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Biomedical subjects

F Takatsu

Publications and source records attributed to F Takatsu.

54 records · Page 3Linked to original sources
PubMed1986

T loop in posterior myocardial infarction: a useful clue to vectorcardiographic diagnosis.

In order to differentiate posterior (posterolateral) myocardial infarction (PMI) from the anterior shift of the QRS loop in "normal variant" cases using a vectorcardiogram, the T loop as well as the QRS loop in the transverse plane (TP) were analyzed in 34 elderly Japanese males with angiographically-proven PMI and in 197 elderly Japanese males with normal coronary arteries and ventricles. T loops in the TP were longer, narrower and more anterior in PMI cases. After this analysis, we propose new criteria for PMI: (A and B) A: maximal T vector equal or anterior to 60 degrees in TP B: at least two of the following three: maximal QRS voltage/maximal T voltage in TP equal to or less than 3.0; QRS-T angle equal to or less than 75 degrees in TP; width/length of T equal to or less than 0.15 in TP. These new criteria for PMI are more specific (p less than 0.01) and more sensitive (p less than 0.05) than Hoffman's criteria.

Adult↗
PubMed1986

Analysis of the evolution of coronary artery disease--evaluation of 227 cases by restudy of coronary arteriography.

Some 227 patients who showed a 50% or greater narrowing of at least one major coronary artery in the first study underwent recatheterization at a mean interval of 35.6 months. Coronary arterial lesions and the degree of narrowing [i.e., normal (absent), 25%, 50%, 75%, 90%, 99% and complete occlusion (100%)] were classified in accordance with the AHA reporting system. When the lesions in the second study showed a change of equal or more than 2 in the above 7 stages in comparison with the first study, either progression or regression was determined. Of the 227 patients, progression occurred in 73 (32%) and regression was found in 7 (3%). In the aggravated group in symptom, progression was noted in 58%, and even in the stabilized group, progression was observed in 22%. As a result of the second study, 15 (21%) out of 73 patients showing progression underwent surgical treatment, and more than half of these cases (9/15) were constituted by the stabilized group. During the above follow-up periods, myocardial infarction occurred subsequently in 14 (19%) out of 73 patients showing progression. Up to the present time, sudden deaths occurred in 8 patients, and 5 out of 8 patients were also of the stabilized group. The authors wish to emphasize from these findings the necessity of aggressively pursuing restudy even in stabilized cases showing symptoms of ischemic heart disease.

Adult↗
PubMed1986

Is it possible to rule out extensive anterior myocardial infarction in the absence of abnormal Q waves in lead I and aVL? Effect of infero-apical extension of infarction over apex.

To determine whether abnormal Q wave in lead I or aVL may be of use to estimate the size of an extensive anterior myocardial infarction, electrocardiographic and left ventriculographic findings were analyzed in 45 patients with old extensive anterior infarction. All 45 patients had a significant narrowing in the proximal segment of left anterior descending coronary artery (LAD) and severe asynergy in anterolateral segment. The patients were divided into two groups; Group I consisted of 35 cases with less involvement of the inferoapical segment and Group II of 10 cases with remarkable extension of the anterolateral infarction into the inferoapical segment due to occlusion of very long LAD supplying the anterior half of posterior interventricular groove. There were no statistical differences in the extent of anterolateral asynergy, number of abnormal Q waves in precordial leads and left ventricular ejection fraction between the two groups. While abnormal Q wave in lead I or aVL was present in 28 cases (80%) of Group I, it was observed in only 3 cases (30%) of Group II (p less than 0.01). Thus, we can't rule out extensive anterior myocardial infarction even if abnormal Q waves are absent in lead I or aVL, in which abnormal Q waves may be cancelled by loss of electromotive force of inferoapical segment due to extension of the anterior infarction over the apex in cases with extraordinarily long LAD.

Electrocardiography↗
PubMed1985

[Short-axis views of left ventriculograms compared with two-dimensional echocardiograms in cases of ischemic heart disease].

