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Biomedical subjects

U Ikeda

Publications and source records attributed to U Ikeda.

At least 181 records · Page 10Linked to original sources

Expression of leukocyte chemotactic cytokines in myocardial tissue.

Cytotoxic action of leukocytes may be involved in the pathogenesis of inflammatory heart muscle disorders. We investigated the expression of rat leukocyte chemotactic cytokines--cytokine induced neutrophil chemoattractant (CINC) and JE--in cultured neonatal rat cardiac myocytes; CINC belongs to the interleukin 8 (IL-8) family and JE is a homologue of human monocyte chemoattractant protein 1 (MCP-1). In Northern blot analysis, CINC and JE transcripts were not clearly observed in unstimulated rat cardiac myocytes. However, their expression was clearly observed after exposure to tumour necrosis factor-alpha (TNF-alpha; 100 U/ml) for 2-6 h. We then evaluated IL-8 and MCP-1 mRNA expression in human endomyocardial biopsy specimens from seven patients with idiopathic dilated cardiomyopathy by polymerase chain reaction analysis. Both IL-8 and MCP-1 mRNA transcripts were recognized in all patients studied. These results show for the first time that leukocyte chemotactic cytokines, IL-8 and MCP-1, are expressed in myocardial tissue, which might contribute to the pathogenesis of inflammatory heart muscle disorders.

Animals↗

Expression of monocyte chemoattractant protein-1 in vascular tissue.

We investigated monocyte chemoattractant protein-1 (MCP-1) mRNA expression in rat vascular smooth muscle cells (VSMC) and in human atherosclerotic arteries to test the involvement of MCP-1 in the pathogenesis of atherosclerosis. In Northern blot analysis, MCP-1 mRNA expression was not observed in unstimulated cultured rat vascular smooth muscle cells (VSMC), but its expression was clearly observed by exposure to tumour necrosis factor-alpha (100 U/ml) for 2-6 h. Mitogen-activated protein kinase activity in VSMC incubated in serum-free culture medium was increased by exposure to 0.5% fetal bovine serum, while the effect was significantly suppressed in the presence of MCP-1 (100 ng/ml). We then evaluated MCP-1 mRNA expression in atherosclerotic arteries obtained from 12 patients undergoing bypass revascularization through reverse transcription-polymerase chain reaction analysis and observed MCP-1 mRNA expression in all atherosclerotic arteries studied. These results support the premise that MCP-1 is secreted by VSMC in atherosclerotic plaques as well as by endothelial cells and macrophages and contributes to the pathogenesis of atherosclerosis.

Animals↗

Expression of cytokine-induced neutrophil chemoattractant in rat cardiac myocytes.

Accumulation and adhesion of leukocytes to cardiac myocytes play important roles in the pathogenesis of inflammation-mediated myocardial injury such as ischaemia/reperfusion and myocarditis. The involvement of leukocyte chemotactic factors has been speculated in these processes. We investigated the expression of cytokine-induced neutrophil chemoattractant (CINC) in rat cardiac myocytes. CINC is a rat equivalent of human interleukin-8. On exposure to interleukin-1 alpha (IL-1 alpha), cultured neonatal rat cardiac myocytes released appreciable levels of CINC both dose- and time-dependently. Tumor necrosis factor-alpha and lipopolysaccharide also significantly increased CINC accumulation in the culture supernatant. CINC mRNA expression was not observed in unstimulated myocytes, however, the expression was markedly induced by exposure to IL-1 alpha with a peak elevation at 3 h. Potent chemotactic activity for neutrophils was detected in the supernatant of cultured rat cardiac myocytes by stimulation with IL-1 alpha. This IL-1 alpha-induced chemotactic activity was significantly inhibited by polyclonal anti-CINC antiserum. Addition of dexamethasone, genistein, actinomycin D or cycloheximide significantly suppressed the IL-1 alpha-induced CINC accumulation. Under hypoxia (95%N2 + 5%CO2), CINC accumulation was increased in a time-dependent manner, and reoxygenation after hypoxia further intensified CINC accumulation. This hypoxia reoxygenation-induced CINC expression was significantly inhibited by pretreatment with dexamethasone. In conclusion, inflammatory stimuli induce the expression of CINC in rat cardiac myocytes, which may lead to myocardial injury via accumulation and activation of neutrophils.

