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Biomedical subjects

S Handa

Publications and source records attributed to S Handa.

At least 253 records · Page 14Linked to original sources
PubMed1991

[Coronary flow characteristics in hypertrophic cardiomyopathy--a study with Doppler catheter].

UNLABELLED: We compared the pattern and reserve of coronary flow in 8 cases of hypertrophic non-obstructive cardiomyopathy (H) with those in 20 cases of chest pain not accompanied by organic heart disease (N). A catheter-tip Doppler velocimeter was positioned in the proximal portion of the left anterior descending (LAD), circumflex (LCX) and right coronary (RCA) arteries. Coronary flow velocity (Vs: systolic peak, Vd: diastolic peak, Vm: mean) was recorded and the area under the velocity curve was divided into systole (* s) and diastole (* d). The time interval between the dicrotic notch in aortic pressure and the peak of diastolic flow velocity was measured (Tpv). Vm was measured before and after intracoronary injection of 6 ml of contrast media, and peak to resting velocity ratio (PRVR) was calculated as an index of coronary flow reserve. RESULT: In LAD, N showed diastolic predominant coronary flow pattern without backward flow. In H, diastolic predominance was more prominent with systolic backward flow, resulting in decrease in * s/* d(H: 0.07 +/- 0.04, N: 0.25 +/- 0.02, p less than 0.01). In H, Vd (H: 20.1 +/- 2.8, N: 9.2 +/- 1.4 cm/sec, p less than 0.05) and Vm(H: 9.5 +/- 1.3, N: 4.9 +/- 0.7 cm/sec, p less than 0.05) were higher, while PRVR was lower (H: 1.7 +/- 0.1, N: 2.6 +/- 0.1, p less than 0.05). In both N and H, the flow pattern of LCX was diastolic predominant with two peaks (one in systole and the other in diastole).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Phase I clinical study on 99mTc-MIBI].

A phase I clinical study on 99mTc-hexakis 2-methoxy isobutylisonitrile (99mTc-MIBI) was carried out in 6 normal volunteers. There was no significant change in vital signs and laboratory parameters attributing to the reagent other than complaint of slight and transient metallic taste immediately after the injection in 4 volunteers. The highest dosimetry was calculated as 1.1 mGy/37 MBq at lower large intestine, which was within the acceptable range. 99mTc-MIBI was rapidly cleared from the blood and accumulated in the heart immediately after the injection with 1.4% dose and 1.8% dose at 5 min at rest and at stress, respectively. The retention of radioactivity in the heart well continued for at least several hours. The heart-to-lung ratio was over 2.00 at 5 min and heart-to-liver ratio was over 1.00 at 60 min. Myocardial planar and SPECT images were obtained with high quality. In conclusion, 99mTc-MIBI is a useful myocardial perfusion imaging agent.

Adult↗
PubMed1991

[Vena caval flow patterns in patients with constrictive pericarditis: analysis by catheter-tip Doppler flowmetry].

Changes in superior and inferior vena caval flow patterns were analyzed in 5 patients with constrictive pericarditis and were compared with those of 10 normal control subjects. Caval flows were measured using catheter-tip Doppler flowmeters. The normal controls showed biphasic M-shaped flow patterns; the peaks of the first forward flow (S wave) and of the second forward flow (D wave) appeared coincident with mid-systole and mid-diastole, respectively. Reverse flows fell during the atrial contraction period (A wave) and late systole (V wave). In the normal controls, the ratios of the S wave to the D wave (S/D ratio) and the A wave to the S wave (A/S ratio) were 2.15 +/- 0.41 and 0.18 +/- 0.10, respectively, and there was a disproportionate respiratory variation in the S and D waves in the normal controls. In constrictive pericarditis, superior and inferior vena caval flow velocities were lower than those in the normal controls. The S/D and A/S ratios were 1.46 +/- 0.27 (p < 0.05 vs control) and 0.66 +/- 0.15 (p < 0.01 vs control), respectively, with the A wave increasing in proportion to the severity of constrictive pericarditis. In addition, there was only a minimal respiratory variation in constrictive pericarditis. In conclusion, recognition of the patterns of the superior and inferior vena caval flow velocities may be useful for diagnosing constrictive pericarditis.

Adult↗
PubMed1991

[Left atrial booster pump function in left ventricular blood filling: clinical and experimental analyses].

