Biomedical subjects

M Asai

Publications and source records attributed to M Asai.

At least 271 records · Page 15Linked to original sources

PubMed1984

[Left ventricular diastolic filling patterns in hypertrophic cardiomyopathy and myocardial infarction: studies by pulsed doppler echocardiography and multi-gated blood pool scans].

Relationship between various parameters of the left ventricular inflow velocity patterns by pulsed Doppler echocardiography and the early diastolic mean filling rate (V1) by multi-gated blood pool scans was evaluated. The materials consist of 26 patients with hypertrophic cardiomyopathy (HCM), 24 with old myocardial infarction (MI), seven with hypertensive heart disease (HHD), seven with dilated cardiomyopathy (DCM), seven with ischemic heart disease (IHD), and 16 normal subjects (N). The results were as follows: 1. Acceleration time (AT) and deceleration time (DT) were significantly prolonged in HCM (120 +/- 20 msec, 147 +/- 23 msec), MI (102 +/- 17 msec, 124 +/- 21 msec), HHD (105 +/- 11 msec, 141 +/- 17 msec) and IHD (111 +/- 16 msec, 122 +/- 20 msec) compared with those of normals (89 +/- 20 msec, 106 +/- 18 msec). 2. V1 was significantly decreased in HCM (1.14 +/- 0.28 sec-1), MI (0.68 +/- 0.24 sec-1), HHD (0.73 +/- 0.12 sec-1), DCM (0.67 +/- 0.30 sec-1) and IHD (1.03 +/- 0.29 sec-1) compared with that of normals (1.48 +/- 0.28 sec-1). 3. There were significant negative correlations between V1 and AT or DT in HCM, IHD with slightly impaired diastolic filling and normals. However, there were significant positive correlations between V1 and AT or DT in MI and DCM. These findings suggested that left ventricular diastolic filling is impaired in both HCM and MI, and that DT-V1 relationship is useful for differentiating HCM characterized by the "chamber stiffness" from MI characterized by the "myocardial stiffness".

Adolescent↗

PubMed1984

[Phono- and echocardiographic studies of the genesis of mitral valve prolapse in patients with funnel chest].

Two-dimensional echocardiograms (2-DE) and phonocardiograms (PCG) were used to clarify the genesis of mitral valve prolapse (MVP) and mitral regurgitation (MR) in 44 patients with funnel chest. These patients were categorized in three groups on the basis of the fronto-sagittal index (FSI) as determined from chest radiographs; 17 as mild, 15 as moderate and 12 as severe funnel chest. Their ages ranged from 5 to 65 years and averaged 24 years. MVP was diagnosed using the long-axis view of the 2-DE, and MR was diagnosed phonocardiographically including provocative test using angiotensin II. The results were as follows: In 44 patients with funnel chest, 20 (45%) had MVP and 15 (34%) had MR, respectively. The incidence of MVP increased directly in proportion to the severity of index, but the incidence of MR did not. In the short-axis view of the left ventricle at the level of the papillary muscles, there was more marked flattening of the interventricular septum than of the left ventricular posterior wall, resulting in deformity of the left ventricular geometry. A distortion index (DI) was used to quantify the degree of distortion of left ventricular shape, calculated as follows: DI = (R-r)/r, where R and r were radii of the curvatures of the interventricular septum and the left ventricular posterior wall, respectively. The DI in end-diastole (DId) and end-systole (DIs) increased in proportion to the severity of funnel chest. Patients were subdivided into four groups on the basis of DId. Incidence of MVP increased in proportion to the degree of distortion of the left ventricular shape. There was, however, no significant difference in the incidence of MR among the four groups. Patients were subdivided; one group of 13 under 14 years of age; another, 31 over 15 years old. The incidence was much higher in the latter than the former, but the incidence of MVP increased in proportion to the severity of funnel chest in both groups. MR was complicated by MR in nearly all cases in the latter group, but none had MR in the former. The DI of patients, whose FSI improved with surgery, apparently improved in addition to the disappearance and/or improvement of their MVP and MR. However, patients whose FSI did not improve with surgery showed little change in DI and persistence of MVP and/or MR.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1984

Brain CT density in chronic schizophrenia.

Explore the source record for details and available documents.

Brain↗

PubMed1983

Brain content of immunoreactive [Leu5]enkephalin and [Met5]enkephalin after pentylenetetrazol-induced convulsions.