Animals↗

Coagulation activity is increased in the left atrium of patients with mitral stenosis.

OBJECTIVES: This study investigated the hemostatic status of the right and left atria in patients with mitral stenosis. BACKGROUND: Systemic thromboembolism is a serious major complication in patients with mitral stenosis. However, the pathogenesis of thromboembolism in mitral stenosis is not fully understood. METHODS: We determined the plasma levels of biochemical markers for platelet activity (platelet factor 4 and beta-thromboglobulin) and status of thrombin generation (fibrinopeptide A and thrombin-antithrombin III complex) and fibrinolysis (D-dimer and plasmin-alpha 2-plasmin inhibitor complex) in specimens of blood obtained from the peripheral vein and right and left atria of 12 consecutive patients with mitral stenosis who were undergoing percutaneous mitral valvuloplasty. RESULTS: Plasma levels of platelet factor 4, beta-thromboglobulin, D-dimer and plasmin-alpha 2-plasmin inhibitor complex in the patients did not differ significantly between the right and left atria, whereas levels of fibrinopeptide A and thrombin-antithrombin III complex in the left atrium were significantly higher than those in the right atrium (fibrinopeptide A in the left and right atria 19.35 +/- 4.64 and 6.31 +/- 0.75 ng/ml [mean +/- SE], respectively, p < 0.02; thrombin-antithrombin III complex in the left and right atria 11.45 +/- 2.29 and 3.98 +/- 0.60 ng/ml, respectively, p < 0.01). Levels of fibrinopeptide A and thrombin-antithrombin III complex in the left atrium did not correlate with mean transmitral gradient, dimension of the left atrium or reciprocal of the mitral valve area. Peripheral blood plasma levels of von Willebrand factor antigen were significantly higher in the patients than in an age-matched control group of normal subjects (168 +/- 25% and 99 +/- 7%, respectively, p < 0.05) but showed no difference in the peripheral blood and right and left atria of the patients. CONCLUSIONS: The coagulation system is activated in the left atrium of patients with mitral stenosis even during anticoagulation.

Adult↗

The coagulation system is activated in idiopathic cardiomyopathy.

OBJECTIVES: We investigated the plasma levels of molecular markers for platelet activity and the thrombotic and fibrinolytic status in patients with hypertrophic cardiomyopathy and dilated cardiomyopathy to determine the activating site of coagulation in these disorders. BACKGROUND: A thromboembolic event is a serious complication in patients with idiopathic cardiomyopathy. However, the activating site of the coagulation system in idiopathic cardiomyopathy has not been fully investigated. METHODS: We determined the plasma levels of molecular markers for platelet activity (platelet factor 4 and beta-thromboglobulin), thrombotic status (fibrinopeptide A and thrombin-antithrombin III complex) and fibrinolytic status (D-dimer and plasmin-alpha 2-plasmin inhibitor complex) in 13 patients with hypertrophic cardiomyopathy, 17 patients with dilated cardiomyopathy and 20 normal subjects. RESULTS: Plasma levels of platelet factor 4, beta-thromboglobulin and plasmin-alpha 2-plasmin inhibitor complex did not differ significantly among the three groups, whereas plasma levels of fibrinopeptide A and thrombin-antithrombin III complex in both patient groups were significantly higher than those in normal subjects. Plasma levels of D-dimer in patients with dilated cardiomyopathy were significantly higher than those in patients with hypertrophic cardiomyopathy and normal groups. In patients with hypertrophic cardiomyopathy, both fibrinopeptide A and thrombin-antithrombin III complex levels were significantly correlated with left atrial diameter. In patients with dilated cardiomyopathy, fibrinopeptide A and thrombin-antithrombin III complex levels showed a positive correlation with left ventricular end-diastolic volume and a negative correlation with fractional shortening of the left ventricle. CONCLUSIONS: The activated coagulation system in patients with hypertrophic and dilated cardiomyopathy may be triggered by left atrial dilation in hypertrophic cardiomyopathy and left ventricular enlargement and dysfunction in dilated cardiomyopathy.