We examined 115 cases of ischemic heart disease to re-evaluate the usefulness and limitations of two-dimensional echocardiography in diagnosing left ventricular asynergy. Short-axis left ventriculography (SA-LVG) using the LAO-caudal angulated projection was performed and their findings were compared with those of the short-axis views of two-dimensional echocardiograms (SA-2DE). Left ventricular (LV) walls the SA-LVG and SA-2DE were divided into the interventricular septum (IVS), the anterior (AW), posterior (PW) and inferior wall segments (IW), and the manifestations of SA-LVG and SA-2DE were compared, corresponding to the four segments. A total of 414 (90%) of the 460 segments were correctly diagnosed by SA-2DE. Among 132 akinetic segments shown by SA-LVG, 123 (93%) revealed akinesis by SA-2DE, and 279 (96%) of 292 angiographically-normal segments also showed normal movement by SA-2DE. However, only 11 segments (35%) of all 32 angiographic hypokinesis were correctly diagnosed by SA-2DE. Thus, SA-2DE was fairly sensitive and useful in diagnosing akinesis and identifying normal contraction. However, it had limitation in diagnosing hypokinesis, as we previously reported.

Coronary Angiography↗
PubMed1984

Body surface isopotential maps in old inferior myocardial infarction undetectable by 12 lead electrocardiogram.

The purpose of this study is to examine the value of body surface isopotential maps in the diagnosis of old inferior myocardial infarction that can not be diagnosed by 12 lead ECG. Forty-three patients with a Q wave of at least 0.02 sec but less than 0.04 sec in width and also less than 25% of the R wave in depth in lead a VF of the 12 lead ECG were selected for this study. The patients were divided into infarction and noninfarction groups based on their clinical histories and cardiac catheterization data. The infarction group showed characteristic surface maps with a minimum which moved from the left posterior chest to the lower back or from the lower back to the right anterior lower chest in the early phase of QRS. The noninfarction group exhibited a minimum which shifted from the back to the right upper chest or from the left anterior chest to the lower back in the same phase. Thus, both groups were clearly distinguishable from each other by the positional change of the minimum in the early phase of QRS. This study suggested that body surface maps contain diagnostic information concerning the presence or absence of inferior myocardial infarction which is not easily available from the 12 lead ECG.

Adult↗
PubMed1983

A case of normal coronary infarction after intracoronary thrombolysis with urokinase.

We report the case of a 50-year-old male who had classical ECG signs of inferior wall myocardial infarction. Intracoronary thrombolysis resulted in fragmentation of a thrombus in the lumen of the right coronary artery. Angiography 1 month later showed no abnormalities at the site of previous thrombus. Ergonovine stress did not produce spasm. We conclude that (1) a mild cardial infarction can occur with an occlusive thrombus arising in angiographically normal coronary arteries; (2) transient change in minimal atheromata or spasm may induce such thrombi; and (3) thrombolytic therapy may be able to expedite recanalization of the occluded artery and salvage the myocardium.

Coronary Angiography↗
PubMed1983

Vectorcardiogram in multiple myocardial infarctions--Correlations between vectorcardiographic and angiographic findings.

To determine the value and limitations of vectorcardiograms (VCGS) for diagnosing multiple myocardial infarctions, correlations between VCG and angiographic findings were analyzed in 307 cases with severe asynergies due to coronary narrowings on left ventriculograms. While the presence of anterioseptal hypokinesis, corresponding to a nontransmural infarction of the anteroseptal wall, lowered the sensitivity of vectorcardiographic diagnosis for inferior and posterior myocardial infarctions, that of inferoposterior hypokinesis did not lower its sensitivity for anterior myocardial infarction. Severe asynergy, corresponding to a transmural infarction, reduced the VCG sensitivity for diagnosing myocardial infarction occurring in the opposite side of the left ventricle.

Coronary Angiography↗
PubMed1983

A case of variant angina and myocardial infarction 6 months after successful bypass surgery.

A 61-year-old man with variant angina underwent bypass surgery to the left anterior descending artery (LAD) which had a 90% narrowing in the proximal segment. The postoperative course was favorable, but 6 months after surgery, the calcium antagonist, diltiazem, with which the patient had been continuously treated since surgery, was stopped because of hepatitis. Immediately after discontinuation of the calcium antagonist, the patient had an acute anterior myocardial infarction. An angiogram demonstrated a patent graft and an anteroapical infarction. The infarction is thought to have been caused by a severe, prolonged spasm of the LAD distal to the graft or diffuse spasm of the LAD throughout its entire length. Thus, after bypass surgery calcium antagonists should be given continuously to patients with variant forms of angina pectoris.

Angina Pectoris, Variant↗
PubMed1982

Clinical significance of the double silhouette in the septal side in left anterior oblique cine left ventriculograms.