Wistar rats were injected daily with convulsant doses of PTZ (40 mg/kg). The brain content of immunoreactive (IR) enkephalins was measured after repetitive clonic convulsions and after the 'kindling' state was reached. In both instances we found a significant increase of IR [Leu5]enkephalin and IR [Met5]enkephalin in septum, striatum and amygdala 24 h after PTZ administration. These results support the suggestion that the peptide increase occurs with repetitive convulsions and not only after the 'kindling' state is reached.

Animals↗

PubMed1983

Cloning and sequence analysis of cDNA for ovine corticotropin-releasing factor precursor.

Previously, Guillemin and Rosenberg and Saffran and Schally demonstrated the presence of hypothalamic factors that stimulated the secretion of adrenocorticotropic hormone (ACTH) by the pituitary gland. Recently, Vale et al. have isolated and sequenced an ovine hypothalamic peptide of 41 amino acids, which is believed to represent the major physiological corticotropin-releasing factor (CRF) (reviewed in refs 5, 6). Available data suggest that hypothalamic CRF enhances both the synthesis and secretion of ACTH and related peptides such as beta-endorphin and beta-lipotropin (beta-LPH) (reviewed in ref. 6), which are all derived from the common precursor, termed ACTH-beta-LPH precursor or preproopiomelanocortin (reviewed in ref. 7). Because CRF mediates the neural control of the pituitary-adrenocortical system, the characterization of its biosynthetic precursor and the gene encoding it is essential for understanding the molecular mechanism underlying the endocrine response to stress. We have now cloned DNA sequences complementary to the ovine hypothalamic mRNA encoding the CRF precursor (referred to hereafter as prepro-CRF). The nucleotide sequence of the cloned cDNA, reported here, has revealed the primary structure of prepro-CRF. The carboxyl end represents the CRF sequence preceded by the tetrapeptide, Arg-Lys-Arg-Arg, and followed by the dipeptide, Gly-Lys. Comparison of the amino acid sequence of prepro-CRF with those of the ACTH-beta-LPH precursor and the arginine vasopressin-neurophysin II precursor suggests that these precursor proteins may be evolutionarily related.

Amino Acid Sequence↗

PubMed1983

Primary structures of beta- and delta-subunit precursors of Torpedo californica acetylcholine receptor deduced from cDNA sequences.

The nicotinic acetylcholine receptor (AChR) from fish electric organ and mammalian skeletal muscle is the best characterized neurotransmitter receptor (reviewed in refs 1-3). The AChR from the electroplax of the ray Torpedo californica consists of five subunits present in a molar stoichiometry of alpha 2 beta gamma delta (refs 4-6); the apparent molecular weights of the alpha-, beta-, gamma- and delta-subunits are 40,000 (40K), 50K, 60K and 65K, respectively. Knowledge of the primary structures of these constituent polypeptides would facilitate the understanding of the molecular mechanism underlying the function of the neurotransmitter receptor. Recently, we have cloned cDNA for the alpha-subunit precursor of the T. californica AChR and have deduced the primary structure of this polypeptide from the nucleotide sequence of the cloned cDNA. Here we report the cloning and nucleotide analysis of cDNAs for the AChR beta- and delta-subunit precursors. The primary structures of the two polypeptides deduced from the cDNA sequences reveal conspicuous amino acid sequence homology among these and the alpha-subunits. The three subunits contain several highly conserved regions which may be essential for the receptor function or inter-subunit interaction.

Amino Acid Sequence↗

PubMed1983

Synthesis and biological activities of the Z isomers of carbapenem antibiotics.

Naturally occurring carbapenem antibiotics having a double bond in the side chain, when refluxed in chloroform containing quarternary alkylammonium halides, were converted into Z isomers in high yields. The mechanism of this new equilibration involves intramolecular proton transfer from the carboxylic acid to the carbon alpha to the sulfur atom in the side chain as shown by deuterium-labeling experiments. Some Z isomers showed stronger protective effects in mice infected by Escherichia coli O-111 and more potent synergistic activities with cefotiam in mice infected by Proteus vulgaris GN4815 than did the naturally occurring E isomers. The decomposition rates of the Z isomers in mouse kidney homogenates were about 3-fold slower than those of the E isomers.

Animals↗

PubMed1983

Synthesis and biological activities of the Z isomers of carbapenem antibiotics.