Antifibrinolytic Agents↗

Inflammatory cytokines and rat vascular tone.

1. Experiments were performed to examine the effect of inflammatory cytokines, interleukin-2 (IL-2), IL-6 and IL-8, on the contractility of rat aorta. 2. Pretreatment of the endothelium-denuded aortic ring with IL-6 for 3 h caused a significant inhibition of its contraction (58.9 +/- 7.8%, n = 9, P < 0.01) when induced by 10(-6) mol/L phenylephrine. 3. On the other hand, IL-2 and IL-8 failed to show significant effects on the contractility of the aorta. 4. This inhibitory effect of IL-6 on phenylephrine-induced contraction showed dose-dependency, and completely disappeared in the presence of 10(-5) mol/L indomethacin. 5. In cultured rat vascular smooth muscle cells (VSMC), the release of 6-keto-prostaglandin F1alpha into the extracellular medium was significantly increased by exposure to IL-6, but not by exposure to IL-2 or IL-8. 6. IL-2, IL-6 and IL-8 showed no effects on the release of nitrite, a stable metabolite of nitric oxide (NO), from VSMC. 7. These results indicate that IL-6, not IL-2 or IL-8, is a potent inhibitor of the alpha-adrenergic-stimulated contraction of vascular smooth muscle and its action is mediated by the increased synthesis of prostacyclin rather than NO.

6-Ketoprostaglandin F1 alpha↗

Monocyte chemoattractant protein 1 inhibits growth of rat vascular smooth muscle cells.

The early atherosclerotic lesion is characterized by the migration of inflammatory cells, including monocytes, which may serve as a source of cytokines such as monocyte chemoattractant protein 1 (MCP-1), a homologue of mouse JE. We investigated the effect of MCP-1 on the growth of vascular smooth muscle cells (VSMC) isolated from rat aortae. In Northern blot analysis, MCP-1/JE transcripts were not observed in unstimulated VSMC, but its expression was clearly observed by exposure to lipopolysaccharide (1 micrograms/ml) for 6 h. Human recombinant MCP-1 inhibited the uptake of [3H]thymidine by VSMC cultured in 0.5% fetal bovine serum (FBS) containing Dulbecco's modified Eagle's medium (DMEM) in a dose-dependent manner. The inhibitory effect of MCP-1 on the growth of VSMC was also confirmed by a change in cell counts. The antiproliferative effect of MCP-1 was significantly blocked in the presence of an anti-MCP-1 antibody. MCP-1-induced inhibition of [3H]thymidine uptake was not affected in the presence of indomethacin (1 micrograms/ml) or NG-monomethyl-L-arginine (0.1 mM), and MCP-1 showed no effect on 6-ketoprostaglandin F1 alpha, guanosine 3',5'-cyclic monophosphate, and adenosine 3',5'-cyclic monophosphate syntheses in VSMC. These results indicate that MCP-1 inhibits the proliferation of VSMC in vitro and that its effect is independent of prostaglandin or nitric oxide generation.

6-Ketoprostaglandin F1 alpha↗

Multiple saccular aneurysm formation in a patient with bilateral coronary artery fistula: a case report and review of the literature.

We describe a case of bilateral coronary artery fistula originating from the left anterior descending and right coronary arteries which showed multiple saccular aneurysm formation. Although saccular aneurysm formation in patients with bilateral coronary artery fistula is extremely rare, only 3 similar cases having been reported before, it shows two distinctive features upon coronary angiography: multiplicity and origin in the left fistulous coronary artery.

Adult↗

Suppressive role of endogenous endothelial monocyte chemoattractant protein-1 on monocyte transendothelial migration in vitro.

