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Biomedical subjects

K Kuramoto

Publications and source records attributed to K Kuramoto.

At least 163 records · Page 9Linked to original sources
PubMed1984

[A clinicopathologic study of valvular aortic stenosis in the aged].

To evaluate the usefulness of phonocardiography (PCG), carotid pulse recording (CAG) and echocardiography (UCG) used in diagnosing valvular aortic stenosis (AS) in the aged, we performed a clinicopathologic study of 23 autopsied patients with pathological evidence of aortic stenosis (AS). There were eight men and 15 women, whose ages averaged 82 years. PCG and CAG were available in 15 patients, and UCG was available in 13 patients. We classified the subjects into three groups; Group A with calcified AS, Group B with bicuspid AS and Group C with rheumatic AS. The following results were obtained. There were 12 patients in Group A, four in Group B and seven in Group C. Patients in Group A were older than those in Group B or C (A; 84-year-old, B; 80-year-old, C; 79-year-old on the average). The mean heart weight of Group A was less than that of Group B or C (A; 345 g, B; 453 g, C; 486 g). Congestive heart failure was more frequent in Groups B and C than in Group A. The fourth heart sound was recorded on the PCG in nine of 11 patients without atrial fibrillation, but there was no difference in incidence among the three groups. An ejection systolic murmur was recorded in all cases and a diastolic murmur of aortic regurgitation in 10. No patients had shudder formation on the CAG. The T-time tended to be prolonged in AS, especially in Groups B and C. The peak of the systolic murmur tended to be late in systole in Groups B and C. A1-peak/LVET was significantly increased in Groups B and C (A; 0.38, B; 0.51, C; 0.47). The decreased amplitude of aortic valvular opening (AVO) and the dense diastolic echo of the aortic valve were observed in all AS cases. The AVO of Group A was significantly less in amplitude than that of Group C (A; 3.6, C; 6.4). Thus, we could differentiate Group A from Groups B and C by various non-invasive techniques. These findings may be attributed to the different anatomic features of the aortic valves among these three groups.

Aged↗
PubMed1982

Hemodynamic effects of salbutamol, an oral long-acting beta-stimulant, in patients with congestive heart failure.

As the efficacy of oral long-acting sympathomimetic drugs is not yet well established, we investigated the hemodynamic effects of orally administered salbutamol in eight heart failure patients. Cardiac index, heart rate, blood pressure, and left ventricular filling pressure were monitored for 6 hours after a single oral administration of 4 to 8 mg salbutamol and placebo. In patients who had received salbutamol, a 40% increase in the cardiac index (+0.75 L/min/m2, p less than 0.01) was noted 1 hour post administration; a 44% increase (peak effect) occurred at 2 hours (+0.84 L/min/m2, p less than 0.05); and a significant increase persisted for 6 hours. Changes in heart rate showed a similar time course; however, the increase was less pronounced (+27% at 2 hours). The changes in blood pressure were slight and none of the eight patients developed ventricular arrhythmia or other complications. After placebo administration, no consistent changes in the hemodynamic parameters were noted. The present study suggests that, due to its sustained positive action on cardiac output, the oral administration of salbutamol may be efficacious in ambulatory patients with low cardiac output due to heart failure.

Administration, Oral↗
PubMed1981

Characteristics of body surface mapping in the aged.

1) Body surface mapping was performed in 15 patients with ischemic heart disease and 5 control subjects before and after isoproterenol infusion. In ischemic heart disease, ST map developed negative areas in the left anterior chest wall extending from mid line to left axillar line after isoproterenol. This distribution on ST depression was different from that of left ventricular hypertrophy or complete left bundle branch block which spared mid anterior chest. The point of maximal ST depression corresponded to one of the conventional chest lead in 6 of 15 cases. In other 9 cases, the point of maximal ST depression was mostly located superiorly to V3-V5. epsilon ST depression correlated well with the maximal ST depression (r = 0.90) but not very well with ST depression at V5 (r = 0.70). On 201 T1 stress scan, a reversible large perfusion defect was detected in 2 out of 5 patients with marked ST depression. These findings suggested that isoproterenol induced ST map changes are useful in diagnosis of myocardial ischemia. 2) Body surface map was obtained in 16 cases with chronic pulmonary disease. The location of the maximum R and initial R was relatively inferior to that of normal controls. Relatively deep S waves were frequently observed. Pulmonary function tests correlated with the maximum R voltage but not with the deepest S. Cases with relatively high pulmonary conus voltage were proved to have right ventricular hypertrophy on 201 T1 myocardial scintigraphy or on echocardiography.