Animals↗

PubMed1983

Primary structures of bovine liver low molecular weight kininogen precursors and their two mRNAs.

By using a mixture of synthetic oligodeoxyribonucleotides as a probe, cloned cDNA sequences specific for low molecular weight (LMW) kininogen have been isolated from a cDNA library of bovine liver mRNA sequences. Nucleotide sequence analyses of cloned cDNA inserts have revealed that bovine liver LMW kininogens are encoded by at least two very similar but distinct mRNAs. The corresponding amino acid sequences show that the LMW kininogen precursors of the two types, composed of 436 and 434 amino acid residues, both contain two internally homologous sequences in the amino-terminal portion between a signal peptide and a bradykinin moiety. The two mRNAs exhibit 15 nucleotide substitutions and 6 nucleotide deletions/additions in their protein-coding regions. The replacement of 13 amino acid residues and the deletions/additions of 2 amino acid residues in the two LMW kininogen precursors are all localized within the internally homologous regions, implying that these regions may be biologically significant in relation to the existence of two LMW kininogens. The nucleotide changes in the two mRNAs also occur in the limited portions that principally encode the internally homologous amino acid sequences. This suggests that the mRNAs are transcribed from the same gene to generate two LMW kininogen precursors differing only in the internally homologous sequences.

Amino Acid Sequence↗

PubMed1983

[Pulsed Doppler echocardiographic observation of right and left ventricular inflow velocity patterns in various types of arrhythmia, with special reference to the mechanism of atrioventricular regurgitation].

To investigate the possibility for detection of atrio-ventricular (A-V) regurgitation in arrhythmias non-invasively, we recorded velocity patterns of blood flow at the inflow tract of the right (RVI) and left ventricles (LVI), and at the outflow tract of the left ventricle (LVO) by pulsed Doppler echocardiography in 32 patients with various types of arrhythmia. They were six cases with supraventricular premature contraction (SVPC), 13 with ventricular premature contraction (VPC), two with second degree A-V block, five with complete A-V block and six with artificial right ventricular pacemaker. The following results were obtained. In SVPC, peak velocity of the preceding early diastolic flow of RVI and LVI was related to the coupling interval. A crucial ectopic atrial contraction occurring at the early diastole augmented right or left ventricular filling by summation of the two kinds of ventricular filling. Peak velocity of the early diastolic flow at RVI and LVI was decreased after SVPC compared with that of normal sinus rhythm. A reverse flow was not observed in RVI or LVI velocity pattern in these cases. In VPC, peak velocity of the preceding early diastolic flow at RVI and LVI was related to the coupling interval. An effective early diastolic flow was not observed when coupling interval was short. A systolic A-V reverse flow was detected in six of eight cases of VPC with compensatory pause. In these six cases, M-mode and two-dimensional echograms showed patterns of tricuspid and/or mitral valve prolapse and systolic "bulging" of the left ventricular posterior wall. Peak velocity of the blood flow at LVO was decreased in VPCs with short coupling intervals, but it was increased markedly in the next beat after compensatory pause (post-extrasystolic potentiation). Velocity pattern of a blood flow at RVI and LVI showed two types of reverse flow patterns in all cases with complete A-V block or with artificial right ventricular pacemaker; a) systolic reverse flow in beats with P wave superimposed on QRS complex or ST segment, and b) diastolic reverse flow in beats with markedly prolonged P-R intervals. Diastolic tricuspid regurgitation was demonstrated by contrast echography at the level of the tricuspid valve orifice, and diastolic mitral regurgitation by left cineventriculography. The clinical implication of pulsed Doppler echocardiography to detect A-V regurgitation during systole and diastole was discussed in various types of arrhythmia.

Arrhythmias, Cardiac↗

PubMed1983

[Mode of production of the splitting of the second heart sound in post-extrasystolic beats].

