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Biomedical subjects

H Kishida

Publications and source records attributed to H Kishida.

15 recordsLinked to original sources
PubMed1992

Antianginal effects of amlodipine at a single dose on exertional angina patients using treadmill exercise testing--a randomized crossover study in comparison with placebo.

With eight cases of stable exertional angina as subjects, the antianginal action and sustained effects of single 10 mg oral doses of new calcium antagonists amlodipine were assessed by treadmill exercise tests in randomized crossover trials with respect to a placebo. Exercise tests were conducted before as well as 4, 8, and 24 hours after administration, and plasma amlodipine concentration was investigated at the same times. The maximal exercise time was 299 +/- 43 seconds before as compared with 346 +/- 49 seconds 4 hours after administration and 368 +/- 50 seconds 8 hours after administration, a significant prolongation in each case (p < 0.01). Moreover, the exercise time elapsed until 1 mm of ST-segment depression, as well as the ST-segment depression measured at the same time, were both significantly improved as compared with the placebo results. The plasma amlodipine concentration reached a peak 8 hours after administration and displayed an effective level even 24 hours after administration. The value of delta PRP measured at the same time during the exercise test was also significantly reduced as compared with the placebo results, even 24 hours after administration of amlodipine. These findings supported the conclusion that single 10-mg doses of amlodipine provide stable antianginal action over a 24-hour period.

Administration, Oral↗
PubMed1992

Circadian variation of ischemic threshold in patients with chronic stable angina.

Circadian variation of ischemic threshold in chronic stable exertional angina was determined in 51 patients with documented coronary artery disease from the Holter monitor results. The peak favored time zones of ischemic attacks were 8 a.m. and 9 a.m. There was no difference in frequency of ischemic attacks, magnitude of ST-segment depression, or duration of ST-segment depression between the two time zones for ischemic attacks, 6-9 a.m. and 0-3 p.m., but the ischemic threshold was lower in the morning than in the afternoon. These observations suggest that the pathogenesis of ischemic attacks differs from one time zone to the other and is considered helpful in planning therapeutic strategies for myocardial ischemia.

Activities of Daily Living↗
PubMed1992

Two cases of variant form angina pectoris associated with myocardial bridge--a possible relationship among coronary vasospasm, atherosclerosis and myocardial bridge.

Myocardial bridge (MB) is a congenital anomaly of the coronary artery and may occur in 5 to 12% of the human population. However, the mechanism of MB-induced myocardial ischemia is still speculative. We report 2 cases of variant form angina pectoris associated with MB in which myocardial ischemia seemed to be related to the interaction between coronary perfusion and MB. In case 1, electrocardiography during anginal attack at rest showed ST elevation in the inferior leads and MB was observed after percutaneous transluminal coronary angioplasty at the site of the right coronary artery lesion following successful dilatation. In case 2, MB of the left anterior descending coronary was located in the identical portion where coronary vasospasm was induced by intracoronary acetylcholine injection, although ischemia during the spontaneous anginal attack was limited to the inferior area of myocardium. These 2 cases suggest that MB can be, at least in some patients, one of the possible causes of the endothelial damage which seems to be related to coronary vasospasm; this was documented in both cases.

Angina Pectoris, Variant↗
PubMed1992

Cardiac events in patients with silent myocardial ischemia.

The clinical implications of silent myocardial ischemic (SMI) episodes in patients with coronary artery disease were assessed in 253 patients whose angina symptoms were resolved by antianginal drugs. This population included 93 patients without a history of myocardial infarction (angina group) and 160 patients with myocardial infarction (infarction group). These patients were further divided into 2 subgroups according to whether or not SMI was detected by Holter monitoring immediately before discharge. The incidence of cardiac events was 19% for the angina group and 18% for the infarction group. The incidence of cardiac events did not differ between the 2 groups, but the cardiac event profile did. Briefly, 14 angina patients experiencing cardiac events needed coronary revascularization for worsening symptoms, while 18 myocardial infarction patients experiencing cardiac events had another infarction. In both angina and myocardial infarction patients, the cumulative rates of cardiac events were significantly higher in the subgroups with SMI (p less than 0.01 in either group). The significant prognostic factors as determined in the Cox regression model were multivessel disease, asynergy score, and SMI on Holter monitoring for angina patients, and SMI on Holter monitoring and multivessel disease for myocardial infarction patients. In conclusion, the cardiac event rate is significantly elevated in the subgroups with SMI, regardless of whether the patient had previous myocardial infarction; patients with SMI carry a poor prognosis, especially when they have a history of myocardial infarction.