Monocyte chemoattractant protein-1 (MCP-1, or monocyte chemotactic and activating factor) is thought to play an important role in monocyte infiltration into tissue, but little is known about its effect on monocyte-endothelium interaction. We examined the effect of MCP-1 produced by cytokine-activated endothelial cells (ECs) on monocyte-endothelium adhesion and subsequent transendothelial migration by using a double-chamber vessel model. Unstimulated ECs showed no MCP-1 expression, but exposure to interleukin-1 beta (IL-1 beta, 25 U/mL) induced marked MCP-1 mRNA expression and protein synthesis. When placed in the lower compartment, recombinant human (rh) MCP-1 (100 ng/mL) produced a 1.9-fold and a 2.7-fold increase in adhesion and migration, respectively, compared with a corresponding 51% and 59% decrease when placed in the upper compartment. Migration of monocytes was dependent on a gradient of rh-MCP-1 from the apical to basilar side of the EC layer. Furthermore, a forward gradient of MCP-1 induced adherent cells to increase their subsequent migration, whereas a reverse gradient induced the cells to detach and completely inhibited their subsequent migration. Pretreatment with IL-1 beta for 4 and 24 hours produced a 20% and 63% increase in monocyte migration, respectively. In the presence of anti-MCP-1 antibody, the increase was further enhanced by 52% and 152%, respectively. These results suggest that endogenous endothelial MCP-1, when secreted by IL-1-stimulated ECs, suppresses monocyte migration in the presence of MCP-1 on the basilar side of the EC layer.(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies↗

Induction of monocyte chemoattractant protein-1 synthesis in human monocytes during transendothelial migration in vitro.

Monocyte chemoattractant protein-1 (MCP-1, or monocyte chemotactic and activating factor) plays important roles in the recruitment of monocytes and thus in the development of atherosclerosis. In this study, we determined whether MCP-1 synthesis was induced by the cellular interaction between monocytes and endothelial cells during the process of transendothelial migration. We found that when human peripheral blood monocytes (2.5 x 10(6) cells) and umbilical vein endothelial cells (HUVECs; 5.0 x 10(5) cells) were cocultured for 5 hours, 7.9 ng/mL MCP-1 was secreted into the medium, whereas when the two were cultured separately, MCP-1 levels were 1.0 and 0.9 ng/mL, respectively. Furthermore, the use of interleukin-1 beta (IL-1 beta)-pretreated HUVECs in cocultures induced twice the levels of MCP-1 as in unstimulated HUVEC culture. Conditioned medium had transendothelial chemotactic activity for monocytes, and this activity was completely abolished by addition of anti-MCP-1 antibody. Although MCP-1 mRNA levels were very low or undetectable in HUVECs or monocytes alone, message could be detected after 2 hours of coculture in total mRNA preparations from both monocytes and HUVECs. mRNA levels increased by 4 hours and had declined slightly by 24 hours. The rapid induction of message suggests that cell contact between monocytes and HUVECs induces the de novo synthesis of MCP-1 protein. Anti-interleukin (IL)-1 alpha/beta and anti-tumor necrosis factor-alpha antibodies, or anti-lymphocyte function-associated antigen-1 and very late antigen-4 antibodies, had little or no inhibitory effects on MCP-1 secretion by cocultures.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Adhesion Molecules↗

Differential effects of an alpha 1-blocker (doxazosin) on diurnal blood pressure variation in dipper and non-dipper type hypertension.

A study was conducted to determine whether sympathetic nerve activity, one of the main regulators of blood pressure, is involved in high blood pressure in the night-time and morning. Twenty-seven untreated hypertensive subjects, in whom hypertension was diagnosed by ambulatory blood pressure (ABP) measurement, who showed a 24 h systolic ABP value over 140 mmHg and/or 24 h diastolic ABP over 90 mmHg were recruited. They also showed a night-time systolic ABP value of over 130 mmHg and/or a night-time diastolic ABP of over 80 mmHg. They were divided into two groups: "dippers (D)" whose night-time ambulatory blood pressure fell by more than 10% of the day-time blood pressure, and "non-dippers (ND)" in whom this phenomenon was absent. We examined the effect of a long-acting alpha 1-blocker (doxazosin) on diurnal blood pressure variation in these subjects with essential hypertension. Baseline casual blood pressure and 24 h systolic ABP were not significantly different between the two groups. However, both night-time and morning ABP in ND were higher than those in D. Administration of doxazosin (mean 73 +/- 13 (SE) d) significantly decreased casual blood pressure, and 24 h, day-time, night-time and morning systolic ABP in the whole cohort. When subjects were divided into D and ND, the day-time and morning systolic ABP decreased significantly after doxazosin treatment in both groups, whereas the night-time systolic ABP decreased significantly only in ND but not in D. These results suggest that sympathetic nerve activity involved in elevating blood pressure during the night may differ between D and ND.