The changes in left and right ventricular systolic time intervals (LV- and RVSTIs) and split interval of the second heart sound (IIA-IIP interval) associated with post-extrasystolic potentiation were studied in 48 patients including 37 without a significant intracardiac shunt or valvular regurgitation or pulmonary hypertension, 7 with aortic stenosis (AS) and 4 with hypertrophic obstructive cardiomyopathy (HOCM). In 19 out of 37 patients mentioned above, LV- and RVSTIs were measured from carotid pulse and pulmonary arterial pulse waves, and IIA-IIP interval of post-extrasystolic beat with a compensatory pause was compared to that of the preceding sinus beat. In the other 29 patients including AS and HOCM, LVSTI, total electromechanical systole of the right ventricle (Q-IIP) and IIA-IIP interval were compared. There was no significant difference in the coupling index [(compensatory pause-coupling interval)/preceding RR interval X 100(%)] among three groups. The following results were obtained: In all patients without HOCM, post-extrasystolic beats showed wider IIA-IIP interval than the control beats independent upon the diseased entity and severity of cardiac function. In pts with HOCM, a IIA-IIP interval was shortened in post-extrasystolic beats. A IIA-IIP interval at post-extrasystolic beats was prolonged in proportion to the augmentation of coupling index. However, this finding was no longer observed in cases with the coupling index of more than 80%. LVSTI: In patients without HOCM, almost no change or prolongation of left ventricular ejection time (LVET) and shortening of left ventricular preejection period (LPEP) were observed in post-extrasystolic beats. The degree of changes in LVET and LPEP was greater in patients with the abnormal left-sided PEP/ET than in patients with the normal PEP/ET. The degree of changes in LPEP was always greater than that in LVET, therefore, total electromechanical systole of the left ventricle (Q-IIA) was shortened in all patients. In HOCM, a marked prolongation of LVET and a shortening of LPEP were observed. The degree of changes in LVET was greater than that in LPEP, therefore, Q-IIA was prolonged in all patients. RVSTI: Prolongation of right ventricular ejection time (RVET) and shortening of right ventricular preejection period (RPEP) were observed in all patients in post-extrasystolic beats. The degree of changes in RVET and RPEP was increased in patients with the increased right-sided PEP/ET. The degree of changes in RVET was greater than or equal to that in LPEP, therefore, Q-IIP showed slight prolongation or no change.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1983

[Studies on the amino acid transport systems in the human placenta--L-alanine and L-leucine uptake by microvillous brush border membrane vesicles].

To characterize the placental amino acid transport systems, L-alanine and L-leucine uptakes were studied using microvillous brush border membrane vesicles prepared from human placenta. The specific activities of alkaline phosphatase and 5'-nucleotidase in the membrane preparation were enriched 9-11 times as high as those in the homogenate. Intravesicular water (IVW) volume determined with 3-O-methyl-D-glucose was 0.59 microliters/mg protein. The saturation kinetics of L-leucine uptake by the vesicles equilibrated with Na+ gave a single set of Km (4.2mM) and Vmax (1.16 mumol/ml IVW/30s). These parameters were clearly different from those for L-alanine uptake reported previously (Asai et al.: Biochem. Int., 4:377, 1982). In the presence of an inward Na+-gradient L-leucine uptake was stimulated about 2 times, but transient accumulation was not observed differing from L-alanine uptake. Discrimination of the neutral amino acid transport systems in the presence of an inward 100mM Na+-gradient revealed that the relative contributions of A, ASC and L systems, and simple diffusion were 55, 20, 15 and 10% for L-alanine, and 45, 0, 15 and 40% for L-leucine, respectively. The results indicate that the neutral amino acid transport systems in the human placental microvillous membranes are clearly different between L-alanine and L-leucine.

Alanine↗

PubMed1983

[Evaluation of left ventricular function in patients with atrial septal defect by exercise echocardiography].

In order to evaluate left ventricular function in atrial septal defect (ASD), 12 cases with ASD, 18 postoperative cases of ASD and 27 normal controls were examined by means of exercise echocardiography using supine bicycle ergometer (50 watts and 3 min). M-mode echocardiograms and left ventricular (LV) short-axis views by two-dimensional echocardiography were subjected to the observation. M-mode echocardiographic studies: ASD group showed an increased stroke dimension (SD) during exercise mainly due to a marked increase of left ventricular end-diastolic dimension ( LVDd ) and a slight decrease of left ventricular end-systolic dimension ( LVDs ). Postoperative ASD group showed an increased SD during exercise mainly due to a marked decrease of LVDs and a slight decrease of LVDd . On the other hand, in normal control group exercise increased SD only by a significant decrease of LVDs . Right ventricular dimension was decreased during exercise in ASD group, but did not change significantly in postoperative ASD and normal control groups. During exercise in ASD group, peak velocity of circumferential fiber shortening (VCF) was increased most markedly, and negative peak VCF was decreased most strikingly. Eight of 12 patients with ASD who showed abnormal interventricular septal motion demonstrated remarkable improvement of the motion during exercise. Two-dimensional echocardiographic studies: Left ventricular short-axis views demonstrated that the shape of the left ventricular cavity changed from flattened to more circular configuration during exercise at end- and early-diastole in ASD group. The shape of the left ventricular cavity at late-systole did not change significantly during exercise in this group. In postoperative ASD group, the left ventricular short-axis view demonstrated circular configuration of the left ventricle at end-diastole both in rest and during exercise. The shape of the left ventricular cavity did not change by exercise. It was concluded that in ASD group cardiac output is increased during exercise by decreasing a left to right shunt at the atrial level and increasing left ventricular filling rate. Therefore, the left ventricular function was found to be good in ASD.

