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Biomedical subjects

M Karakawa

Publications and source records attributed to M Karakawa.

31 records · Page 2Linked to original sources
PubMed1993

Left ventricular function during exercise after aortic valve replacement.

To evaluate the difference in left ventricular function during exercise after successful aortic valve replacement, left ventricular function was investigated using radionuclide angiography in 12 patients with normal resting left ventricular systolic function. Patients were divided into two groups: Group 1 was comprised of 5 patients after aortic valve replacement for aortic stenosis and group 2 was comprised of 7 patients for aortic insufficiency. Left ventricular ejection fraction increased significantly during exercise in both groups. The increase in systolic arterial pressure to left ventricular end-systolic volume was significantly larger in group 1 than group 2, whereas the increase in left ventricular end-diastolic volume was significantly larger in group 2 than group 1. Thus, increase in left ventricular contractility played an important role in regulating increased left ventricular ejection fraction during exercise in patients with aortic prostheses for aortic stenosis, whereas increase in left ventricular end-diastolic volume played an important role in patients with aortic prostheses for aortic insufficiency.

Adult↗
PubMed1993

Effect of body characteristics on the variables of signal-averaged electrocardiogram in healthy teenage subjects.

Ventricular late potentials are obtained by signal-averaged surface electrocardiography. Late potentials have been reported to be affected by body characteristics or left ventricular mass. To evaluate late potentials in relation to body characteristics, 52 healthy Japanese young volunteers (21 girls, 31 boys) aged 15-16 years were studied. QRS duration in men was significantly longer than in women. There were no significant differences in low-amplitude signal and root mean square voltage between women and men. When relations between signal-averaged electrocardiographic parameters and body characteristics were examined, QRS duration had positive linear correlations with weight and body mass index. The slope of QRS duration and weight relation, and QRS duration and body mass index relation was significantly steeper in men compared to those in women; a prolongation of QRS duration in men compared to women as weight and body mass index increased. Our results indicated that QRS duration in teenage healthy subjects should be used with caution because it is affected by gender.

Adolescent↗
PubMed1992

[Left ventricular systolic time intervals during paroxysmal supraventricular tachycardia: the difference between A-V nodal re-entry and A-V re-entry].

In this study, the differences in hemodynamic changes during paroxysmal supraventricular tachycardia (PSVT) between A-V nodal re-entry and A-V re-entry were evaluated. In 8 patients with A-V nodal re-entrant tachycardia and 10 with A-V re-entrant tachycardia, electrophysiological studies were performed to measure systolic time intervals (pre-ejection period: PEP, ejection time: ET, PEP/ET ratio: PEP/ET). These measurements were obtained in the control state (atrial pacing at 90/min) and during PSVT with simultaneous recordings of electrocardiogram and femoral arterial pulse tracing. During PSVT, there was no difference in the heart rate between the 2 groups, but ventriculo-atrial conduction time was shorter in A-V nodal re-entry than in A-V re-entry. There was a marked fall in the ET and an increase in PEP/ET in all the patients when PSVT was induced. PEP increased significantly in A-V nodal re-entry, but did not change in A-V re-entry. This resulted in a greater increase in the PEP/ET suggesting a greater deterioration of the hemodynamic consequences in A-V nodal re-entry than in A-V re-ent y. Thus, the hemodynamic changes of PSVT differ between these 2 types of re-entrant circuits, which are mainly influenced by the ventriculo-atrial conduction time.

Adult↗
PubMed1990

[The role and clinical value of thallium-201 myocardial scintigraphy in ischemic heart disease].

To define the role and clinical value of thallium-201 myocardial scintigraphy in ischemic heart disease, 967 consecutive patients referred to our laboratory since 1985 were studied. The purpose of scintigraphy has changed from diagnosing myocardial ischemia to assessing myocardial viability with the progress of coronary angioplasty. At present, thallium-201 myocardial scintigraphy has become an indispensable noninvasive method for the management of patients with ischemic heart disease.

Adolescent↗
PubMed1989

Relationship between the coronary diameter and occurrence of vasospastic angina in patients with normal coronary arteries.

Coronary artery diameters were measured after various interventions in 30 patients without angina pectoris (group 1) and in 15 with angina pectoris (group 2: rest, or rest and effort angina) who had normal coronary arteries. The coronary artery diameters were significantly smaller in many coronary segments in group 2 than in group 1 during a control state, after exercise and ergonovine, but became nearly identical after isosorbide dinitrate in both groups. Patients in group 1 had diffuse narrowing but no focal vasoconstriction after ergonovine and all the segments had a diameter of more than 50% of that after isosorbide dinitrate. The change of coronary artery diameter in group 2 patients who had no vasospasm by ergonovine was the same as that in group 1. Patients in whom vasospastic angina was induced had local vasoconstriction or severe diffuse narrowing (less than 45%). These results indicate that angina pectoris patients with normal coronary arteries had an acceleration of coronary arterial basal tone, but vasospastic angina pectoris was not induced just by the general response of the coronary artery to various interventions in addition to the accentuated basal tone. For vasospastic angina to occur, local abnormal response to various interventions must be present.

