[The clinical significance of exercise-induced ST-segment elevation-electrocardiographic and arteriographic evaluation in 23 patients (author's transl)].
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Biomedical subjects
Publications and source records attributed to J Fujii.
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The diastolic characteristics of the left ventricle with special reference to the patterns of left ventricular filling and diastolic posterior wall movement were studied echocardiographically in 95 patients with various cardiac conditions including constrictive pericarditis, idiopathic cardiomyopathy (CCM, HCM), valvular aortic stenosis (AS), mitral stenosis (MS), hypertension (HT), aortic insufficiency (AI), mitral insufficiency (MI), and in 20 normal subjects. 1. Various types and severities of LV diastolic abnormalities were revealed by analyzing the patterns of posterior wall movement and LV filling in three diastolic phases--rapid filling period, slow filling period, and atrial filling period, respectively. 2. Disturbances of posterior wall distension and LV filling during the rapid filling period with a compensatory augmentation of atrial contribution to LV filling were observed in most patients. These patients also showed a markedly decreased posterior wall velocity and LV filling rate during rapid filling period. 3. E-F slope was significantly decrease in patients with MS, AS, and HCM. E-F slope correlated well with DPWV and RFR in most patients. In MS, however, DDR decreased to a disproportionate degree with a decrease in DPWV and RFR, probably due to the structural changes and decreased mobility of the mitral valve. From this study, we conclude that the patterns of the left ventricular filling and posterior wall movement during three phases of diastole obtained by echocardiography is useful in detecting left ventricular diastolic abnormalities.
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We have applied the new technique of dual echocardiography to determine the sequence of atrial contraction as reflected in the simultaneously recorded movements of the tricuspid and mitral valves. The study group included 29 normal subjects and 23 patients with either atrial flutter, coarse atrial fibrillation or atrial tachycardia with block. In normal individuals, right atrial contraction preceded left atrial contraction, with an average interatrial contraction time of 17 +/- 8 msec. In contrast, the atrial contraction sequence was reversed in atrial flutter, with left preceding right atrial contraction and a prolonged interatrial contraction time of 82 +/- 20 msec. In two patients with atrial tachycardia with block, atrial contraction was either simultaneous or left preceded right atrial contraction by a brief interval. The sequence of atrial excitation, as determined by electrode catheter recordings from the right and left atria in one patient with atrial flutter and one patient with normal sinus rhythm, was the same as the contraction sequence. Left atrial pacing reversed both excitation and contraction sequences. After cardioversion of three patients from atrial flutter to normal sinus rhythm, interatrial contraction time was shortened but remained longer than in normal subjects, suggesting an interatrial conduction disturbance in patients with atrial flutter. In coarse atrial fibrillation, the contraction sequence varied. Significant motion of both mitral and tricuspid valves coincident with fibrillary waves occurred frequently, especially when the fibrillary waves were coarse and regular. Dual echocardiography permits the noninvasive determination of the sequence of atrial contraction and excitation, and may be useful in studying the characteristics of atrial arrhythmias.
The effect of amyl nitrite (AN) on the vectorcardiographic T loop was studied in 17 cases who had negative T waves in the left chest leads of ECG. Thirty sec after AN inhalation the maximum T vector was displaced to the left and anteriorly in 15 and to the left and posteriorly in 2 cases. The magnitude of maximum spatial T vector was decreased and the spatial T loop became more circular. Changes in the amplitude of T loop projected to the scalar lead X were closely related with changes in the heart rate which would represent the sympathetic tone.
Ligation of the main femoral artery is followed by a rapid development of collateral arteries. To detect an increase in vascular permeability of the collateral arteries, colloidal carbon (1 ml/Kg, iv) was injected into 153 rabbits at various times after ligation or sham-ligation of the main femoral artery. These animals were killed later and collateral arteries was dissected. Increase in vascular permeability was identified by the presence of visible carbon deposits on the vascular walls. The carbon deposits were frequently found on the intermediate segments of the collateral system in legs with ligation, but were not found on any arteries either in legs with sham-ligation or in contralateral untouched legs. The increase in vascular permeability was observed in 15 of 17 animals as early as 6 hours, in 32 of 36 animals 1 day but only in 5 of 21 animals 6 to 8 days after ligation. The arterial segments with carbon deposits showed various structural changes such as fragmentation of the internal elastic layer, degeneration of the medial muscle and deposition of fibrinoid material. These results indicate that vascular permeability transiently increases in the intermediate segments of developing collateral arteries. Acute vasodilatation may be responsible for the increase in vascular permeability.
The weight and protein contents of the aorta and left ventricle were measured in rabbits with two-kidney or one-kidney Goldblatt hypertension (group 2H and group 1H) and in respective control animals (group 2C and group 1C). 14 days after a renal artery constriction the protein contents of the aorta were greater in group 2H (124+/-3 mg) than in group 2C (95+/-2 mg) (p less than 0.001) and in group 1H (124+/-5 mg) than in group 1C (102+/-4 mg) (p less than 0.001). The weight and protein contents of the aorta and of the left ventricle were also significantly greater in group 1H and group 2H than in group 1C and group 2C respectively. Furthermore in both types of hypertension the weight and protein contents of these two organs significantly correlated to the blood pressure. These results indicate that hypertrophy of the aorta as well as the left ventricle develops already in early developing stage of Goldblatt hypertension.