Adolescent↗

PubMed1983

[Phase analysis of mitral regurgitation in mitral valve prolapse: comparison of pulsed Doppler echocardiography with phonocardiography].

The clinical implication of the timing of mitral regurgitation (MR) in mitral valve prolapse (MVP) was investigated by comparison of the phonocardiographic patterns of the regurgitant murmur with either prolapsing phase of the mitral valve determined by two-dimensional echocardiography (TDE) or regurgitant flow patterns by pulsed Doppler echocardiography (PDE). A total of 23 patients (pts) with MVP was classified into five subsets on the basis of the phonocardiographic findings: six pts with a pansystolic murmur, seven with a late systolic murmur, two with an early systolic murmur, three with only a click(s) and five with a angiotensin II-induced regurgitant murmur (provocative MR). A comparative study between the regurgitant murmur and regurgitant flow patterns was also made in 10 pts with MR due to other etiology (four pts of rheumatic MR, three of ruptured chordae tendineae and three of papillary muscle dysfunction). MR was detected at or just above the mitral orifice using a combined system of the PDE and TDE from a transcutaneous approach. The results obtained were as follows: Phase of MR detected by PDE coincided well in timing with a regurgitant murmur recorded on the phonocardiogram (PCG) except one patient. In four of five pts with provocative MR, abnormal Doppler signals indicating MR were detected even at rest and these coincided temporally with a newly developed regurgitant murmur by provocation. Phase of MR detected by PDE was not synchronous with prolapse of the mitral leaflets examined by TDE in five out of 23 pts, suggesting that MR does not necessarily occur in accordance with mitral prolapse. Regurgitant flow patterns examined by PDE in 30 pts including 10 pts of MR due to other etiology were either a widely dispersed dot pattern or a narrow banded reverse flow pattern. Pts with a loud systolic regurgitant murmur (Levine 3/6 or greater) tended to show a widely dispersed dot pattern, and pts with a soft systolic regurgitant murmur (less than Levine 2/6) showed a narrow banded reverse flow pattern. In conclusion, PDE seems to be more sensitive than PCG for the detection of MR in MVP, and PDE may serve to the qualitative as well as quantitative evaluation of MR in MVP.

Adolescent↗

PubMed1983

[Studies on the mechanisms of the third and fourth heart sounds: with special reference to the phase analysis of mitral flow velocity pattern].