The clinical significance of a line often visible in left ventriculograms performed in the left anterior oblique position was analyzed. This line runs inside the free border of the septal silhouette, and occasionally displays a movement completely different from that of the border. Analysis of ventriculograms of 189 patients with single-vessel disease suggested that the movement of this line reflects the contractile state of the left ventricular myocardium near the posterior interventricular groove, supplied by the right coronary or circumflex artery. Evaluation of this line may be useful for a more complete assessment of left ventricular function in patients with ischemic heart disease.

Cineangiography↗
PubMed1982

Correlation between body surface isopotential maps and left ventriculograms in patients with old inferoposterior myocardial infarction.

In 24 patients with old inferoposterior myocardial infarction, body surface isopotential maps were compared with left ventriculographic findings. In 16 patients with asynergy restricted to the inferior and/or posterolateral segment, surface potential abnormalities due to infarction were observed during specific phases of QRS and in specific portions on the chest surface depending on the location and extent of ventricular severe asynergy (akinesis and dyskinesis). However, the remaining eight patients with coexisting severe asynergy in the anterior, apical, or septal segment showed surface potential maps quite different from those of the former patients. It is suggested that body surface isopotential maps are a useful clinical tool for detecting the location and extent of ventricular severe asynergy in patients with old inferoposterior myocardial infarction.

Aged↗
PubMed1982

Re-evaluation of the vectorcardiographic criteria for inferior myocardial infarction. Correlation between vectorcardiograms and left ventriculograms.

In 72 patients satisfying the vectorcardiographic criteria described by Young et al, vectorcardiographic findings were compared between a group of patients with an inferior myocardial infarction and a false positive group to increase the specificity of the vectorcardiographic diagnosis of inferior myocardial infarction. The first group was composed of 18 cases, with angiographic findings of inferior myocardial infarction and the false positive group was composed of 54 cases which had no significant narrowing of coronary arteries. Vectorcardiographic parameters such as the angle between the X axis and maximal QRS vector, the duration of initial superior force, the maximal superior deviation (QY) and the maximal inferior deviation (RY) were analyzed and only QY and QY/RY showed statistically significant differences between the 2 groups. Of these two parameters, QY/RY indicated a more definite difference. In addition, the rate of false positive cases was reduced prominently if the criterion of QY/RY above or equal to 0.2 was added to the criteria of Young et al. The direction of the maximal T vector was downward in 2 cases (11%) in the inferior myocardial infarction group, but downward in 44 cases (81%) in the false positive group.

Coronary Angiography↗
PubMed1981

A correlative study of anteroseptal asynergy and vectorcardiograpic findings in 276 cases with the lesion of the left anterior descending coronary artery.

Correlation of asynergies on the left ventriculogram with the transverse and frontal plane QRS loops recorded by the Frank lead system was investigated in 276 cases with a significant lesion of the left anterior descending coronary artery (luminal narrowing of 75% or more). Among the 97 cases with akinesis or dyskinesis in the anterior and/or septal segments, 84 satisfied the transverse plane VCG criteria for anterior myocardial infarction. Of the remaining 13 cases, 6 were diagnosed to have high lateral myocardial infarction based on the frontal plane VCG findings. Six of the 7 cases that were not diagnosed as having myocardial infarction evidenced concomitant akinesis in the inferoposterior segment. Of the 24 cases which had akinesis or dyskinesis localized in the apex, 10 showed a VCG pattern of anterior and/or high lateral myocardial infarction. Among 92 cases with hypokinesis in the anterior and/or septal segments, only 16 had VCG findings of anterior and/or high lateral myocardial infarction. There were no significant differences in the frequency of "bite" between these patients and the normal control group.

Coronary Disease↗
PubMed1981

Correlation between body surface isopotential maps and left ventriculograms in patients with old anterior myocardial infarction.

In 30 patients with old anterior myocardial infarction, body surface isopotential maps were correlatively studied with left ventriculographic findings. In 25 patients with ventricular asynergy restricted to the anterior segments, surface potential abnormalities due to infarction were observed during specific phases of QRS and in specific portions of the chest surface depending on the location and extent of severe ventricular asynergy (akinesis and dyskinesis). However, the remaining 5 patients with co-existing severe asynergy in the inferoposterior segment, showed body surface potential maps quite different from those of the above 25 patients. It was suggested that body surface isopotential maps were useful in detecting the location and extent of ventricular severe asynergy in patients with old anterior myocardial infarction.

Adult↗