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Biomedical subjects

M Tanimoto

Publications and source records attributed to M Tanimoto.

248 records · Page 14Linked to original sources
PubMed1979

Echocardiographic features of Uhl's anomaly. A case report.

M-mode echocardiography on a fifty-eight year old female with Uhl's anomaly showed several characteristic findings, which were considered to be useful in differentiating Uhl's anomaly from Ebstein's. Those findings were normal tricuspid diastolic closing velocity, the relatively early tricuspid valve opening, easy visualization of the tricuspid valve in usual position and the unusual mid-diastolic pulmonic valve full opening. The premature opening of the pulmonic valve correlated with the right atrial and ventricular mid-diastolic pressure exceeding that of the pulmonary artery.

Diagnosis, Differential↗
PubMedDate not supplied

Congenital giant aneurysm of the left innominate vein: is surgical treatment required?

Congenital aneurysms of the thoracic venous system are rare. In particular, innominate venous aneurysms are extremely rare. We describe a 16-year-old girl whose chest x-ray suggested a mediastinal tumor. Three-dimensional contrast-enhancement magnetic resonance venography showed a giant sacciform aneurysm of the left innominate vein and dilatation of the right innominate vein. The patient was asymptomatic, and there were no significant physical findings. Therefore, the patient is being followed without surgical treatment.

Adolescent↗
PubMedDate not supplied

Normal changes in left ventricular filling and hemodynamics during dobutamine stress echocardiography.

During high-dose dobutamine infusion, there is a dose-dependent increase in cardiac output, a reduction in systemic vascular resistance, a reduction in left ventricular size, an increase in the mitral A wave velocity, a reduction in the E/A velocity ratio, and a reduction in the isovolumic relaxation time, with little change in the rate-corrected isovolumic relaxation time. Left ventricular cavity obliteration is common. This information may be useful in defining the mechanism of hypotension commonly seen during dobutamine stress echocardiography. It is speculated that the diastolic behavior of the left ventricle during dobutamine stress echocardiography, especially the isovolumic relaxation time, may provide an additional indicator of early myocardial ischemia, but this needs to be confirmed by larger independent studies.

Adrenergic beta-Agonists↗
PubMedDate not supplied

Transesophageal echocardiographic evaluation of mitral regurgitation in hypertrophic cardiomyopathy: contributions of eccentric left ventricular hypertrophy and related abnormalities of the mitral complex.

This study was designed to evaluate the contribution of eccentric left ventricular hypertrophy and its related organic and spatial abnormalities of the mitral complex to the occurrence of mitral regurgitation in patients with hypertrophic cardiomyopathy We selected 45 consecutive patients with systolic mitral regurgitation by color Doppler echocardiography and performed transesophageal echocardiography in all patients. Eighteen patients were in the obstructive group and 27 patients were in the nonobstructive group of hypertrophic cardiomyopathy with asymmetric septal hypertrophy. Twenty subjects without any cardiac disorders served as the control group. The maximum area of mitral regurgitation was significantly greater in the obstructive group than in the nonobstructive group. Mitral regurgitation appeared more frequently during pansystole in the two groups with hypertrophic cardiomyopathy, particularly in the obstructive group. Mitral valve prolapse was observed in 20 (44%) of the 45 patients with hypertrophic cardiomyopathy. Distances between the posterior papillary muscle and anterior or posterior mitral anulus were significantly smaller in the two groups with hypertrophic cardiomyopathy than in the normal control group. In the obstructive group, the length of the anterior mitral leaflet and the thickness of the rough zone of the anterior mitral leaflet at mid-diastole were significantly greater than in the other groups. Systolic anterior motion was observed in all patients with obstructive cardiomyopathy and contact between the interventricular septum and the anterior mitral leaflet during early diastole was observed in 17 of the 18 patients in the obstructive group.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiomyopathy, Hypertrophic↗
PubMedDate not supplied

Assessment of right-to-left shunt flow in atrial septal defect by transesophageal color and pulsed Doppler echocardiography.

