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Biomedical subjects

N Yoshimoto

Publications and source records attributed to N Yoshimoto.

At least 37 records · Page 2Linked to original sources

Aortic regurgitation: quantitation with MR imaging velocity mapping.

Aortic regurgitation (AR) in five healthy volunteers and 26 patients (mean age, 60.3 years; range, 25-83 years) was quantitatively measured with magnetic resonance (MR) imaging velocity mapping. Cine transverse images of the ascending aorta (32 phases per cardiac cycle) were acquired by using a gradient-echo sequence with a velocity-encoding bipolar pulse applied in the section-selection direction with a 1.5-T MR imaging unit. The aortic flow was calculated by integrating the product of area and mean velocity of the ascending aorta at each phase over a cardiac cycle. The negative and positive velocity values indicated antegrade and regurgitant flow, respectively, which allowed calculation of forward and regurgitant flow. Inter- and intraobserver variation of regurgitant fraction (RF) measurement was small (r = .956, standard error of the estimate [SEE] = 1.2%, n = 31; and r = .998, SEE = 0.35%, n = 10, respectively). RF determined with MR imaging agreed well with Doppler echocardiographic (n = 26) and aortographic (n = 9) grading of AR. Reproducible, quantitative, and noninvasive measurement of AR is possible with MR velocity mapping.

Adult↗

Effects of a thromboxane A2 synthetase inhibitor on ventricular fibrillation threshold during coronary artery occlusion and reperfusion.

The effects of a new thromboxane A2 synthetase inhibitor (DP-1904) on electrical stability of the heart were tested in anesthetized, open chest dogs. The incidence of spontaneous ventricular arrhythmias, ventricular refractory period and ventricular fibrillation threshold (VFT) during ligation of the left anterior descending coronary artery (LAD) for 180 min and after reperfusion were measured as indices of stability. Ventricular fibrillation and ventricular tachycardia occurred spontaneously after ligation of LAD in 56% of 9 control dogs and 29% of 7 dogs which received intravenous DP-1904 (100 mg) before ligation of LAD (n.s.). In the control group, the ventricular refractory period decreased in the ischemic region; consequently, the difference in refractory period duration between the ischemic and non-ischemic regions (i.e., dispersion) increased 30 min after coronary ligation (7 +/- 9 ms vs 32 +/- 17 ms, p less than 0.05). The dispersion at 30 min after coronary ligation, though, was not affected in the DP-1904 treated group (2 +/- 4 ms vs 10 +/- 9 ms, n.s.). The VFT (determined with pulse trains) decreased from 28 +/- 5 mA to 15 +/- 11 mA (p less than 0.05) 30 min after coronary ligation in the control group, but was not affected (30 +/- 0 mA vs 27 +/- 4 mA) in the DP-1904 group. The plasma concentration of thromboxane B2 decreased after DP-1904 administration (baseline vs 30 min after coronary ligation: 475 +/- 165 pg/ml vs 165 +/- 74 pg/ml, n = 3, p less than 0.05), while the concentration of 6-keto-prostaglandin F1 alpha increased gradually. In conclusion, DP-1904 prevents a decline in electrical stability in the ischemic region of the canine heart during coronary occlusion.

6-Ketoprostaglandin F1 alpha↗

[Study of quantitative measurement of tricuspid regurgitation using Doppler echocardiography].

The volume of tricuspid regurgitation (VTR) was measured using two-dimensional color and continuous wave Doppler echocardiography. The value of VTR showed significant correlations with the maximum area (r = 0.77), the maximum distance (r = 0.73) and the maximum width (r = 0.59) in the regurgitant signal, right ventricular pressure (r = 0.63) and the diameter of right atrium (r = 0.40). When the tricuspid regurgitation was divided into two types in viewpoint of its flow direction-flow directed to center of atrium (A type) and that directed to atrial septum (B type), VTR showed closer correlations with the maximum area (r = 0.90) and the maximum distance (r = 0.87) in A type. But in B type, their relativities were decreased (r = 0.51 and r = 0.40, respectively). The VTR was well related with the severity of tricuspid regurgitation based on the Miyatake's classification. This evidence indicated that the quantitative measurement of tricuspid regurgitant volume using two-dimensional color and continuous wave Doppler echocardiography is more accurate and useful compared with conventional semi-quantitative method.