Left atrial booster pump function produces variable effects on cardiac output. Generally, cardiac output decreases by only 15-20% when atrial fibrillation occurs, however, in some cases, hemodynamic collapse occurs through loss of left atrial contraction. We evaluated the relative significance of left atrial booster pump function in acute or chronic load and in myocardial ischemia using the left ventricular volume curve. Blood entering into the left ventricle during the left atrial contraction phase (FVLA) represents the left atrial volume work, and the ratio of FVLA to the left ventricular filling volume during one cardiac cycle (%FVLA) represents the relative significance of left atrial booster pump function in cardiac output. In dog experiments, we calculated the change in FVLA and %FVLA by measuring the the left ventricular internal minor axis diameter and using Pombo's method. We also measured the change of the left atrial segment length as a direct indicator of left atrial contraction. In the acute change in preload, FVLA changed with stroke volume, but %FVLA remained unchanged. The change in FVLA correlated with the direct indicator of the left atrial excursion; the extent of the left atrial segment length (LASL). During acute change of left ventricular afterload, both FVLA and %FVLA were unchanged. In regional myocardial ischemia, both FVLA and %FVLA were increased, suggesting an increase in the left atrial booster pump function. In clinical study, we calculated FVLA and %FVLA from the left ventricular diameter using M-mode echocardiography. In chronic volume overloading (aortic regurgitation), FVLA increased while %FVLA was maintained unchanged. The same FVLA-%FVLA relationship was observed in acute volume loading. In cases of left ventricular hypertrophy (LVH) and old myocardial infarction (MI), both FVLA and %FVLA were increased, suggesting the increased left atrial booster pump function. In these cases, the left ventricular rapid filling velocity decreased, suggesting that impairment of rapid filling caused the increase of left atrial preload and hence increased left atrial volume work. The results of this study show that in old MI and in LVH, both left atrial volume work and the relative significance of left atrial booster pump function increase. We concluded that prevention of atrial fibrillation may be very important in these diseases.

Animals↗
PubMed1991

[Real-time coronary blood flow measurement in patients with atrial fibrillation: a study using a catheter-tip Doppler velocimeter].

To clarify the influence of changes in the cardiac cycle length (R-R) and aortic pressure on the coronary blood flow, a catheter-tip Doppler velocimeter was applied for 16 patients with chronic atrial fibrillation (11 with valvular heart disease, 2 with coronary artery disease, 2 with cardiomyopathy and one with atrial septal defect). An area under the coronary flow velocity curve during systole (integral of S), diastole (integral of D) and one cardiac cycle (integral of T) for the proximal portion of the left anterior descending artery (LAD: 12 cases) or the right coronary artery (RCA: 10 cases) was calculated in beat-by-beat. Then, the correlations between each area and the R-R, systolic period (S), diastolic period (D) and aortic pressure were assessed. In both the LAD and RCA, prolongation of R-R associated with prolonged D increased integral of D, which caused an increase of integral of T. Integral of D correlated with D (p < 0.05), but integral of S did not correlate with S, and the degree of change in integral of S or S was much less than that in integral of D or D. R-R or D of the preceding beat correlated inversely (p < 0.05) with integral S in 11 of 12 LAD cases. In the RCA, positive correlations between R-R or D of the preceding beat and integral of S were observed in cases with mitral stenosis (n = 6) or coronary heart disease (n = 1), but not in other cases; a case with aortic regurgitation or hypertrophic cardiomyopathy, negative, and dilated cardiomyopathy, no correlation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Effects of 3-methylsulphonyl-4,5,3',4'-tetrachlorobiphenyl and 7,8-benzoflavone on aryl hydrocarbon hydroxylase activity in Ah responsive and Ah nonresponsive strains of mice.