Adrenergic alpha-Antagonists↗

Nitric oxide synthesis in cardiac myocytes and fibroblasts by inflammatory cytokines.

OBJECTIVE: The aim was to investigate nitric oxide (NO) synthase activity in cultured neonatal rat cardiac myocytes and fibroblasts upon treatment with inflammatory cytokines interleukin 1 beta (IL-1 beta), tumour necrosis factor alpha (TNF-alpha), IL-2, IL-6, IL-8, transforming growth factor beta (TGF-beta) and gram negative bacterial lipopolysaccharide (LPS). METHODS: NO and guanosine 3',5'-cyclic monophosphate (cGMP) synthesis was measured in cultured neonatal rat cardiac myocytes and fibroblasts, using Griess reagent and an enzyme immunoassay kit, respectively. The expression of inducible NO synthase (iNOS) mRNA and protein was assayed by northern and western blotting, respectively. RESULTS: Incubation of cardiac myocytes for 24 h with IL-1 beta (10 ng.ml-1) or LPS (1 microgram.ml-1) caused significant increases in NO and cGMP production. TNF-alpha, IL-2, IL-6, IL-8, and TGF-beta showed no significant effect on their production. IL-1 beta induced NO and cGMP production in a time and dose dependent manner. IL-1 beta also increased iNOS mRNA and protein accumulation in cardiac myocytes. Simultaneous incubation of IL-1 beta with NG-monomethyl-L-arginine, genistein, calphostin C, cycloheximide, or actinomycin D completely inhibited the IL-1 beta induced NO production by cardiac myocytes. TGF-beta, dexamethasone, or cyclosporin A also dose dependently inhibited the IL-1 beta induced NO production. Exposure to IL-1 beta for 12-24 h decreased the beating rate of cardiac myocytes, but addition of dexamethasone completely overcame this inhibition. In contrast to cardiac myocytes, incubation of cardiac fibroblasts for 24 h with IL-1 beta or LPS showed no significant effect on NO or cGMP production. CONCLUSIONS: These observations suggest that IL-1 beta/LPS responsive iNOS, which is an important regulator of contractile function of the heart, is present in cardiac myocytes but not in cardiac fibroblasts.

Amino Acid Oxidoreductases↗

Effects of endogenous endothelial interleukin-8 on neutrophil migration across an endothelial monolayer.

OBJECTIVE: Recent studies suggest that interleukin-8 (IL-8) is involved in the neutrophil infiltration of subendothelial myocardial tissue in the ischaemia/reperfusion injury associated with acute myocardial infarction. The aim of this study was to investigate the effects of IL-8 on transendothelial neutrophil migration using an in vitro three dimensional double chamber migration assay system. METHODS: Human neutrophils were incubated with human endothelial cell monolayers for 1 h, and adherent and migrated neutrophils were then counted. Expression of IL-8 mRNA and secretion of its protein by endothelial cells were analysed respectively by northern blotting and ELISA. RESULTS: Recombinant human (rh) IL-8 (50 ng.ml-1) placed in the lower compartment significantly increased neutrophil adhesion 1.7-fold and transmigration 2.3-fold, compared with control conditions using medium alone in both compartments. In contrast, rh IL-8 (50 ng.ml-1) in the upper compartment significantly inhibited neutrophil adhesion and transmigration by 53% and 61% respectively compared with controls. Neutrophil adhesion and transmigration was dependent on the IL-8 concentration gradient between upper and lower compartments. Unstimulated endothelial cells showed no IL-8 expression, but endothelial cells pretreated with IL-1 beta (25 U.ml-1) markedly induced endogenous IL-8 mRNA and protein accumulation. When endothelial cells were cocultured with neutrophils, enhanced endogenous IL-8 production was observed. Pretreatment of endothelial cells with IL-1 beta for 4 and 24 h increased neutrophil transmigration 2.8-fold and 3.0-fold respectively, compared with unstimulated endothelial cells. The addition of anti-IL-8 monoclonal antibody (12.5 micrograms.ml-1) to the upper compartment with IL-1 beta-pretreated endothelial cells further enhanced transmigration from 2.8- to 3.3-fold and from 3.0- to 4.3-fold respectively. CONCLUSIONS: Endogenous endothelial IL-8, secreted from activated endothelial cells into the apical side of endothelial cell monolayers, has an inhibitory effect on transendothelial migration of neutrophils, suggesting that IL-8 may prevent excessive neutrophil infiltration of myocardial tissue from circulating blood in the reperfusion injury associated with acute myocardial infarction.