To investigate the clinical significance and problems of right-to-left (R-L) shunt flow dynamics in atrial septal defects, we performed transesophageal color and pulsed Doppler echocardiography in 30 patients with atrial septal defects of the ostium secundum type. The 30 patients consisted of 20 with a pulmonary artery systolic pressure of less than 40 mm Hg, four with a pressure of 40 to 60 mm Hg, three with a pressure of 90 mm Hg or more, two patients with pulmonic stenosis, and one patient with Ebstein's anomaly. R-L shunting was determined by the presence of a shunt flow signal across the defect during each cardiac cycle. The time of R-L shunt flow was compared with the various parameters obtained by echocardiography and cardiac catheterization. R-L shunt flow signals were detected at the following times: (1) at the onset of ventricular contraction or the closing phase of the tricuspid valve in five patients with isolated atrial septal defect. These patients showed an increase of mean right atrial pressure but had no severe pulmonary hypertension; (2) during ventricular systole in five of 26 patients with tricuspid regurgitation and one patient with Ebstein's anomaly. The tricuspid regurgitant signal was directed toward the ostium of the defect in three patients and was massive in the other patients; (3) during middiastole in three patients without pulmonary hypertension. These patients showed massive left-to-right shunt flow from end systole to early diastole; and (4) during atrial systole in three patients with severe pulmonary hypertension and two patients with pulmonic stenosis. The former, in particular, showed the aliasing signal as a high-speed shunt flow. In two of the three patients with severe pulmonary hypertension, R-L shunting continued from atrial systole to early ventricular systole and was also observed in early diastole. R-L shunt flow was detected in patients with atrial septal defects not only with pulmonary hypertension but also without pulmonary hypertension and was influenced by the right atrial pressure in the phase of tricuspid valve closing, the volume or direction of tricuspid regurgitation, rebound flow caused by massive left-to-right shunt flow, the grade of right ventricular distensibility or the complication of pulmonary hypertension, and complications with other cardiac anomalies. Thus R-L shunt flow in patients with atrial septal defects was detected easily by transesophageal color and pulsed Doppler echocardiography because of the high efficiency of this method for its detection.

Adolescent↗
PubMedDate not supplied

Transesophageal pulsed Doppler echocardiographic study of pulmonary venous flow in mitral stenosis.

For evaluation of pulmonary venous flow (PVF) in mitral stenosis, transthoracic and transesophageal echocardiography were performed in 33 patients with mitral stenosis and 20 normal controls. The peak systolic flow velocity of the PVF was significantly lower in patients with mitral stenosis and atrial fibrillation. The peak diastolic flow velocity of the PVF was significantly lower in the patients with mitral stenosis than in normal controls. The diastolic wave recorded as laminar flow in the mitral stenosis group showed a peak in the rapid filling phase with a gradually descending slope of velocity during mid to late diastole. There was a significant negative correlation between the peak diastolic flow velocity of the PVF and the pressure half time from transmitral flow obtained by continuous wave Doppler in the mitral stenosis group. These results demonstrate that evaluation of the PVF is helpful in understanding hemodynamic events between the left atrium and left ventricle in patients with mitral stenosis.

Adult↗
PubMedDate not supplied

[Decrease in the serum concentration of triiodothyronine in patients with acute edematous pancreatitis].

Serum concentrations of triiodothyronine (T3), Thyroxine (T4) and Thyrotropine (TSH) were measured in ten patients hospitalized in an emergency way due to acute edematose pancreatitis clinically diagnosed and confirmed in the laboratory through the finding of values of amilase higher than 180 I.U. By means of venopunction 5 ml. of blood were taken from each patient in order to determine the thyroidal profile and amilasemia at the moment of internment and after 72 hours of the disease development. Results demonstrated a decrease of the values of T3, 72 hours after the patients entered the hospital, with normal values for T4 and TSH. This decrease reached levels of hypothyroidism with no clinical data of the disease.

Acute Disease↗
PubMedDate not supplied

[Changes in left ventricular inflow and pulmonary venous flow patterns during preload alteration in dilated heart].