In general, C57BL/6NQdj (C57) and DBA/2JCrj (DBA) strains of mice are considered to be the aryl hydrocarbon (Ah) responsive and Ah nonresponsive strains of mice, respectively, which are determined by whether the hepatic aryl hydrocarbon hydroxylase (AHH) activity is enhanced (Ah responsive) or not (Ah nonresponsive) after the treatment of 3-methylcholanthrene (MC). In this study, first, we examined that the Ah responsiveness was systemically regulated in the lungs and kidneys as well as in the liver and observed its systemic control in these three organs in the two strains of mice. Then, we prepared the hepatic microsomes of the two strains of mice after the treatment of MC (42 mg/kg, once), 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, 20 micrograms/kg, 6 times) and 2,3,4,7,8-pentachlorodibenzofuran (PenCDF 60 micrograms/kg, 6 times) in order to investigate the effects of 3-methylsulphonyl-4,5,3',4'-tetrachlorobiphenyl (3-MSF-TCB, 1.5-45 micrograms/ml) and 7,8-benzoflavone (ANF, 1.4-42 micrograms/ml) on the respective hepatic microsomal AHH activities and the following results were obtained. 1. As compared with the control enzyme activity, TCDD-induced AHH activity was the highest, PenCDF-induced one the second and MC-induced the lowest in both strains of mice. The inductions of the enzyme activity by these chemicals were much more remarkable in the Ah responsive C57 strain than those in the Ah nonresponsive DBA strain. 2. 3-MSF-TCB and ANF enhanced or reduced the enzyme activity depending on both their concentrations and kinds of microsomes, namely, those prepared from untreated control mice and mice treated with MC, TCDD or PenCDF.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Effect of structural modification of several groups on the D-ring of grayanotoxin on its depolarization potency in squid giant axon.

The purpose of this investigation was twofold, 1) to clarify the pharmacological significance of various groups on the D-ring of grayanotoxin (GTX) and 2) to determine possible sites on GTX which are available for preparing pharmacological probes. All GTX derivatives were directly applied to the intracellular phase of internally perfused squid giant axons. A dose-response curve for each GTX analog was constructed using depolarization as an index and assuming a simple one-to-one stoichiometry. By comparing EC50 and the maximum depolarization caused by GTX analogs, the main factors affecting potency were found to be: the formation of 1) electrostatic interaction, 2) a hydrogen bond between groups on the D-ring of GTX and part of the Na channel protein and 3) balance between hydrophilicity and hydrophobicity in the GTX molecule. Biologically essential groups like those in the A- and B-rings were not recognized. A suitable site on GTX for synthesizing pharmacological probes is probably position C-17 of grayanotox-15-ene compound, because in chemical modification, bulkier groups can be introduced without a total loss of biological activity of GTX. Another possible site for modification is position C-14R, because this portion is on the molecular surface opposite biologically essential groups. It can be speculated that in GTX binding, possible molecular moiety of the Na channel facing the D-ring of GTX is rich in positively charged amino groups.

Animals↗
PubMed1991

[Smoking habit and cardiovascular diseases].

The relationship between smoking and ischemic heart disease was discussed, in terms of the smoking habit and the mechanisms of acute and chronic effects of smoking on the cardiovascular system as one of the coronary risk factors, with reference to exercise capacity and coronary flow reserve. The smoking habits of 1000 consecutive patients with ischemic heart disease, who were evaluated with coronary angiography, were analyzed. High percentages of smokers were observed in the younger generation. It was up to 86% in the 4th decade, though it was only 48% in the 8th decade. There was no large difference in other risk factors between smokers and non-smokers. The exercise capacity with and without smoking was evaluated with treadmill exercise test in 6 healthy volunteers. The exercise time was decreased with smoking, compared to without smoking, indicating a decrease in exercise capacity due to smoking. The elevated concentration of carbon monoxide in blood decreased the ability of oxygen transport. The increased lactic acid level in blood with smoking suggested anaerobic energy production acting as a part of the energy source. The smoking increased the myocardial oxygen consumption in relation to increase in heart rate and blood pressure. It decreased coronary flow reserve, shown by a peak to resting flow velocity ratio measured with the Doppler flow velocimeter. In coronary heart disease, therefore, the threshold of myocardial ischemia was decreased by smoking. The decrease in coronary flow reserve recovered with cessation of smoking for more than 2 days.

Adult↗
PubMed1990

Production of endothelin in human cancer cell lines.

Endothelin (ET)-1 is a vasoconstrictor peptide derived from endothelial cells and now known to be a local regulator of vascular tonus. Recent studies, however, have revealed that ET-1 functions also as growth factor in various cells. By using a specific ET-1 radioimmunoassay, immunoreactive (IR) ET-1, ranging from 4.2 to 150 pM (minimum detectable amount, 4.0 pM), was detected in 13 of 42 human cancer cell lines. The frequencies of IR-ET-1 production and its concentrations were high in mammary, pancreatic, and colon carcinoma cell lines. IR-ET-1 produced by cancer cells possessed the same molecular size as synthetic ET-1 and also had ET-1-like biological activity. Moreover, Northern blot analysis revealed bands corresponding to ET-1 mRNA in cancer cell lines, indicating that IR-ET-1 produced by cancer cells is a product of the ET-1 gene. Since ET-1 in the spent media is present in a sufficient amount to stimulate cellular growth, we sought ET-1 receptors in four pancreatic carcinoma cell lines and human skin fibroblasts. No ET-1 receptors were detected in the pancreatic carcinoma cell lines. However, human skin fibroblasts possessed a large number of ET-1 receptors. This finding raises the possibility that ET-1 produced by cancer cells plays a modulatory role in the growth of stromal cells surrounding cancer cells.

