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Biomedical subjects

I Kuwajima

Publications and source records attributed to I Kuwajima.

80 records · Page 5Linked to original sources
PubMed1976

A clinicopathological study on the electrical axis of the heart in 1,000 autopsy cases.

The electrical axis of the heart in 1,000 aged people more than 56 years of age was classified as normal axis in 58%, left axis deviation in 17.4%, mild left axis devaition in 21.9%, and right axis deviation in 2.7%. Pathological examination disclosed that left axis deviation was associated with myocardial infarction in 20%, right bundle branch block in 16%, but showed no significant relationships with coronary sclerosis, myocardial fibrosis and cardiac hypertrophy. Right axis deviation was associated with right bundle branch block in 66.7% and right ventricular hypertrophy in 22.2%

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PubMedDate not supplied

[Two autopsy cases of aortitis syndrome in the elderly].

Two autopsy cases of aortitis syndrome (Takayasu's aortitis) in the elderly are presented. Case 1 was an 81-year-old woman in whom hypertension was observed at age 37, and difference of right and left arm blood pressure was pointed out at age 65. She was referred to the authors' hospital at age 72. Chest X-ray and computed tomography of the thorax indicated atypical coarctation and diffuse calcification of the aorta. Case 2 was a 69-year-old woman in whom hypertension was pointed out at age 49, and blood pressure in the arms was found to differ from that in the legs at age 63. Chest X-ray and computed tomography showed diffuse calcification and marked narrowing of the descending aorta. Pathological examination revealed marked calcification in the thickened adventitia of the aorta with mild atherosclerotic change. Irregular fibrotic changes of the adventitia and degeneration of elastic fibers of the media of the aorta were noted in both cases, and were consistent with Takayasu's aortitis. This disorder is common in young women and only a small number of elderly cases are reported although its incidence is increasing. Diffuse calcification of the aorta with an absence of inflammatory signs, which is frequent in older patients, were observed in both case. Systemic hypertension is the most important risk factor with coarctation of the aorta in Takayasu's aortitis. Bypass surgery is recommended in young patients, however in elderly patients, it is generally avoided, in favor of medical control of hypertension.

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Regression of left ventricular hypertrophy in two-kidney, one clip Goldblatt hypertension.

The effect of regression of left ventricular hypertrophy (LVH) on ventricular performance was studied in two-kidney, one clip Goldblatt hypertensive rats (2K1C) treated with methyldopa or by unclipping. Sham operations were performed in a total of 21 rats; 12 and nine were studied after 4 and 6 weeks, respectively. Hypertension was induced in 38 additional rats. Of these, 11 were studied at 4 weeks. Cardiac index was measured by electromagnetic flowmetry under light ether anesthesia, and ventricular performance was assessed by rapid intravenous saline infusion. Of the remaining 27 hypertensive rats at 4 weeks postclipping, 10 were treated with methyldopa (400 mg/kg/day) and nine were unclipped; eight were left untreated as controls. Two weeks thereafter, ventricular performance was determined as described above. When expressed as the relationship between cardiac index and LV end-diastolic pressure, ventricular performance tended to be depressed in 2K1C. Ventricular performance, mean arterial pressure, and LV-to-body weight ratio returned to control in unclipped rats. Whereas methyldopa resulted in regressed LVH, its effect on mean arterial pressure and total peripheral resistance was not as marked as unclipping, both remaining significantly increased (p less than 0.001). The disparate effects of unclipping and methyldopa on systemic hemodynamics indicate that the improved ventricular performance with methyldopa was related more to its effect on LVH, suggesting that in these animals regression of LVH was associated with improved ventricular performance.

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Effect of perindopril on 24-hour blood pressure levels and hemodynamic responses to physical and mental stress in elderly hypertensive patients.

This study assessed the effects of an angiotensin-converting enzyme (ACE) inhibitor, perindopril, on the 24-hour blood pressure (BP) profile and hemodynamic responses to isometric exercise and mental stress in elderly hypertensive patients. We performed ambulatory BP monitorings and echocardiographic studies during hand-grip exercises and a mental stress test before and after the 10-week administration of perindopril in 11 elderly patients (mean age, 71.8 years). Office BP was significantly decreased by perindopril treatment. Both daytime and nighttime systolic BP decreased significantly without any change in circadian pattern (P < 0.05). Daytime diastolic BP was also significantly decreased by perindopril (P < 0.05); nighttime diastolic pressure was decreased, but this result was not statistically significant. The reduction in 24-hour BP was associated with a decreased left ventricular end-systolic dimension (P < 0.01) and an increased fractional shortening (P < 0.01), suggesting reduced afterload due to arterial dilatation. The left ventricular mass index was not changed by perindopril therapy, and neither were systolic and diastolic BP responses to the handgrip exercises. The increases in systolic BP during mental stress was augmented after perindopril therapy, although systolic BP during mental stress after treatment was significantly lower than before treatment (P < 0.05). These results indicate that perindopril is effective in reducing ambulatory 24-hour BP levels and is associated with improved systolic function caused by dilatation of resistance vessels.

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Circadian blood pressure change after carteolol chloride in younger and older hypertensive patients.

To determine whether there is an age-related difference in circadian blood pressure changes after administration of a beta-adrenergic blocker, 24-hour ambulatory blood pressure was measured before and after administration of long-acting carteolol, a beta-blocker with intrinsic sympathomimetic activity, in 9 younger and 13 older hypertensive patients. Ambulatory blood pressure was measured noninvasively using an ambulatory blood pressure monitor every 30 minutes for 24 hours before and 8 weeks after a once-daily administration of 15 mg of carteolol. Systolic and diastolic blood pressure in the office significantly decreased in both groups after 8 weeks of carteolol treatment. The whole-day systolic and diastolic blood pressures also fell significantly after carteolol treatment in both groups. Carteolol reduced systolic and diastolic blood pressures during the day in both groups. However, no reduction was observed in nighttime systolic blood pressure in either group, although nighttime diastolic blood pressure tended to decrease in the younger group (P = 0.051). The pulse rate during the night significantly increased in both groups, although no change was observed during the day in either group. We conclude that the antihypertensive effect of carteolol on the circadian blood pressure pattern in younger and older hypertensive patients is comparable. Carteolol reduced only daytime blood pressure while hardly affecting the nighttime blood pressure in both groups.

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