Search PubMed⌕ Search

Biomedical subjects

Katsusuke Yano

Publications and source records attributed to Katsusuke Yano.

At least 73 records · Page 4Linked to original sources
PubMed2004

[Predictive factors of deteriorating left ventricular function after direct percutaneous coronary intervention for acute anterior myocardial infarction].

OBJECTIVES: To evaluate useful predictors for the deterioration of left ventricular function after direct percutaneous coronary intervention in patients with acute myocardial infarction. METHODS: This study included 96 consecutive patients with first acute anterior myocardial infarction reperfused successfully by direct percutaneous coronary intervention within 6 hr of the onset, who underwent left ventriculography in the acute (soon after reperfusion therapy) and chronic (20 +/- 8 days after onset) phases. The left ventricular ejection fraction (LVEF), and the difference in LVEF (delta LVEF) between the two stages were calculated. The patients were divided into two groups according to the delta LVEF (low delta LVEF group: delta LVEF < 0%, n = 30; high delta LVEF group: delta LVEF > or = 0%, n = 66). RESULTS: There were significantly more patients with diabetes mellitus (53% vs 18%, p = 0.0009), older age (73 +/- 11 vs 67 +/- 12 years, p = 0.003) and complete occlusion of the culprit artery (13% vs 35%, p = 0.03) in the low delta LVEF group than in the high delta LVEF group. Left ventricular end-diastolic volume index (LVEDVI: 75 +/- 14 vs 62 +/- 15 ml/m2, p = 0.002) in the chronic stage and delta LVEDVI(5 +/- 8 vs -3 +/- 14 ml/m2, p = 0.04) were significantly worse in the low delta LVEF group than in the high delta LVEF group. Multivariate analysis identified diabetes mellitus as the only independent predictor of reduction of LVEF (odds ratio 4.44, 95% confidence interval 1.27-15.52, p = 0.02). CONCLUSIONS: Some patients with acute anterior myocardial infarction treated by direct percutaneous coronary intervention had reduction of the LVEF. There was a close relationship between reduction of the LVEF and left ventricular remodeling. Diabetes mellitus was the most useful predictor of reduction of the LVEF.

Aged↗
PubMed2004

Effect of physical exercise training on health-related quality of life and exercise tolerance in patients with left ventricular dysfunction.

OBJECTIVES: The improvement of exercise tolerance and quality of life (QOL) are essential in the treatment of patients with heart failure. The influence of physical exercise training on QOL was investigated in patients with left ventricular dysfunction. METHODS: Health-related QOL was evaluated using the Medical Outcomes Study Short-Form 36 Health Status Survey (SF-36) before and 3 months after individualized exercise training determined by cardiopulmonary exercise testing in 65 patients. The 44 patients who could carry out more than two-thirds of the prescribed exercise were classified into two groups: Group A (11 patients)with left ventricular ejection fraction < 40% and Group B (33 patients) with left ventricular ejection fraction > or = 40%. The remaining 21 patients served as the control group. RESULTS: The mean value of SF-36 improved significantly with exercise training only in Group A (50.8 +/- 25.3 to 62.1 +/- 22.2, p < 0.05). Group A also had an increase in peak Vo2 (18.9 +/- 3.5 to 21.4 +/- 3.6 ml/min/kg, p < 0.005) and a decrease in brain natriuretic peptide. The 24 patients (9 in Group A, 15 in Group B) with improved SF-36 values after the exercise training showed a negative correlation between the change of the mental component summary and the peak Vo2 (r = - 0.606, p < 0.05). CONCLUSIONS: Exercise training improves both the QOL, especially the mental component, and the exercise tolerance in patients with left ventricular dysfunction.

Adult↗
PubMed2003

The effects of aging on atrial endocardial electrograms in patients with paroxysmal atrial fibrillation.