Cell Line↗
PubMed1990

Accumulation of gangliosides with N-acetylneuraminosyl(alpha 2-6)lactosamine structure in primary human hepatoma.

Gangliosides of hepatomas have been analyzed by using a monoclonal antibody directed to N-acetylneuraminosyl(alpha 2-6)lactoneotetraosylceramide (sialyl(alpha 2-6)paragloboside), which was prepared by injecting the monosialoganglioside fraction of human meconium into BALB/c mice. The monoclonal antibody, named MSG-15, was found to bind sialyl(alpha 2-6)paragloboside, but it failed to react with other gangliosides, including N-acetylneuraminosyl(alpha 2-3)lactoneotetraosylceramide (sialyl (alpha 2-3)paragloboside) and "Ii"-type gangliosides. MSG-15 was found to recognize NeuAc alpha 2-6Gal beta structure of the ganglioside. Gangliosides obtained from human hepatomas were analyzed by immunostaining on high-performance thin-layer chromatography plates using the monoclonal antibody MSG-15. All primary hepatoma samples used in this study (nine samples) were found to contain sialyl(alpha 2-6)paragloboside, which accounted for 13-31% of the monosialoganglioside fractions in the hepatomas. Furthermore, MSG-15 recognized several monosialogangliosides in addition to sialyl(alpha 2-6)paragloboside. These gangliosides apparently also contain a terminal NeuAc alpha 2-6Gal beta structure. Other ganglioside fractions obtained from hepatoma and meconium were immunostained on thin layer chromatography plates with MSG-15. Additionally, another monoclonal antibody (H-11), which recognizes terminal lactosamine structure, was used to immunostain these fractions after sialidase treatment. Bands stained with both monoclonal antibodies showed similar mobilities to each other in the di- and trisialoganglioside fractions as well as monosialoganglioside fraction. In control liver, GM3 ganglioside accounted for 92% of monosialoganglioside fraction, and sialyl(alpha 2-6)paragloboside accounted for less than 1% of the fraction. Immunohistochemical study by using MSG-15 in tissue sections from hepatocellular carcinoma and normal liver tissues demonstrated that only hepatocellular carcinoma cells gave a positive reaction. These results suggest that the biosynthetic pathway of gangliosides containing NeuAc alpha 2-6Gal beta 1-4GlcNAc beta structure is activated in hepatoma cells.

Animals↗
PubMed1990

Atrial natriuretic peptide secretion in rabbits with aortic regurgitation.

We investigated whether or not the extent of secretion of atrial natriuretic peptide (ANP) was altered during the chronic course of aortic regurgitation (AR) in rabbits. AR was induced by aortic valve perforation in 20 rabbits. Left ventricular end-diastolic pressure (LVEDP) was used as an index of the severity of heart failure. LVEDP and plasma immunoreactive(IR)-ANP were measured before and at 15 min, 1 week, and 4 weeks after induction of AR. In each period a correlation between LVEDP and plasma IR-ANP was observed, and the coefficients and covariances did not vary throughout the experiment. We conclude, therefore, that a chronic change in ANP secretion does not develop during the first 4 weeks after induction of AR in rabbits.

Animals↗
PubMed1990

Intracoronary endothelin-1 increases coronary retrograde pressure by constricting arterioles.