To investigate the genesis of the third ( IIIs ) and fourth heart sounds (IVs), apical phonocardiograms were recorded simultaneously with pulsed Doppler signals of the mitral flow and interventricular septal (IVS) and left ventricular posterior wall (PW) echoes by M-mode echocardiography in 26 cases with the IIIs and 11 cases with the IVs. The following results were obtained: Cases with the IIIs were classified into the following three groups according to the time relationship between the IIIs and a rapid filling wave (D wave) of the mitral flow velocity pattern. IIIs -peak group: The IIIs occurred coincidently with the peak of the D wave in five healthy adolescents and in 12 cases with absolute left ventricular volume overload including mitral regurgitation (MR: eight cases), postoperative atrial septal defect (ASD: three cases) and ventricular septal defect (one case). IIIs -delay group: The IIIs occurred about 38 msec after the peak of the D wave in eight cases with relative left ventricular volume overload including congestive cardiomyopathy (CCM: three cases) and ischemic heart disease (IHD: five cases). IIIs -early phase group: The IIIs occurred about 35 msec before the peak of the D wave in a case with acute MR due to chordal rupture. In the IIIs -peak group, the IIIs coincided in time with the points of inflection (check points) of both the IVS and PW during rapid filling phase in three cases with MR of mild to moderate degree and one case of postoperative ASD. In the IIIs -delay group, the IIIs occurred simultaneously with either the check point of the IVS or PW in two cases with CCM and one case with IHD, and it occurred before the check points of both the IVS and PW in two cases with severe MR of IIIs -peak group and in a case with acute MR due to chordal rupture of IIIs -early phase group. Cases with the IVs were classified into following 2 groups according to the time relationship between the IVs and the atrial contraction wave (A wave) of the mitral flow velocity pattern. IVs-peak group: The IVs occurred coincidentally with the peak of the A wave in six cases with left ventricular hypertrophy including hypertrophic cardiomyopathy (five cases) and hypertension (one case). IVs-delay group: The IVs occurred about 33 msec after the peak of the A wave in five cases with left ventricular dilatation or dysfunction including old myocardial infarction (two cases), CCM (one case), postoperative ASD (one case) and aortic regurgitation (one case). There were two types of IVs in time relationship between the IVs and the check points of the left ventricular wall during atrial contraction phase.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1983

[Mode of splitting of the second heart sound in patients with hypertrophic cardiomyopathy].

Mode of the splitting of the second heart sound ( IIs ) and left ventricular systolic time intervals (STIs) in patients (pts) with hypertrophic cardiomyopathy were compared with those in hypertension (HT) with the global hypertrophy of the left ventricular wall. Forty-seven pts with hypertrophic cardiomyopathy [non-obstructive type (HCM, 30 pts), obstructive type (HOCM, 17 pts)] and 21 pts with HT were studied. The pts with HCM were classified as septal hypertrophic type (19 pts) and apical hypertrophic type (11 pts) on the basis of the echocardiographic findings. The pts with HOCM were classified as resting type (13 pts) and latent type (provoked by amyl nitrite: 4 pts) on the basis of the obstructive sign at rest. Mode of the splitting of the IIs : a) The pts with HCM showed a wide splitting of the IIs . The mean split interval during held expiration (IIA-IIP) was 41.0 +/- 9.9 msec. Twenty pts (67%) showed abnormal respiratory splitting. The mean IIA-IIP interval in septal hypertrophic type (45.3 +/- 9.0 msec) was significantly wider than that in apical hypertrophic type (33.6 +/- 6.7 msec) (p less than 0.05). There was a positive correlation between IIA-IIP interval and the thickness of the upper portion of the interventricular septum (r = 0.63). b) Nine out of 13 pts with resting type of HOCM showed a paradoxical (reversed) splitting with a mean IIA-IIP interval of -23.8 +/- 24.4 msec. On the other hand, pts with latent type showed a wide splitting similar to HCM with a mean IIA-IIP interval of 35.0 +/- 7.1 msec. c) The pts with HT showed a single IIs or physiological splitting. The mean IIA-IIP interval was 14.5 +/- 9.3 msec, which was significantly decreased than that of normals or the pts with HCM (p less than 0.01). Left ventricular systolic time intervals: a) The pts with an either type of HCM showed a short corrected left ventricular electromechanical systole [(Q-IIA)c] due to the shortening of the corrected left ventricular ejection time (LVETc). b) The pts with resting type of HOCM showed a long (Q-IIA)c due to the prolongation of LVETc, but latent type showed the same change as in HCM. c) The pts with HT showed a tendency of prolongation of (Q-IIA)c due to slightly short LVETc and long corrected pre-ejection period (PEPc). Fractional shortening of the left ventricle (%FS) and mean velocity of circumferential fiber shortening (mean VCF) calculated from echocardiograms were significantly greater in both types of HCM than those in normals and HT (p less than 0.05). Left ventricular end-diastolic dimension was significantly decreased in the pts with septal hypertrophic type of HCM than in others.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1983

[Exercise echocardiography in different types of hypertension classified by left ventricular geometry; comparison with hypertrophic cardiomyopathy].

