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Biomedical subjects

N Kanemoto

Publications and source records attributed to N Kanemoto.

At least 91 records · Page 5Linked to original sources
PubMed1984

A case of primary pulmonary hypertension treated with prazosin and isosorbide dinitrate.

Successful vasodilator therapy of a 27-year-old woman with primary pulmonary hypertension is described. Prazosin 2 mg, orally in combination with isosorbide dinitrate 10 mg, sublingually caused a marked fall in pulmonary vascular resistance. Pulmonary hemodynamics reevaluated after 3 months of combination therapy with prazosin 1 mg qid and isosorbide dinitrate 5 mg qid showed sustained improvement. Therefore, in selected patients with primary pulmonary hypertension, this combination therapy can be used.

Administration, Oral↗
PubMed1984

QRS normalization of bundle branch block by ventricular fusion.

A 61-year-old woman who suffered from acute inferior myocardial infarction with right bundle branch block developed complete atrio-ventricular block. QRS normalization of right bundle branch block as a result of ventricular fusion of the conducted sinus beat with right bundle branch block and idioventricular impulse originating in the ipsilateral side of the block is described.

Bundle-Branch Block↗
PubMed1983

Noninvasive assessment of left ventricular performance following transluminal coronary angioplasty.

We studied 36 patients with successful transluminal coronary angioplasty (group 1) noninvasively using exercise electrocardiography, exercise T1-201 myocardial scintigraphy and equilibrium radionuclide ventriculography before and 3-5 days after the procedure. Six patients who underwent aortocoronary-bypass surgery (group 2) and 10 patients with stable angina pectoris (group 3) served as controls. All patients had arteriographically documented coronary artery disease at least in one major coronary vessel (stenosis greater than or equal to 70%). In group 1, average coronary stenosis was 81.1 +/- 8.4% before dilatation and 44 +/- 13.7% after the procedure (P less than 0.001). Ischemia score in the exercise electrocardiography decreased from 2.4 +/- 2.7 before dilatation to 0.4 +/- 0.8 after the procedure (P less than 0.001). Myocardial perfusion in computerized T1-201 myocardial scintigraphy 5-10 min after exercise expressed as vitality index (the ratio of T1-201 uptake in the ischemic region to the region of maximal uptake in the same image analyzed carefully in the same view in 2 studies) increased from 72.9 +/- 8.4% before dilatation to 79.9 +/- 11.7% after the procedure (P less than 0.001). Ejection fraction at rest increased from 47.2 +/- 9.2% to 51.0 +/- 9.7% (P less than 0.001) and during exercise from 39.9 +/- 10.5% to 49.4 +/- 10.9% (P less than 0.001) before and after the procedure. In group 2, noninvasive studies showed a tendency to improvement after surgery. In group 3 no significant changes were noted. We conclude that transluminal coronary angioplasty improves both coronary perfusion to ischemic areas supplied by critical coronary artery stenoses and left ventricular function, especially during exercise, if luminal diameter is dilated by greater than 20%.

Adult↗
PubMed1983

Detection and quantification of left main coronary artery stenosis by two-dimensional echocardiography.

This study was undertaken to determine the diagnostic feasibility of detecting both qualitatively and quantitatively stenotic wall abnormalities in the left main coronary artery (LMCA) and its bifurcation. Adequate two-dimensional echocardiographic (2DE) images of the LMCA were obtained in 18 of 20 patients with angiographically proven coronary artery disease (CAD). In 15 of 18 patients the LMCA was completely imaged but in different 2DE-planes in most of the cases. Only in 4 of 18 patients could adequate images of the bifurcation, including the central parts of left anterior descending and circumflex branches, be demonstrated. On the contrary, the 2DE detected calcification of the LMCA identified by fluoroscopy in only 2 of 5 patients. As to quantitative analysis, the correlation of luminal diameters in stenotic and non-stenotic coronary artery obtained from 2DE and coronary angiography was satisfactory (r = 0.69, p less than 0.01). These results suggest that 2DE can be useful for the follow-up study of LMCA disease. However, this method is not indicated for the detection of more distal left coronary artery stenosis occurring beyond the bifurcation.

Adult↗
PubMed1983

Quantitative evaluation of exercise T1-201 myocardial scintigraphy before and after transluminal coronary angioplasty. A preliminary report.