Adult↗

Two dimensional polar display of cardiac blood pool SPECT.

A new method of ECG gated cardiac blood pool SPECT to illustrate the left ventricular (LV) wall motion in a single static image, two dimensional polar display (2DPD), was described. Circumferential profiles of the difference between end diastolic and end systolic short axis images of the LV were displayed in a similar way to the bull's eye plot of 201Tl myocardial SPECT. The diagnoses by 2DPDs agreed with those by cinematic displays of ECG gated blood pool SPECT in 74 out of 84 segments (85.5%) of abnormal motion, and 155 our of 168 segments (80.3%) of normal motion. It is concluded that 2DPD can evaluate regional wall motion by a single static image in a significant number of patients, and is also useful in comparing with the bull's eye image of 201Tl myocardial SPECT.

Aged↗

The unfolded map using 201T1 myocardial SPECT.

The unfolded map is a new method to show the 201T1 distribution of left ventricle using SPECT. In 52 cases these maps were obtained at the stress study and 4 h later. The maximal count profiles of the perimeters for each short axis image were unfolded and were arranged from the apex to base of the left ventricle into a two dimensional map. All patients had chest pain and were suspected of coronary artery disease. The unfolded map had significant correlations between coronary arteriogram and exercise ECG findings. In conclusion, this method reflects the ischemic area of left ventricular myocardium, closer to the real left ventricular myocardium than Bull's eye display and is useful in the diagnosis of coronary heart disease.

Adult↗

Effectiveness of ECG-gated magnetic resonance imaging in diagnosing cardiovascular diseases.

Nuclear magnetic resonance imaging (MRI) is a noninvasive method which can discriminate between flowing blood and vascular walls, and is expected to contribute to the diagnosis of cardiovascular diseases. Since the data acquisition by conventional MRI is too long for precise cardiac imaging, the ECG-gated method is mandatory in evaluating cardiac function and producing cardiac images of high quality. To evaluate the effectiveness of ECG-gated MRI, left ventricular wall motion and ejection fraction by MRI were compared with those obtained by radionuclide technique. Two types of MR imagers were used: one with a resistive magnet (0.15 Tesla) for 12 patients, and the other with a superconductive magnet (0.35 Tesla) for eight patients. MRI imaged cardiac muscle and vascular walls without the need for any contrast media or radionuclides. The superconductive apparatus provided better quality images than did the resistive one. Comparing MRI with radionuclide technique regarding left ventricular wall motion, resistive and superconductive MRI data correlated satisfactorily with those of radionuclide technique, except in the inferior wall, which was better evaluated by radionuclide technique. Left ventricular ejection fraction obtained by MRI was moderately lower than those obtained by radionuclide technique, though the correlation was good [r = 0.84 (resistive unit) and r = 0.85 (superconductive unit)]. In addition to three-dimensional morphological information, ECG-gated MRI provides information nearly comparable to that of radionuclide technique in the evaluation of left ventricular function and wall motion. Therefore, we regard gated MRI as effective in evaluating various aspects of cardiovascular diseases.

Adult↗

Intravenous lidocaine as a suppressant of coughing during tracheal intubation.