STUDY OBJECTIVE: The aim was to determine the site of coronary vasoconstriction induced by endothelin, by investigating the response in terms of retrograde pressure and reactive hyperaemia. EXPERIMENTAL MATERIAL: Twelve anaesthetised mongrel dogs, 12-14 kg, were used for the studies. DESIGN: The left anterior descending coronary artery was cannulated and perfused with blood through an extracorporeal bypass. The effects of intracoronary endothelin-1 (1-500 pmol) on coronary blood flow, coronary flow reserve (the peak reactive flow and the repayment after 15 s coronary occlusion), and retrograde coronary pressure during coronary occlusion were studied (n = 7). The retrograde coronary flow was collected from the bypass at each dose (n = 5). MEASUREMENTS AND MAIN RESULTS: At doses of greater than 20 pmol the coronary flow decreased dose dependently and reached almost zero flow at 500 pmol. The coronary flow reserve also decreased; however, the retrograde pressure was raised dose dependently at doses of greater than 10 pmol. At a dose of 500 pmol, the retrograde pressure was increased to 61 mm Hg [82(SEM 12)% of the coronary perfusion pressure]. Retrograde flow remained unchanged throughout the experiment. CONCLUSIONS: The endothelin-1 induced rise in retrograde pressure is in accordance with a dose dependent reduction in coronary flow reserve, and collateral flow was not augmented by endothelin. It is concluded that the effect of endothelin-1 on coronary circulation in situ was mainly due to the constriction of small resistant vessels.

Animals↗
PubMed1990

Blood group A-active glycosphingolipids analysis by the combination of TLC-immunostaining assay and TLC/SIMS mass spectrometry.

Blood group A-active glycosphingolipids from human erythrocyte membranes were identified by the combination of thin-layer chromatography and matrix-assisted secondary ion mass spectrometry (TLC/SIMS). Partially purified lipid extracts were chromatographed by TLC and then blood group A-active glycolipids were detected by TLC-immunostaining assay using anti-A antibody. The parts of the plates which contained the same Rf area as anti-A positive spots were cut out and subjected to direct SIMS analysis. The TLC/SIMS spectra were quite similar to those obtained by ordinary SIMS. Detailed information, such as molecular weight, molecular species, ceramide portion, and oligosaccharide sequence, was obtained. Also, peracetylated blood group A-active glycolipids were analyzed in a similar manner. After the position of A-active glycolipids on a TLC plate was confirmed by in situ deacetylation and TLC-immunostaining, acetylated A-active glycolipids were also analyzed by the TLC/SIMS. Enhanced sensitivity was obtained with peracetylated glycolipids. Consequently, small amounts of unpurified bioactive glycolipids can be readily analyzed by TLC/SIMS.

Carbohydrate Sequence↗
PubMed1990

Biochemical and immunological studies on two distinct ganglioside-hydrolyzing sialidases from the particulate fraction of rat brain.

Ganglioside-hydrolyzing sialidase activity was solubilized from rat brain particulate fraction by using Triton X-100 plus sodium deoxycholate. When chromatographed on AH-Sepharose 4B, the solubilized activity was resolved into two peaks, which were designated sialidases I and II in order of elution. The two sialidases were purified by using sequential chromatographies on Octyl-Sepharose CL-4B, Phenyl-Sepharose CL-4B, and Sephadex G-200. Sialidase II was purified further by Mono Q-FPLC. Overall purification was 450- and 2,150-fold, for sialidases I and II, respectively. Purified sialidases I and II were maximally active at near pH 5.0 and exhibited M = 70,000 by gel filtration. Sialidase I hydrolyzed gangliosides but scarcely other substrates including 4-methylumbelliferyl-NeuAc (4MU-NeuAc). Sialidase II hydrolyzed oligosaccharides, glycoproteins, and 4MU-NeuAc although gangliosides appeared to be preferential substrates. Sialidase II cleaved GM2 much faster than sialidase I. An antibody raised in rabbits against sialidase I reacted with only sialidase I and an antibody against sialidase II reacted with only sialidase II. A subcellular distribution study suggested sialidase I in the synaptosomal membrane and sialidase II in the synaptosomal and lysosomal membranes, and this was verified by using the above antibodies.

Animals↗
PubMed1990

A simple and specific assay of glycosyltransferase and glycosidase activities by an enzyme-linked immunosorbent assay method, and its application to assay of galactosyltransferase activity in sera from patients with cancer.