Angina Pectoris↗
PubMed1992

[Silent myocardial ischemia in myocardial infarction patients: its prognostic significance].

To evaluate the prognostic and clinical significance of silent myocardial ischemia (SMI), we examined cardiac events in 160 patients with old myocardial infarction who underwent ambulatory Holter monitoring, treadmill exercise testing and coronary angiography. Using the Cox's proportional hazard regression model and the survival curves with the Kaplan-Meier method, we identified the predictors of cardiac events. The incidence of cardiac events for all the patients during the 44-month follow-up period was 18%. The significant predictors of unfavorable outcomes were severe coronary lesions and SMI. The incidence of SMI was 38%. The cardiac event rate in patients with SMI was higher than in those without SMI (32 vs 9%, p < 0.05). The most frequent cardiac event in patients with SMI was reinfarction, and the significant predictors of cardiac events for these SMI patients were lower ejection fraction and maximum ST depression on Holter monitoring. In conclusion, SMI proved to be a significant predictor of unfavorable outcome in patients with old myocardial infarction. It was, therefore, suggested that revascularization (PTCA/CABG) should be used as early as possible in patients with SMI whether anginal symptoms are present or not.

Aged↗
PubMed1992

[Clinical analysis of 6 cases of pericardial cysts].

We present a clinical analysis of 6 cases of pericardial cysts. There were two males and four females. Only one case of them had complaint of persistent cough. Four of 6 were observed in right costo-phrenic angle, and 2 were in left costo-phrenic angle. Surgical excision was performed in 6 cases, and all patients recovered good health. We suggest that in cases of pericardial cysts, surgical treatment should be performed, even if patients would not have remarkable complaint.

Adult↗
PubMed1979

Effects of K+ and K+-induced polarization on (dV/dt)max, threshold potential, and membrane input resistance in guinea pig and cat ventricular myocardium.

We studied the non-membrane potential-dependent effect of K+ on (dV/dt)max and threshold potential in guinea pig and cat ventricular myocardium. Membrane potential (MP) was changed uniformly in segments (length less than or equal to 1.0 mm) of papillary muscles by applying extracellular polarizing current pulses across a single sucrose gap. Control [K+]o was 5.4 mM and test [K+]o values were 2.0, 10.0, 11.5, 13.0, 16.2, 20, 22, and 24.0 mM. Each muscle was studied under four conditions: (1) control [K+]o and unaltered (control level) resting MP (Em); (2) one of the test [K+]o values and the unaltered (test level) Em; (3) the same test [K+]o and Em held at the control level; (4) control [K+]o and Em held at the test level. At all [K+]o greater than or equal to 11.5 mM, (dV/dt)max showed a decrease significantly (P less than 0.01) greater than the corresponding MP-dependent decrease in both guinea pig and cat myocardium. This non-MP-dependent decrease averaged 7.5% at 11.5 mM, 26.5% at 13.0 mM, 37.2% at 16.2 mM, and 22.7% at 20.0 mM. At [K+]o greater than or equal to 20.0 mM, (dV/dt)max was predominantly slow-channel-dependent; it was increased by hyperpolarization to -110 mV at [K+]o = 20 and 22 mM but not at [K+]o = 24mM. Threshold potential became progressively less negative with increasing [K+]o, but this effect was dependent only on MP. The membrane input resistance (rm) was determined by two opposing factors: at a given [K+]o, rm increased with depolarization; and at a given MP, rm decreased with increasing [K+]o. Our study shows that non-MP-dependent depression of (dV/dt)max in the ventricular myocardium occurs at [K+]o concentrations that may be encountered in vivo.

Action Potentials↗
PubMed1976

Review of the pocket-electrocardiograph (PECG) in a large general medical clinic.

Two hundred and twenty patients were selected for testing with the patient-activated Pocket Electrocardiography (PECG) because angina pectoris and similar diagnoses could not be excluded. They were selected during a 30-month period from the population of approximately 12,000 new patients visiting a general medical clinic at Nippon Medical School Hospital. The test confirmed the preliminary diagnosis in 79.1%; 9.6% were not confirmed and 11.3% did not have an attack during the PECG examination. The PECG examination is useful in the differential diagnosis of angina pectoris, cardiac neurosis, phantom arrhythmia, and arrhythmia when the routine ECG examinations are essentially negative.

Adolescent↗