Effects of intravenously administered lidocaine on cough suppression during tracheal intubation under general anesthesia were evaluated in two studies. In study 1, 100 patients received either a placebo or 0.5, 1.0, 1.5, or 2.0 mg/kg lidocaine intravenously 1 min before tracheal intubation. All visible coughs were classified as coughing. The incidence of coughing decreased as the dose of lidocaine increased. A dose of 1 mg/kg or more of intravenous lidocaine suppressed the cough reflex significantly (P less than 0.01). Coughing was suppressed completely by 2 mg/kg of intravenous lidocaine. In study 2, 108 patients received 2 mg/kg lidocaine intravenously or a placebo 1, 3, 5, 7, 10, or 15 min before intubation. The same criteria for determining whether a patient did or did not cough during tracheal intubation were used as in study 1. The incidence of coughing decreased significantly (P less than 0.01) when 2 mg/kg of lidocaine was injected intravenously between 1 and 5 min before our attempting intubation. Cough reflex was suppressed completely by plasma concentrations of lidocaine in excess of 3 micrograms/ml.

Adolescent↗

Interaction of methoxamine with compensatory vasodilation distal to coronary stenoses.

The interaction of alpha 1-receptor mediated vasoconstriction with the compensatory vasodilation distal to coronary stenoses was examined in 9 open-chest dogs. Stenoses on proximal circumflex artery were produced by a circumferential wire snare; an intermediate stenosis was defined by reduction of the reactive hyperemia repayment to 70%, a critical stenosis by prevention of any repayment following a 15-s occlusion. Methoxamine (Vasoxine), 500 micrograms, was infused via a small catheter distal to the stenosis under a constant coronary perfusion pressure of 80 mmHg and a constant heart rate of 160 bpm. The vasoconstrictive response to methoxamine correlated with the degree of reactive hyperemia repayment after 15 s occlusion (r = 0.74) and the preexisting level of poststenotic resistance (r = 0.62). At increasing peripheral coronary pressure distal to the stenosis the resistance of the stenosis was reduced (r = -0.84). Thus, alpha 1-adrenergic vasoconstriction is less marked with increasing compensatory vasodilation distal to coronary stenosis. The severity of the stenosis is reduced at increased intraluminal pressure, probably by distention of its luminal area. Methoxamine might induce a redistribution of coronary blood flow towards ischemic regions and reduce ischemic injury.

Animals↗

Effects of cardiac contraction on segmental coronary resistances and collateral perfusion.

This study examined the reactions of coronary arteries and microvessels to changes in left ventricular pressure, as well as their significance for collateral circulation. Collateral perfusion pressure was measured as peripheral coronary pressure of an occluded coronary artery after embolisation of its terminal vascular bed with 20 micron microspheres in 9 anesthetized dogs. With measurement of collateral perfusion pressure it was then possible to determine the segmental coronary resistances of the coronary arteries and the microvasculature. Left ventricular pressure was increased by aortic clamping during autoregulation and after maximal pharmacological dilation of the coronary circulation. During autoregulation, the increase in left ventricular pressure induced a resistance decrease mainly in the postcollateral microvessels. With maximal vasodilation, the increase in left ventricular pressure induced a resistance increase mainly in the postcollateral microvessels. Finally with ventricular fibrillation, the resistance of the postcollateral microvasculature was markedly decreased. We conclude that both metabolic regulation of coronary blood flow and extravascular compression of coronary circulation by cardiac contraction act predominantly on postcollateral microvessels. Coronary collateral circulation may be impaired at increased left ventricular pressure.

Animals↗

Angiographic changes in the coronary artery associated with cyclical reductions of coronary blood pressure.

Morphological changes associated with cyclical reductions of blood pressure in the partially constricted coronary artery of anesthetized dogs have been examined. In the constricted coronary segments, smooth and diffuse spasm, rosary-like spasm, a localized narrowing indicating a platelet aggregate or thrombus, and no obvious change were observed during the pressure reductions in 3, 5, 2 and 5 of 15 trials of 12 preparations, respectively. In the distal segments of the same preparations, segmental spasm and diffuse spasm were observed during the pressure reductions in 8 and one trials, respectively. The changes in the constricted and distal segments appeared simultaneously or independently. The change which indicates obstruction of the distal segments with platelet aggregates or thrombi was observed in none. The results indicate that spasm, but not platelet aggregates or thrombi, in the constricted segments and/or distal segments plays the major role in the cyclical reductions of blood pressure in the partially constricted coronary artery.