A simple, sensitive, and specific assay method for glycosyltransferase and glycosidase activities has been established by means of an enzyme-linked immunosorbent assay (ELISA) using monoclonal antibody, H-11 directed to lactoneotetraosylceramide (nLc4Cer). Enzyme activity was determined by assaying the amount of reaction product, nLc4Cer with the ELISA method. For the assay of galactosyltransferase activity, lactotriaosylceramide (Lc3Cer) immobilized on a 96-well microtiter plate was incubated with bovine milk galactosyltransferase in cacodylate buffer (pH 6.8) containing Triton CF-54, Mn2+, and UDP-galactose. Optimum incubation conditions for the enzyme were determined. Glycosidase activity was also assayed by the ELISA method by using Clostridium perfringens sialidase and neolacto-series gangliosides as substrates, and the substrate specificities towards the gangliosides were examined. By this method, 3-100 pmol of reaction product could be determined. The assay method has several advantages as follows: 1, the method is simple; 2, separation of the reaction product is not required; 3, quantification and identification of the reaction product were done simultaneously; 4, naturally occurring substrates are available (especially for glycosidase); 5, many samples can be assayed in one microplate; 6, sensitivity is very high. The present method was applied for the detection of galactosyltransferase in human sera. Significant elevations of the galactosyltransferase levels were observed in the sera from cancer patients. The formation of nLc4Cer was confirmed by employing the TLC-immunostaining method for bands of Lc3Cer after incubation of the bands with serum and cofactors on an HPTLC plate.

Antibodies, Monoclonal↗
PubMed1990

[Pharmacokinetics and clinical effects of cefdinir 5% fine granules in pediatrics].

Cefdinir (CFDN), a newly developed oral cephalosporin in 5% fine granular form, was administered to 10 boys at 1 hour before meal (in the fasting state) and concentrations of the drug in plasma and urine and its urinary recovery rates were determined. The subjects were divided into 2 groups of 5 boys each; one group received 3 mg/kg of CFDN, and the other, 6 mg/kg. To 6 of the 10 children the drug was administered in the two different dose levels using the cross-over method. To study clinical and bacteriological effects of this drug, a mean dose of 4.6 mg/kg t.i.d. was administered for 8 days on the average to 40 children with various infections; pharyngitis (4 cases), tonsillitis (2), acute bronchitis (2), pneumonia (8), scarlet fever (6), acute purulent otitis media (1), urinary tract infection (12), impetigo (2), phlegmon (1), lymphadenitis (1) and subcutaneous abscess (1). MICs were determined for 6 drugs including CFDN, cefaclor, cefixime (CFIX), methicillin, cloxacillin (MCIPC), amoxicillin (AMPC) against 13 strains of 6 species freshly isolated from children receiving CFDN. An inoculum size of 10(6) cfu/ml was used in the MIC-determinations. Adverse reactions and abnormal laboratory findings attributable to this drug were also examined in these patients. The results obtained are summarized as follows. 1. Mean plasma peak levels of CFDN were observed at 3 hours after administration in both the 3 mg/kg and 6 mg/kg groups with mean peak values of 0.68 and 1.35 micrograms/ml, respectively. Mean half-lives were 2.06 hours in the 3 mg/kg group and 1.61 hours in the 6 mg/kg group, and mean AUCs were 3.5 in the former and 6.5 micrograms.hr/ml in the latter. Thus, dose-response between the 2 doses was observed in plasma levels and AUCs. 2. To 3 patients, CFDN was given in the two different doses using the cross-over method. Mean plasma peak levels of CFDN were 0.71 and 1.31 micrograms/ml in the doses of 3 mg/kg and 6 mg/kg, respectively. Half-lives were 1.39-2.90 hours in the 3 mg/kg group and 1.21-1.48 hours in the 6 mg/kg group, with AUCs of 3.4-3.7 and 4.1-7.5 micrograms.hr/ml, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Oral↗
PubMed1990

[Left ventricular performance following mitral valve replacement in patients with tight mitral stenosis combined with mild aortic regurgitation].

The severity of aortic regurgitation is difficult to estimate prior to mitral valve replacement (MVR) in cases with tight mitral stenosis (MS), because low output state due to mitral obstruction masks signs of aortic regurgitation. This study clarified left ventricular performance, possibly affected by increased diastolic loading after MVR. The study subjects consisted of 12 patients with pure mitral stenosis (MS group) and 11 with combined mitral stenosis and aortic regurgitation (MSAR group). The diagnosis was made by cardiac catheterization preoperatively. The aortographic grade of aortic regurgitation was class 1 or 2 according to the AHA classification. Both groups were matched in terms of severity in mitral obstruction evaluated by mitral valve area. On preoperative echocardiographic evaluation, there was no difference in the mean values of LVDd, LVSd, and %FS between the groups MS and MSAR. After surgery, symptoms improved in each patient. Echocardiography performed three months after MVR revealed no differences in these parameters between both the groups. We concluded that aortic regurgitation evaluated as class 1 or 2 preoperatively does not increase in respect to left ventricular diastolic overloading and echocardiographic left ventricular performance remains unchanged.

Adult↗