) to 0 (= dyskinesis). The wall motion index (WMI) derived from the sum of the 10 segment scores represented an overall index of wall motion (maximum = 40). In addition, the more widely used % abnormally contracting segments (%ACS) was calculated. The severity of wall motion abnormalities were associated with significant increases in heart rate and ESVI, whereas EDVI began to increase under more severe damage to the myocardium. Our data are consistent with those of Klein who found that the LV enlarges only when 20 to 25% of the surface area is rendered akinetic. There were significant decreases in EF and PSP/ESV with moderate reduction in wall motion, and the relation between EF and PSP/ESV was curvilinear. Information about ventricular volume and systolic blood pressure might be of additional value to EF for a more complete understanding of the changes in the functional state of the LV. Global LV function was compared between anterior and inferior myocardial infarcts. The size of %ACS was larger in anterior than in inferior infarction and a greater decrease in WMI in the former suggested larger infarct size in anterior infarction. As a result, ESVI was significantly larger in anterior infraction than in anterior infraction. However, an increase in EDVI was not significantly different between the two groups. EF was reduced to a greater extent in anterior than in inferior infarction. The overall data indicate that patients with anterior infarction have more severe impairment of left ventricular global function than do those with inferior infarction.</p>","PeriodicalId":77861,"journal":{"name":"Journal of cardiography. Supplement","volume":" 8","pages":"43-52"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14842349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Numbers and sizes of myocytes, amount of interstitial space, fibrosis and disarray in dilated cardiomyopathy].","authors":"H Fujiwara,&nbsp;T Onodera,&nbsp;M Tanaka,&nbsp;T Fujiwara,&nbsp;C Kawai,&nbsp;Y Hamashima","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The features characteristic of dilated cardiomyopathy (DCM) are dilatation of the left ventricular cavity without thickening of the wall, and decreased contractility of the left ventricle. The myocardial wall thickness depends on three variables: the number of muscle layers, the mean size of myocytes and the percent area of interstitial space. To clarify the histological pathogenesis of the special features of DCM, these three variables including wall thickness, fibrosis and disarray in the left ventricular wall of autopsied hearts were quantitatively measured in 10 patients with DCM, 10 patients with hypertrophic cardiomyopathy (HCM) and 20 patients with normal hearts (N). The heart weight was 651 +/- 128 g in the DCM group, 614 +/- 216 g in the HCM group, and 280 +/- 40 g in N group. The S (ventricular septum)/F (left ventricular free wall) of the wall thickness was 9 +/- 1/9 +/- 1 (mm) in DCM, 25 +/- 5/16 +/- 2 (mm) in HCM, and 13 +/- 1/13 +/- 1 (mm) in the N group. The S/F of % fibrosis was 9 +/- 5/11 +/- 4 in DCM, 14 +/- 4/8 +/- 5 in HCM, and 1 +/- 1/1 +/- 1 in N. S/F of the size (mu) of myocytes was 18 +/- 2/21 +/- 3 in DCM, 19 +/- 3/21 +/- 2 in HCM, and 13 +/- 1/14 +/- 1 in N. S/F of the numbers of muscle layers was 310 +/- 60/260 +/- 40 in DCM, 630 +/- 80/360 +/- 70 in HCM.(ABSTRACT TRUNCATED AT 250 WORDS)</p>","PeriodicalId":77861,"journal":{"name":"Journal of cardiography. Supplement","volume":" 9","pages":"27-33"},"PeriodicalIF":0.0,"publicationDate":"1986-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14878962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}