BACKGROUND: The prevalence of atrial fibrillation (AF) has been reported to increase with advancing age. Histologic studies in AF have demonstrated that the percentage of fibrosis and degenerative changes in the atrial muscle increase significantly with age. HYPOTHESIS: This study was undertaken to assess the influence of advancing age on atrial endocardial electrograms recorded during sinus rhythm in patients with paroxysmal atrial fibrillation (PAF), which had not been assessed previously. METHODS: Right atrial endocardial catheter mapping during sinus rhythm was performed in 111 patients with PAF to evaluate the influence of advancing age on atrial endocardial electrograms. The bipolar electrograms were recorded at 12 sites in the right atrium, and an abnormal atrial electrogram was defined as lasting > or = 100 ms, and/or showing eight or more fragmented deflections. RESULTS: In all, 1,332 right atrial endocardial electrograms were assessed and measured quantitatively. The number of abnormal atrial electrograms in patients with PAF showed a significantly positive correlation with age (r = 0.34; p < 0.0005). Patients aged > 60 years had a significantly greater mean number of abnormal electrograms (2.58 +/- 2.05) than those aged < 60 years (1.43 +/- 2.03; p < 0.004). The longest duration (r = 0.35; p < 0.0005) and the maximal number of fragmented deflections (r = 0.29; p < 0.005) of atrial electrograms among the 12 right atrial sites also showed a significantly positive correlation with age. CONCLUSIONS: Aging alters the electrophysiologic properties of the atrial muscle in patients with PAF. Elderly patients have a significantly greater abnormality of atrial endocardial electrograms than do younger ones. There is a progressive increment in the extension of altered atrial muscle with advancing age in patients with PAF.

Adult↗
PubMed2003

Histological study on the distribution of autonomic nerves in the human heart.

To investigate the distribution of autonomic nerves in the human heart, six autopsied hearts without cardiovascular disease were studied by a histochemical method for acetylcholinesterase (AChE) and by an immunohistochemical method for tyrosine hydroxylase (TH). The density of nerve distribution was microscopically calculated by the point-counting method to evaluate regional distribution of the autonomic nerves. There were more AChE-positive nerves and TH-positive nerves in the atrium than in the ventricle, and more at the base than at the apex in the ventricle. There were more AChE-positive nerves in the subendocardial area than in the subepicardial area of the myocardium. In the atrium, AChE-positive nerves were more numerous than TH-positive nerves. On the other hand, there were more TH-positive nerves than AChE-positive nerves in the ventricle. Predominancy of the distribution density at the anterior to the posterior wall of the ventricle was observed for TH-positive nerves. The different distribution patterns of sympathetic and parasympathetic nerves could modify cardiac performance under both physiologic and pathologic conditions.

Acetylcholinesterase↗
PubMed2003

A rare case of aortic tube graft occlusion 35 years after coarctectomy.

A 52-year-old male with a history of repair of aortic coarctation by prosthetic tube graft replacement 35-years ago developed anterior spinal artery syndrome caused by acute functional occlusion of the aorta at the repair site where pseudoaneurysm formation was observed. The patient was rescued by an emergency axillofemoral bypass, and residual hypertension in upper limbs was improved by elective ascending aorta-descending aorta bypass grafting.

Aneurysm, False↗
PubMed2003

Administration of nifedipine CR immediately after awakening prevents a morning surge in hypertensive patients. Case report of three cases.

Although the blood pressure-lowering action of some long-acting calcium antagonists may last more than 24 h, some patients taking this drug still experience a morning surge, i.e. an early morning increase in blood pressure. We evaluated this morning surge in three hypertensive patients with morning surge after administration of antihypertensive drugs including nifedipine CR. Nifedipine CR is one of the once-a-day formulations of nifedipine, which after administration, results in two peaks in the plasma concentration of nifedipine. The first concentration peak of occurs 3 h after administration and the second around 12 h after intake. When the time of intake of nifedipine CR was changed from after breakfast to immediately after awakening, the morning surge was suppressed in these patients without the use of other drugs such as alpha- or beta-blockers. Administration of nifedipine CR immediately after awakening is one option that can be used to prevent morning surge as well as to control blood pressure throughout the day.