Animals↗

Nocturnal angina pectoris. Comparison between angina with ST segment elevation and depression documented by continuous orthogonal ECG recording.

In 30 patients with nocturnal angina, the night-time ECGs were continuously recorded, and the time and duration of attack, cyclic character of attacks, the relation of chest pain to ischemic ECG changes and arrhythmias during attack were compared between 18 cases with ST elevation and 12 cases with ST depression during attack. In cases with ST elevation, 1) attacks occurred between 2:00 and 8:00 a.m., being most frequent between 4:00 and 5:00 a.m. 2) the duration of attack measured from the duration of ischemic ECG changes was less than 5 min in 88% of the attacks, 3) the attack often recurred with intervals less than 30 min and ECG changes were often unaccompanied bt chest pain, 4) the attack was complicated with various kinds of arrhythmias. These features were in marked contrast to the cases with ST depression, in which attacks were evenly distributed over the night-time, of longer duration, sporadic in occurrence and far less complicated with arrhythmias. These data suggest that the difference of mechanisms causing attacks between both groups.

Adult↗

Effect of 2-nicotinamidethyl nitrate (SG 75) on coronary circulation.

The effect of a new chemical agent, SG 75, on coronary blood flow of anesthetized dogs has been examined. Intravenous administrations of this agent in a dose of 10 microgram/Kg or over caused a significant increase in blood flow of non-constricted coronary artery. Percent increases in flow were 40 (10 microgram/Kg), 95 (50 microgram/Kg), 145 (100 microgram/Kg), and 195 (250 microgram/Kg). The increases were significantly larger than those caused by the same doses of diltiazem, verapamil, nitroglycerin, isosolbide dinitrate, and papaverine. The durations of the increase in flow were 12 (10 microgram/Kg), 23 (50 microgram/Kg), 28 (100 microgram/Kg), and 46 min (250 microgram/Kg), and they were longer than those caused by diltiazem and verapamil. A slight reduction in left ventricular tension and an increase in aortic blood flow were also observed following the administrations of SG 75 in a dose of over 50 microgram/Kg. A decrease in heart rate was produced with a dose of over 500 microgram/Kg. However, PQ interval of electrocardiogram became shorter. Intravenous administrations of SG 75 in doses of 50 and 150 microgram/Kg caused an increase in blood flow of the constricted coronary artery, while nitroglycerin (10 and 30 microgram/Kg) and nifedipine (1 and 3 microgram/Kg) reduced it. The results indicate that SG 75 is a potent and long-acting coronary vasodilating agent and it causes an increase in blood flow of constricted as well as non-constricted coronary artery.

Animals↗

Prostaglandin E2 and epinephrine participate in cyclical reduction of coronary blood pressure and flow.

The effects of the agents that inhibited synthesis of prostaglandins (PGs) and thromboxanes (TXs) on cyclical reduction of blood flow in partially constricted coronary artery of anesthetized dog were examined. The cyclical reduction of coronary blood flow was eliminated by intravenous injections of aspirin that inhibited synthesis of endoperoxides, of benzydamine that inhibited synthesis of endoperoxides and TX A2, and of phenylbutazone that inhibited synthesis of PG E2, but was not of reduced glutathione that inhibited synthesis of TX A2 and accelerated synthesis of PG E2. In the preparations in which cyclical reduction of blood flow did not occur spontaneously, intracoronary injection of PG E2, but not of PG F2a, induced the cyclical reduction. The cyclical reduction was also induced by intravenous injections of epinephrine and reduced glutathione that accelerated synthesis of PG E2. The results indicate participation of PG E2 in the cyclical reduction of coronary blood flow.

Animals↗