Quantitative evaluation of exercise T1-201 myocardial scintigraphy was carried out to determine the effect of transluminal coronary angioplasty (TCA) in 15 patients with critical coronary artery stenoses (greater than or equal to 70%). Thirteen lesions were successfully dilated (reduction in stenosis by more than 30%); two were unsuccessful. Calculated indices from T1-201 myocardial scintigraphy, using a semi-automatic computer image processing system, included washout factor (WF), vitality index (VI) and redistribution factor (RDF). No changes were noted in WF before and after dilatation. The VI increased in successfully dilated patients from 66.3 +/- 8.5% (mean +/- SD) to 77.8 +/- 10.9% (p less than 0.001) in the areas perfused by the vessels containing the lesions. The RDF decreased significantly after dilatation from 4.4 +/- 6.1% to 1.2 +/- 2.8% (p less than 0.05) 1 hour after exercise and from 10.4 +/- 7.5% to 4.1 +/- 4.2% (p less than 0.01) 3-4 hours after exercise. From these results, we conclude that the perfusion of ischemic areas distal to critical coronary artery stenoses improves following successful dilatation. T1-201 myocardial scintigraphy was shown to be very useful in the evaluation of TCA.

Adult↗
PubMed1982

Critical review-current status of T1-201 myocardial scintigraphy in patients with ischemic heart disease.

Thallium-201 myocardial scintigraphy (TMS) is the most important, accurate and noninvasive diagnostic tool for the detection of regional myocardial perfusion. This agent is a potassium analog and the biological half life in normal myocardium is 4 hours. Therefore, serial imaging after a single dose of T1-201 at the peak of the exercise makes differential diagnosis possible between stress induced ischemia (transient perfusion defect with redistribution) and myocardial fibrosis or scar (permanent defect). The reproducibility is around 90%. The overall sensitivity in 4,094 patients reviewed from the literature was 83% with a specificity of 87%. The accuracy of TMS for the diagnosis of ischemic heart disease was 85%. Sensitivity increases in the order of visual (83%), computer analysis of standard scintigraphy (91%), and computer analysis of pinhole tomography (96%), but there is no significant difference in specificity among them. Also, sensitivity increases in the order of single (73%), double (83%) and triple (90%) vessel disease. However, TMS does not indicate the correct number of vessels involved. In this paper, we discuss the current status of use and limitations of TMS in the diagnosis of ischemic heart disease.

Animals↗
PubMed1982

Congenital corrected transposition of the great arteries: case report of three adults.

Three cases in adults of corrected transposition of the great arteries (CTGA) with concomitant fairly rare cardiac anomalies are described; a 54-year-old man with left sided atrio-ventricular valvular (tricuspid) regurgitation, a 31-year-old woman with atrial septal defect and a 21-year-old man with partial dysplasia of pulmonary valve with mild pulmonary stenosis. Clinical findings and diagnostic methods including two-dimensional echocardiography and computed tomography are discussed briefly.

Adult↗
PubMed1981

201Tl-myocardial scintigraphy: current status in coronary artery disease, results of sensitivity/specificity in 3092 patients and clinical recommendations.

This review is concerned with qualitative and quantitative sectorial 201Tl-redistribution analysis of exercise myocardial scintigraphy (EMS). In 3092 cases the sensitivity (specificity) was on average 83 (90) %, the average CAD prevalence being 71%. Sensitivity (Se) for EMS (ExECG) increased from 73 (43) % in single vessel disease through 83 (69) % in double vessel to 90(77) % in triple vessel disease (n = 879); average Se was 77% for LAD-, 79% for RCA- and 65% for LCX-stenosis. Se for detection of the real extension of CAD conversely decreased from 59% in SVD through 41% in DVD down to 33% in TVD. Clinical recommendations for EMS and rest scans are outlined in CAD (atypical angina, follow-up after bypass-surgery, percutaneous transluminal angioplasty), in non-coronary artery disease (non-ischemic cardiomyopathies, right ventricular hypertrophy) and in pediatric cardiology.

Cardiomegaly↗
PubMed1981

Experimental study on monocrotaline induced pulmonary hypertensive rats. (1) Effect of long-term injection of immunosuppressant.

To investigate the involvement of the immune mechanism in the development of pulmonary hypertension in rats given monocrotaline, pulmonary hypertension was induced in rats and the effect of daily injection of prednisolone was studied. Fifty six Sprague-Dawley rats (4 week-old males, 50-60 g) were divided into four groups as follows: (1) injection of monocrotaline alone (A: 17 rats), (2) injection of monocrotaline + long-term injection of prednisolone (B: 22 rats), (3) long-term injection of prednisolone (C: 7 rats) and, (4) long-term injection of physiological saline solution (D: 10 rats). The survival time was prolonged, and slightly better results in the pressure of the right ventricle, hypertrophy of the right ventricle and lesions of lung tissue were obtained in B than in A. However, the rise in the RV pressure the hypertrophy of the right ventricle in B were more pronounced than in C and D, and findings in the lung tissue closely resembled those of A. Judging from the above, it is certain that long-term injections of prednisolone improve the lung tissue lesions and prolong the life of monocrotaline induced pulmonary hypertensive rats. However, it is unlikely that the immune reaction plays a leading role in the development of pulmonary hypertension in the rats.

Animals↗