Adult↗
PubMed2003

Effects of radiation on fatty liver and metabolic coronary risk factors among atomic bomb survivors in Nagasaki.

In order to clarify the basic mechanism(s) linking radiation exposure and coronary heart disease (CHD), we here collected ultrasonographic data on fatty liver and measured levels of metabolic CHD risk factors from November 1990 through October 1992 in 1,517 Nagasaki atomic bomb survivors (575 men and 942 women). Using a cross-sectional study design, we examined the effects of radiation dose on fatty liver and CHD risk factors by means of a multiple logistic regression model. Fatty liver was related to the metabolic CHD risk factors associated with insulin resistance syndrome: obesity, hypertension, hypercholesterolemia, low high density lipoprotein (HDL)-cholesterol, hypertriglyceridemia, and abnormal glucose metabolism. Radiation dose was positively related to fatty liver, low HDL-cholesterol, and hypertriglyceridemia, whereas it had no effects on obesity, hypertension, hypercholesterolemia, or abnormal glucose metabolism. The present results suggested that radiation dose was related to 1) fatty liver, which clustered the metabolic CHD risk factors associated with insulin resistance syndrome and 2) atherogenic lipid profiles. It is suggested that these associations are involved in the basic mechanism(s) linking radiation exposure and CHD.

Aged↗
PubMed2003

An unusual case of bilateral coronary artery aneurysms and aortic aneurysms complicated by stenotic lesions.

A 71-year-old Japanese woman presented with a chief complaint of throbbing sensations in the abdomen. When she was 16 years old, she was exposed to atomic radiation since she was 1.2 km away from the drop zone of the Nagasaki atomic bomb. Abdominal CT performed at the age of 61 revealed the presence of localized calcification below the renal artery, together with abdominal aortic aneurysms measuring 4.9 cm in maximum diameter. Since the abdominal aortic aneurysms enlarged in May 2000, the patient was admitted to our department for further examinations and treatment on July 7. Although the patient did not complain of thoracic symptoms, cardiac catheterization revealed the presence of multiple coronary artery aneurysms and severe stenosis in the main trunk of the left coronary artery and proximal regions of the right coronary artery, together with a complicated collateral circulation course. Coronary artery aneurysms were localized similar to the abdominal aortic aneurysms, and were complicated by severe calcification and obstructive lesions. Coronary arterial bypass grafting was performed after the severity of the coronary artery aneurysms was morphologically evaluated. The course of the abdominal aortic aneurysms was followed without surgical treatment. Although the etiology of the aneurysm formation in this patient was investigated, it remained unclear.

Aged↗
PubMed2003

Coexistence of familial hypertrophic cardiomyopathy and vasospastic angina pectoris in two brothers.

Two brothers had familial hypertrophic cardiomyopathy and vasospastic angina pectoris concurrently. Their family history showed that one of their sisters had hypertrophic cardiomyopathy and another brother died suddenly at age 52. The clinical diagnosis of hypertrophic cardiomyopathy was confirmed by an echocardiogram and left ventriculography. They had typical chest pain at rest, and a significant vasospasm of coronary arteries with chest pain and obvious ST-T changes in the electrocardiograms was provoked by intracoronary injection of acetylcholine in both patients. The administration of a calcium antagonist and nitrate was effective for ameliorating chest pain with no cardiovascular events during the follow up period of more than 3 years. Although underlying pathophysiologic abnormalities of familial hypertrophic cardiomyopathy and vasospastic angina pectoris are considered to be transmitted genetically, the genetic backgrounds of these cases remain to be clarified.

Aged↗
PubMed2003

The hemodynamic benefit of biventricular pacing therapy on mitral regurgitation as demonstrated in a patient with ischemic cardiomyopathy and intermittent left bundle branch block.