Adult↗
PubMed1989

[Quantitative assessment of arterial capacitance in human by noninvasive method].

The purpose of this study was to determine the magnitude of arterial capacitance in human by noninvasive method. In 60 patients (Age: 62.1 +/- 13.4 years) without cardiovascular disease first-pass radionuclide angiography was performed using a digital gamma camera to calculate cardiac output and stroke volume (SV). Systolic interval (ts), diastolic interval (td) and arterial blood pressure were measured using ECG, phonocardiography and sphygmomanometer. We assumed a simple model in which all capacitance (C) lumped into one site with a resistance (R) in parallel to the C. C was calculated by the following basic equations. (Formula; see text) arterial diastolic pressure, E: left ventricular external work. Our results showed: 1) Arterial capacitance ranged from 0.38 ml/mmHg to 2.10 ml/mmHg and more than 60% of stroke volume was pooled in the arterial capacitor during systole. 2) Arterial capacitance fell linearly with age (C = 2.37-0.02 x Age, r = -0.680, p less than 0.001). It is concluded that the capacitor played an important role in arterial circulation.

Adult↗
PubMed1989

[Effect of isometric hand-grip exercise on left ventricular diastolic filling in patients with effort angina: a pulsed Doppler echocardiographic study].

To detect myocardial ischemia and to estimate cardiac reserve in patients with effort angina pectoris without history of myocardial infarction, left ventricular diastolic filling was measured using Doppler echocardiography during isometric handgrip exercise. Nineteen patients with effort angina pectoris undergoing coronary angiography and 16 normal subjects were studied. The angina patients were categorized in two groups: 12 with single vessel disease (SVD) and seven with multiple vessel disease (MVD). Fifty percent maximum voluntary contraction isometric handgrip exercise was performed for two minutes. 1. The resting A/R in the angina group was significantly greater than that of the normal subjects (SVD: 1.20 +/- 0.24, MVD: 1.21 +/- 0.27, normal 0.85 +/- 0.10) (p less than 0.001). However, the values of many cases in these three groups overlapped. 2. In SVD, the A/R increased significantly during isometric handgrip exercise (1.20 +/- 0.24 to 1.96 +/- 0.66: p less than 0.001). The delta A/R (0.76 +/- 0.15) was significantly greater than that of patients in other groups (MVD: 0.10 +/- 0.13, normal: 0.09 +/- 0.01) (p less than 0.001). Consequently, the A/R after exercise clearly distinguished the SVD from the normal subjects. 3. In MVD, the A/R did not change significantly during exercise (1.21 +/- 0.27 to 1.31 +/- 0.41), and there were no significant differences in delta A/R as compared to the normal subjects (p less than 0.01). The A/R decreased during exercise in three of the seven patients, and this was markedly different from that of the normal subjects. These findings suggest that assessment of changes in left ventricular diastolic filling during isometric handgrip exercise is useful in detecting myocardial ischemia and in estimating cardiac reserve in patients with effort angina pectoris.

Adult↗
PubMed1988

[Infarct size related to the distribution and site of coronary artery lesions studied by the unfolded map technique using single photon emission computed tomography].

To assess the relative importance of the anatomical characteristics of the coronary artery distribution and the sites of the arterial stenoses in relation to infarct size, 21 patients with old myocardial infarction and angiographically-proven 90% or greater stenoses (AHA classification) of one of the major coronary arteries were studied. The infarct size was evaluated by a new quantitative method, the unfolded map, derived from single photon emission computed tomography (SPECT). Eleven patients had right coronary artery disease (Group RCA: segment 1; five patients and segment 2; six patients). Seven patients who had the large left anterior descending artery (LAD) which was distributed to the inferior portion of the apical area were defined as Small R, and four patients with large RCA as Large R. Ten patients each had a significant stenosis in the LAD (Group LAD: segment 6; six patients and segment 7; four patients). Four patients with significant stenosis proximal to segment 9 were defined as Pre-9, and seven patients with stenosis distal to the segment, as Post-9. Stress T1-201 scintigraphy with SPECT was performed and the unfolded map was obtained with data of the maximal count circumferential profiles in the redistribution image. Infarction was defined as a defect below 55% of the standard value. The necrotic area ratio expressed as percentage of the defect area to the entire map area was calculated and used as the indicator of infarct size. Although there was no significant difference in the necrotic area ratio between segment 1 and 2 lesions. Large R had the significantly larger necrotic area ratios (24.9 +- 4.6%) than did Small R (9.7 +- 4.4%; p less than 0.01). In the Group LAD, there was no significant difference in the necrotic area ratio between segment 6 and 7 lesions, but Pre-9 had the larger ratio (30.4 +- 3.3%) than did Post-9 (15.4 +- 7.7%; p less than 0.01). These data suggest that the factors related to infarct size are either the distribution of the coronary arteries in the apical area in the Group RCA or the sites of the stenotic lesions relative to the branching portion of the first diagonal branch in the Group LAD.

Adult↗