Changes in left ventricular inflow (LVIF) and pulmonary venous flow (PVF) patterns during preload alteration were assessed in 30 patients with dilated heart, including 10 patients with dilated cardiomyopathy and 20 with old myocardial infarction. Transesophageal Doppler echocardiography was performed during lower body negative (LBNP, -40 mmHg) and positive pressure (LBPP, +40 mmHg) in all 30 patients and 20 normal controls. Eight of the 30 patients showed the "pseudonormalization (PN)" pattern, and 22 showed the "decreased early diastolic wave (E) and compensatorily increased atrial contraction wave (A) (N-PN)" pattern of LVIF in the control state. The diastolic wave (PVD) of the PVF and E of the LVIF were significantly higher, and the second systolic wave (PVS2) of the PVF and A of the LVIF were lower in the PN group than in the N-PN group. The amplitude of the atrial contraction wave (PVA) of the PVF in both groups of dilated heart patients was larger than in the normal group. The ratio of the amplitude of the atrial contraction wave to the total vertical deflection (A/H) of the apexcardiogram and mean pulmonary capillary wedge pressure (PCWP) in the PN group were greater than those in the N-PN group in the control state. LVIF in six of the 22 N-PN patients changed to the PN pattern during LBPP, and in three of eight PN patients changed to the N-PN pattern during LBNP. The six patients demonstrating the change from the N-PN to PN pattern showed a significant increase in PVD and PVA during LBPP compared with the control state, and a significant increase in PCWP in the control state compared with the 14 patients without a change in LVIF. Peak velocity of E in each group was decreased during LBNP and increased during LBPP, but peak velocity of A did not change during preload alteration. Peak velocity of PVS2 in the normal group was significantly decreased, and those of the PN and N-PN groups were decreased but not significantly during LBNP. The peak velocity of PVD was decreased during LBNP in the PN and N-PN groups, and the decrease was significantly higher in the former than in the latter.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMedDate not supplied

[Detection of right-to-left shunt flow in atrial septal defect using transesophageal color and pulsed Doppler echocardiography].

The clinical significance of right-to-left (R-L) shunt flow dynamics in atrial septal defects (ASD) were investigated using transesophageal color and pulsed Doppler echocardiography in 30 patients with ASD of the ostium secundum type, including 20 with systolic pulmonary artery pressures (sPA) less than 40 mmHg, 4 with sPA of 40 to 60 mmHg, 3 with sPA of 90 mmHg or greater, 2 with pulmonic stenosis and 1 with Ebstein's anomaly. R-L shunting was detected by a shunt flow signal across the defect during a cardiac cycle. The timing of the R-L shunt was compared with various parameters obtained by echocardiography or cardiac catheterization. R-L shunt flow at the onset of ventricular contraction or closing phase of the tricuspid valve was detected in five patients with isolated ASD associated with increased mean right atrial pressure, but no severe pulmonary hypertension. R-L shunt flow during systole was detected in five of 26 patients with isolated ASD and tricuspid regurgitation and in one patient with Ebstein's anomaly. The tricuspid regurgitation signals in three of the five patients were directed toward the defect, while the other two had massive tricuspid regurgitation. R-L shunt flow during mid-diastole was detected in three patients without pulmonary hypertension. Massive left-to-right shunt flows occurred during the phase from end-systole to early diastole. R-L shunt flow during atrial systole was detected in three patients with severe pulmonary hypertension and two with pulmonic stenosis. The severe pulmonary hypertension patients, in particular, showed the aliasing signal as a high speed shunt flow, and in two of these, R-L shunt flow continued from atrial systole to early ventricular systole, and was also observed in early diastole. R-L shunt flow was detected in ASD patients with and without pulmonary hypertension, and was influenced by right atrial pressure at the phase of tricuspid valve closing, volume or direction of tricuspid regurgitation, rebound flow due to massive left-to-right shunt flow, grade of right ventricular distensibility or pulmonary hypertension, and other cardiac complications.

Adolescent↗