We report a 75-year-old man with ischemic cardiomyopathy who had mitral regurgitation which was increased markedly by intermittent left bundle branch block (LBBB). He complained of angina-like chest pain that was preceded by episodes of LBBB. During LBBB, a marked elevation of the V wave in the pulmonary capillary wedge pressure was shown, and an increase in mitral and tricuspid regurgitation was observed with color Doppler echocardiography. Biventricular pacing (BVP) therapy was selected so as to protect the patient from episodes of LBBB. After BVP, the patient did not experience chest pain or dyspnea. This case sheds valuable light on the ongoing investigation of the hemodynamic benefit of BVP.

Aged↗
PubMed2003

Hypercalcemia due to vitamin D intoxication with clinical features mimicking acute myocardial infarction.

We report a case of hypercalcemia in an elderly patient due to vitamin D intoxication with clinical features and electrocardiogram (ECG) findings mimicking acute myocardial infarction. A 78-year-old man was referred to our department with symptoms of general fatigue, anorexia and chest pain. The ECG demonstrated ST elevation in leads V1 to V3 and diffuse T wave flattening, resulting in myocardial infarction being suspected. However, his symptoms, including chest pain, gradually improved and the ECG returned to normal in accordance with a fall in his serum calcium level. We introduce the use of QaTc interval shortening in differentiating ST-T changes of hypercalcemia from those of true myocardial ischemia.

Aged↗
PubMed2003

Segmental mediolytic arteriopathy involving celiac to splenic and left renal arteries.

A 46-year-old man presented with a huge splenic artery dissecting aneurysm that had been incidentally found and was successfully resected before rupture. The histopathologic findings were compatible with segmental mediolytic arteriopathy (SMA). Simultaneous involvement of the left renal and right common iliac artery was observed. The patient was also found to have an adrenocortical adenoma, gastrointestinal stromal tumor, hepatocellular carcinoma and schizophrenia. The relationship between SMA and other accompanying diseases was discussed.

Adrenal Cortex Neoplasms↗
PubMed2003

Arteriovenous fistula of internal thoracic vessels.

Arteriovenous fistula of internal thoracic vessels is rare. We report a case of a 77-year-old woman with a fistula between the left internal thoracic artery and vein after a mediastinal needle biopsy through the anterior chest wall. The incidence of internal thoracic arteriovenous fistulas seems to be increasing because the number of cardiac and thoracic surgical procedures is increasing. It is important to consider an internal thoracic arteriovenous fistula as part of the differential diagnosis in patients with continuous murmur in the parasternal area.

Aged↗
PubMed2003

[Comparison of clinical characteristics between elderly and young patients with bradycardia less than 80,000 beats per 24 hours].

Few researchers have conducted 24-hour total heart beat (THB) studies in patients with bradycardia, and its prevalence and significance in the elderly remain controversial. The aim of this study was to compare of distribution of THB, underlying diseases and effects of medication on THB in inpatients with bradycardia less than 80,000 beats/24 hrs between elderly and young patients. There were 303 Holter monitorings of bradycardia out of 7,687 consecutive monitorings, with only the earliest monitoring registered when duplicating. The age distribution of these 303 patients with bradycardia showed a two-peak pattern: a large peak at age 65-70 and a small peak at age 15-20. Thus we divided them into a young group aged under 65 (194 patients: mean 49.1) and an elderly group aged 65 or more (109 patients: mean 71.0). There was no difference in mean THB or distribution of THB between the two age groups, irrespective of medication which had a side effect of bradycardia. Underlying diseases included three bradyarrhythmias; such as sinus bradycardia, sick sinus syndrome and II or III degree AV block, long QT syndrome, ischemic heart disease, cardiomyopathy, valvular disease and others. There was no difference in mean THB or distribution of THB between the two age groups in each disease group. Moreover, with respect to bradyarrhythmias, there was a small distribution of THB between 75,000 and 70,000 beats/24 hrs in patients without medication while there was a sparse distribution of THB in patients with medication.

Adolescent↗