We investigated left ventricular (LV) function in 40 patients (pts) with hypertension (HT), 16 pts with hypertrophic cardiomyopathy (HCM), 3 pts with ASH and HT and in 27 control subjects by M-mode echocardiography using supine exercise (50 watts, 3 minutes). The hypertensive subjects were echocardiographically divided into three subsets; the normal LV (17 cases), the hypertrophied LV (17 cases) and the dilated LV (6 cases). Similarly, pts with HCM were echocardiographically and cineangiographically divided into three subsets; ASH (asymmetric septal hypertrophy, 6 cases), APH (predominant apical hypertrophy, 6 cases) and DFH (diffuse left ventricular hypertrophy, 4 cases). Changes of left ventricular dimension Controls and HT: Stroke volume was increased during exercise in the controls, normal LV and hypertrophied LV groups by decreasing LV end-systolic dimension ( LVDs ), but it was increased in dilated LV group by increasing LV end-diastolic dimension ( LVDd ) (Frank-Starling mechanism). LVDd was increased transiently in the controls and normal LV group during recovery, but its grade and duration were more pronounced in the latter. LVDd did not change significantly in hypertrophied and the dilated LV groups. HCM: LVDd and LVDs did not change significantly during exercise in all 3 groups. LVDd was increased transiently during recovery in ASH group, but not in the other groups. Changes of peak velocity of circumferential fiber shortening (VCF) and the ratio of peak systolic blood pressure to LV end-systolic volume (PSP/ LVVs ). Controls and HT: Peak VCF was increased during exercise most markedly in the normal LV group, but it was not increased in the dilated LV group. PSP/ LVVs was increased significantly during exercise in the controls, the normal and hypertrophied LV groups, but not in the dilated LV group. HCM: Peak VCF showed a significant increase during exercise in ASH group, but not in the other two groups. Changes of the D/S ratio. The ratio of systolic to diastolic velocity of the LV posterior wall was expressed as a D/S. This ratio did not change significantly in the controls, HT and APH groups, but it was decreased significantly in ASH and DFH groups. LV end-systolic wall stress and LVDs relationship ( ESWst - LVDs ).(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

PubMed1983

[Pulsed Doppler echocardiographic assessment of diastolic left ventricular hemodynamics in hypertrophic cardiomyopathy: relationship between the mode of left ventricular filling and the distribution of left ventricular hypertrophy].

In order to clarify left ventricular relaxation and filling in different types of hypertrophic cardiomyopathy (HCM), velocity patterns of blood flow at the inflow tract of the left ventricle (LV) were recorded by pulsed Doppler echocardiography and compared with those of normal subjects (26 cases). Forty-one patients with HCM were classified into the following 4 groups according to the distribution of LV hypertrophy and the evidence of cavity obstruction of the LV; with asymmetric septal hypertrophy (ASH: 15 patients), apical hypertrophy (APH: 10), diffuse hypertrophy ( DIH : five) and obstruction of the LV cavity (HOCM: 11). The HOCM group consisted of five cases of ASH type and six of APH or DIH type. Acceleration time (AT), deceleration time (DT) and the A/D ratio were measured on the pulsed Doppler echocardiogram. The M-mode echogram of the LV was recorded and subsequently digitized to obtain peak LV filling rate. The results were as follows: AT was significantly prolonged in 4 groups of HCM compared with that of the normal subjects. But there was no significant difference in AT among various HCM groups. DT was markedly prolonged in 4 groups of HCM compared with that of the normal subjects, but DT was significantly shortened in the ASH group compared with that of the APH or HOCM group. DT of the HOCM group was divided into the following 2 types according to the duration; normal or slightly prolonged DT (three cases) and markedly prolonged DT (eight). The former group belonged to the ASH type of LV hypertrophy in all cases, and two of them showed a third heart sound. An apical diastolic murmur was recorded in four patients of the ASH group, and six of the HOCM (five cases with ASH type and one with APH type). The A/D ratio was significantly increased in 4 groups of HCM compared with that of the normal subjects. But there was no significant difference among HCM groups. Diastolic descent rate (DDR) of the mitral valve echogram was significantly reduced in 4 groups of HCM compared with that of the normal subjects, particularly in the ASH and HOCM groups. DDR was roughly correlated with DT in the HCM group (r = -0.40, p less than 0.02). Peak LV filling rate was markedly decreased in the ASH, APH and HOCM groups compared with that of the normal subjects. There was a significant negative correlation between peak LV filling rate and DT (r = -0.49, p less than 0.01). In conclusion, the mode of LV filling in HCM showed various patterns according to the location of ventricular hypertrophy and the presence of cavity obstruction of the LV.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