[Effects of spontaneous respiration on echocardiographic measurement of the right ventricular dimension (author's transl)].
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Biomedical subjects
Publications and source records attributed to T Sawayama.
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The cardiovascular system was examined in 19 cases of familial amyloid polyneuropathy. In a group of patients with neurological involvement, various cardiac abnormalities were common, including orthostatic hypotension, prominent apex cardiographic A waves, abnormal apical systolic waves (bulges), systolic murmurs, mid-systolic clicks, QS waves, atrioventricular block, left bundlebranch block, and abnormalities of ejection time and pre-ejection period. Though there was one case with pronounced cardiac abnormality despite a normal neurological state, and though cardiovascular symptoms appeared later than neurological symptoms, the degree of cardiac involvement generally paralleled the severity of the neurological disorder.
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In 13 patients with old myocardial infarction diagnosed with use of the electrocardiogram, coronary angiogram and left ventriculogram and in 11 patients without infarction, thallium-201 imaging with a color display computer system was carried out. In the group without infarction the average ratio of activities in two regions of interest within the myocardial wall, excluding the apex, was 1.14 (1.08 to 1.23). In the group with infarction the average ratio of noninfarcted to infarcted areas was 1.44 (1.23 to 1.78). Objective detection of infarction was possible in 12 patients (92 percent) in the group with infarction. In two patients, the earlier electrocardiographic pattern of infarction had resolved by the time of imaging. These results suggest that the sensitivity of thallium-201 imaging in the diagnosis of old myocardial infarction may be greatly enhanced by objective and quantitative analysis using a color display computer system.
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In 6 cases with sinus rhythm and one with atrial fibrillation, the bipolar surface electrocardiograms were taken through band pass filters simultaneously with the intracavitary His bundle electrogram, and averaged using a signal processer. By these relatively simplified procedures 'blips' considered to be derived from His bundle potentials between PR segments could be recorded. It was found that 'blips' originating from the His bundle were recorded most distinctly when a cathode was applied to the posterior mid-line and an anode to the sternum, both at the level of the fourth intercostal space. In some instances it was possible to record 'blips' probably derived from the bundle-branches. To identify the onset of ventricular potentials it was necessary to refer to the surface electrocardiograms taken with a usual time constant. The interval from the onset of 'blip' to the onset of ventricular activity (BV) agreed perfectly with the directly recorded His bundle to ventricle conduction time (HV) in 6 out of 7 cases investigated, and in the remaining case this interval was found to be only 1 ms longer than the HV.
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