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Biomedical subjects

H Takezawa

Publications and source records attributed to H Takezawa.

At least 55 records · Page 3Linked to original sources
PubMed1986

Aneurysm of the left aortic sinus caused by Takayasu's arteritis: compression of the left coronary artery producing coronary insufficiency.

A 45 year old Japanese woman with an aneurysm of the left aortic sinus is described. The main trunk of the left coronary artery was displaced upward, and the proximal portion of the circumflex branch was markedly compressed and displaced posteriorly, causing subendocardial infarction and angina. The diagnosis of Takayasu's arteritis was made based on: 1) age, sex and nationality of the patient; 2) inflammatory signs followed by weakness of the right radial pulse; and 3) typical angiographic findings. Five previously reported cases are reviewed.

Aortic Aneurysm↗
PubMed1986

Successful treatment of acute, severe aortic regurgitation caused by Takayasu's arteritis: a case report.

Acute, severe aortic regurgitation due to dilatation of the aortic root was studied in a 16-year-old Japanese female with Takayasu's arteritis. The patient was admitted because of acute pulmonary edema followed by systemic illness characterized by fever, anorexia, and general fatigue. The echocardiogram and aortogram demonstrated acute, severe aortic regurgitation due to dilation of the aortic root. She was successfully treated with aortic valve replacement and steroid. Microscopic examination of the aortic wall demonstrated granulomatous lesions with multinucleated giant cells. Now, three years later, she remains asymptomatic and hemodynamically stable.

Adolescent↗
PubMed1986

[Right ventricular ischemia evaluated by radionuclide ventriculography].

The clinical usefulness of radionuclide ventriculography (RNV) was evaluated in patients with right ventricular ischemia. The subjects consisted of 25 patients with acute inferior myocardial infarction, 19 patients with old myocardial infarction and six patients with angina pectoris who had severe stenosis of the right coronary artery. In patients with acute inferior myocardial infarction, follow-up radionuclide studies were performed during the recovery periods on the first, 7th-14th, and 30th hospital day. Fifteen of the 25 patients initially had decreased right ventricular ejection fractions (evidence of right ventricular infarction). The mean value was 28 +/- 8% on the initial day, but 7-14 days and 30 days after the acute attack, it improved markedly to 36 +/- 9% and 39 +/- 9%, respectively. Regional wall motion abnormality resolved in 10 of the 15 patients on the 30th hospital day. In 25 patients with old myocardial infarction or with angina pectoris, RNV was performed at rest and during supine exercise to determine the influence or right coronary artery disease. Right ventricular ejection fraction was changed by exercise from 42 +/- 7% to 44 +/- 10% in patients with proximal artery lesions, and from 45 +/- 7% to 50 +/- 10% in patients with distal artery lesions. Right ventricular ejection fraction increased in patients with isolated right coronary artery disease (rest: 44 +/- 8%, exercise: 49 +/- 9%), decreased in patients with combined left anterior descending artery disease (rest: 40 +/- 6%, exercise: 38 +/- 11%) and increased in patients with combined circumflex artery disease (rest: 43 +/- 5%, exercise: 47 +/- 6%). We concluded that right ventricular infarction is a frequent complication in patients with inferior myocardial infarction. However, right ventricular ejection fraction and right ventricular regional wall motion abnormality improve dramatically within one month. Stress-induced ischemia would be rare in patients with isolated right coronary artery disease. The above findings support the notion that the right ventricular myocardium has peculiar coronary perfusions.

Angina Pectoris↗
PubMed1986

[Power spectrum of heart murmurs: special reference to mitral regurgitant murmurs].

Heart murmurs, especially the mitral regurgitant murmurs of 40 patients were analyzed using the fast Fourier transformation technique. 1. Three types of frequency spectral pattern of mitral regurgitation (MR) were demonstrated: A) broad, spanning 100 to 500 Hz, B) narrow, characterized by one giant peak, and C) two peaks. The reason for these patterns was not clear, but they may be related to various hemodynamic events. 2. The mean frequency (f) in MR was 295 +/- 38 Hz and it increased in proportion to the regurgitant grade: e.g., Sellers II, 258 +/- 27 Hz; Sellers III, 294 +/- 23 Hz; and Sellers IV, 311 +/- 65 Hz. The accumulated percentage of the 200-400 Hz component decreased, while that of the 400-600 Hz component increased. 3. The f in MR of various etiologies were as follows: It was higher in ruptured chordae tendineae, rheumatic cases and mitral valve prolapse syndrome, but was lower in papillary muscle dysfunction and dilated cardiomyopathy. In the latter two, the percentage of the 0-200 Hz component was greater than in other disorders. The degree of left ventricular dysfunction and of myocardial injury may be responsible for the changes in the propagation properties. In ventricular septal defect and aortic stenosis, the f was 306 +/- 12 Hz and 230 +/- 40 Hz, respectively. The frequency spectrum of the latter was lower than that of MR, which may be derived from the difference between ejection and regurgitant murmurs; whereas, that of ventricular septal defect was similar to that of rheumatic MR. 4. The relation between the frequency spectrum and the phase of systole was studied. In dilated cardiomyopathy and papillary muscle dysfunction, the f of each phase increased in late systole; whereas, the maximum f was in mid-systole in other disorders. 5. Administration of amyl nitrite resulted in a decreased f, an increased percentage of the 0-200 Hz component, and a decreased 400-600 Hz component. The spectral distribution shifted to the lower frequency region. Results of this study suggested that significant information can be obtained from the frequency analysis of heart murmurs.