Aged↗
PubMed1981

The pathogenetic role and treatment of elderly hypertension.

The clinicopathological study on the atherosclerosis and cerebrovascular and cardiac complications was carried out in 1561 consecutive autopsied cases in the elderly. The subjects were classified into 3 groups: 702 cases (45.0%) of normotension, 276 cases (17.7%) of systolic hypertension and 583 cases (37.3%) of diastolic hypertension. The acceleration of atherosclerosis by hypertension was prominent in sixties and seventies, less remarkable in eighties and almost none in nineties. The effect of hypertension was remarkable on cerebral artery, aorta and coronary artery in this order, and no difference was found between the systolic and diastolic hypertension groups. On the basis of atherosclerotic changes, strokes and myocardial infarction were prevalent in both these groups in comparison with the normotension group. The difference between the systolic and diastolic hypertension groups and the normotension group was prominent in sixties and seventies, but in eighties only the diastolic hypertension group showed a significant difference with the normotension group. The effect of hypertension was more remarkable on strokes than myocardial infarction. The lack of remarkable effect of hypertension on the cases over eighty may be attributed to the progression of atherosclerosis with age in normotensive cases. The 4 year prospective trial on the effectiveness of the antihypertensive treatment was performed in 100 mild hypertensive patients of the aged, averaging 76.1 years. The matched pair group was selected by the age, sex and blood pressure. Cerebrovascular and cardiac complications were observed in 4 cases of 10.5% of 38 cases of the drug group, and in 9 cases or 22.0% of 41 cases of the placebo group. When the elevation of blood pressure over 200/110 mmHg, observed in 8 cases in the placebo group, were included as one of the cardiovascular complications, the complications in placebo group reached 41.5%, showing a significant difference. Other complications such as cancers, infections and bone or joint diseases, were observed in 12 cases or 31.6% in the drug group and in 17 cases or 41.5% in the placebo group. Blood pressure was decreased from 171/87 to 151/80 in the drug group in the 4 year period. The present study suggested that antihypertensive treatment was effective in the aged hypertension, and careful follow up was needed not only for cardiovascular complications but also for general health condition.

Age Factors↗
PubMed1981

Prospective study on the treatment of mild hypertension in the aged.

The 4 year prospective trial on the effectiveness of the antihypertensive treatment was performed in 100 mild hypertensive patients of the aged, the average age being 76.1 years. Dropouts during the drug-off control period were 9 cases. The matched pair group was selected by the age, sex, and blood pressure. Forty-four drug treated cases and 47 placebo treated cases were comparable in blood pressure as well as in laboratory data. Cerebrovascular and cardiac complications were observed in 4 cases or 10.5% in the drug group, and in 9 cases or 22.0% in the placebo group. When 8 cases of blood pressure elevation over 200/110 mmHg in the placebo group were added to the cardiovascular complications, dropouts in placebo group reached 41.5%, and this showed the significant difference. Other complications were observed in 12 cases or 31.6% in the drug group and in 17 cases or 41.5% in the placebo group. Major complications were cancers, infections, and bone or joint diseases. Blood pressure was decreased from 171/87 to 151/80 in the drug group, and the average decrease was 20/7 mmHg in 4 year period. No significant changes in hematocrit, serum protein, urea nitrogen, uric acid, sodium, and potassium were observed during the trial period. The present study suggested that antihypertensive treatment was effective in the aged with mild hypertension, and that careful follow up was needed not only for cardiovascular complications but also for general health condition.

Age Factors↗