Adolescent↗
PubMed1986

Acute effects of ibopamine hydrochloride on hemodynamics, plasma catecholamine levels, renin activity, aldosterone, metabolism and blood gas in patients with severe congestive heart failure.

Acute effects of 200 mg of orally given 4-[2-(methylamino)ethyl]-o-phenylene diisobutyrate hydrochloride (ibopamine hydrochloride) which is a new diisobutyric ester of N-methyldopamine, on hemodynamics and metabolism were evaluated in 11 patients with severe heart failure (New York Heart Association class IV). Significant effects occurred within 30 min and persisted for 6 h after dosing. Peak effects were observed at 2 h. At peak effects, cardiac index increased from 2.53 to 3.07 l/min/m2 (+20%, p less than 0.01), stroke volume index from 35 to 41 ml/beat/m2 (+18%, p less than 0.05), stroke work index from 35 to 44 g X m/beat/m2 (+26%, p less than 0.05), epinephrine from 0.05 to 0.15 ng/ml (+200%, p less than 0.05), urine volume from 50 to 81 ml/h (+61%, p less than 0.05), pulmonary capillary wedge pressure decreased from 23 to 18 mmHg (-24%, p less than 0.001), mean pulmonary arterial pressure from 33 to 27 mmHg (-19%, p less than 0.001), right atrial pressure from 10 to 7 mmHg (-27%, p less than 0.001), systemic vascular resistance from 1735 to 1546 dyne X s X cm-5 (-11%, p less than 0.1), pulmonary vascular resistance from 204 to 168 dyne X s X cm-5 (-25%, p less than 0.05), arterio-venous oxygen difference from 6.09 to 5.36 ml/dl (-12%, p less than 0.05), norepinephrine from 0.45 to 0.34 ng/ml (-24%, p less than 0.1), renin activity 1.80 to 1.26 ng/ml/h (-30%, p less than 0.05), respectively, whereas there were no significant changes in blood gases, heart rate, blood pressure, double product, aldosterone, urine Na+, K+ or lactate/pyruvate.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

Potential prevention of myocardial rupture resulting from acute myocardial infarction.

The clinical characteristics of 30 cases of myocardial rupture resulting from acute myocardial infarction were analyzed. Predisposing factors of myocardial rupture appeared to be the following (1) age 60 years or older, (2) female, (3) no previous history of angina or myocardial infarction, (4) hypertension on admission, (5) persistent or recurrent chest pain, (6) physical activity and/or emotional unrest, (7) less than 10 days since the onset of myocardial infarction. From 1979 to 1982, we tried to eliminate these risk factors in the acute stage of myocardial infarction, of which hypertension appeared to be the most important and main correlating factor. The incidence of myocardial rupture before elimination of risk factors was 31.2% (26 of 84 patients) which was reduced to 8.8% after elimination. In the years 1981 and 1982, only two cases of myocardial rupture were found in each year, 4.3% and 5.6% of MI patients, respectively.

Adult↗
PubMed1985

Effects of nifedipine and diltiazem on hemodynamic responses at rest and during exercise in hypertensive patients.

Twelve patients with uncomplicated systemic hypertension were treated with nifedipine (30 mg/day) and diltiazem (180 mg/day) for 1 month each, and performed two stage (50 watt and 100 watt) of bicycle ergometer exercise before and after each period of administration. Both drugs produced significant reduction in systolic and diastolic blood pressure at rest and during exercise, while the mean values of systolic blood pressure tended to be less with nifedipine than with diltiazem. Nifedipine caused a nonsignificant increase in heart rate at rest and during exercise, but diltiazem significantly decreased it at rest and during exercise. Cardiac output was significantly increased at rest and during mild exercise (50 watt), but not during more strenuous exercise (100 watt) with both drugs. Thus, different actions in arterial vasodilation and chronotropism between nifedipine and diltiazem in usual clinical doses were noted. However, nifedipine and diltiazem may be effective in hypertensive patients, probably with left ventricular dysfunction, because both drugs reduced systemic blood pressure even during exercise with simultaneous increase in cardiac output at rest and during mild exercise.

Adult↗
PubMed1985

Sudden death during ambulatory monitoring in a patient with left main coronary artery disease.

A 61 year old male with left main coronary artery disease died suddenly during ambulatory Holter monitoring. The monitoring documented ST depression followed by ST elevation, followed by junctional and ventricular escape rhythms with no measurable blood pressure by cuff methods. The mechanism of sudden death in patients with left main coronary artery disease is thought to be a combination of ventricular fibrillation or bradyarrhythmia and electromechanical dissociation secondary to a sudden onset of severe pump failure.

Angiography↗