Blotting, Northern↗

Effects of inflammatory cytokines on vascular tone.

OBJECTIVE: To assess the direct effects of the inflammatory cytokines interleukin-2 (IL-2), interleukin-6 (IL-6) and interleukin-8 (IL-8) on vascular smooth muscle contraction. METHODS: Smooth muscle contractility was studied in the thoracic aorta isolated from male Sprague-Dawley rats. Syntheses of cAMP and nitric oxide (NO) were investigated in cultured rat vascular smooth muscle cells (VSMC). RESULTS: Pretreatment of the rings with IL-6 (10 ng/ml) for 180 min caused a significant inhibition of their contraction in response to 10(-5) M phenylephrine, wile Il-2 (10 ng/ml) and IL-8 (100 ng/ml) showed no significant effect on the contraction. The inhibitory effect of IL-6 exhibited a dose-dependency (0.1 approximately 10 ng/ml). In cultured rat VSMC, synthesis of cAMP was increased time-dependently by IL-6, while IL-2 and IL-8 failed to show any significant effects. IL-2, IL-6 and IL-8 did not affect the production of nitrite, a stable metabolite of NO, by VSMC. CONCLUSIONS: IL-6, but not IL-2 and IL-8, is a potent inhibitor of vascular contraction, which effect is mediated through the increased cAMP synthesis.

Animals↗

Nitric oxide release from rat aortic smooth muscle cells is not attenuated by angiotensin converting enzyme inhibitors.

We investigated the effects of angiotensin converting enzyme inhibitors on nitric oxide (NO) synthesis in cultured rat vascular smooth muscle cells. We measured the production of nitrite, a stable metabolite of NO, and the expression of inducible NO synthase mRNA by vascular smooth muscle cells. Incubation of the culture with interleukin-1 beta (10 ng/ml) for 24 h caused a significant increase in nitrite levels. The basal and interleukin-1 beta-induced nitrite production by vascular smooth muscle cells were not affected by the presence of angiotensin converting enzyme inhibitors (0.1 approximately 10 microM), enalaprilat, cilazaprilat or captopril. Unstimulated vascular smooth muscle cells expressed no inducible NO synthase transcripts, whereas incubation with interleukin-1 beta for 24 h induced marked inducible NO synthase mRNA expression. The angiotensin converting enzyme inhibitors, however, had no effects on the interleukin-1 beta-induced inducible NO synthase mRNA expression. These results indicate that angiotensin converting enzyme inhibitors do not attenuate NO synthesis by vascular smooth muscle cells under basal and interleukin-1 beta-stimulated conditions.

Amino Acid Oxidoreductases↗

Involvement of LDL receptor in the proliferation of vascular smooth muscle cells.

To study the involvement of the low-density lipoprotein (LDL) receptor in the growth of vascular smooth muscle cells (VSMC), we compared the proliferation of cultured VSMC from Watanabe heritable hyperlipidemic (WHHL) rabbits, which lack the LDL receptor, and VSMC from normal Japanese white rabbits in response to platelet derived growth factor (PDGF). The increase in the number of VSMC from WHHL rabbits in response to PDGF (10(-8) M) was significantly lower than that of VSMC from normal rabbits. PDGF stimulated the synthesis of DNA in VSMC from both normal rabbits and WHHL rabbits, but the response was significantly lower in the latter. To determine the involvement of the LDL receptor in the decreased mitogenic response of WHHL rabbit VSMC, we used an anti-LDL receptor monoclonal antibody (MAb) to normal rabbit VSMC; DNA synthesis of VSMC was stimulated by PDGF, but the effect was significantly blocked by the anti-LDL receptor MAb. Mitogen-activated protein (MAP) kinase activity in normal rabbit VSMC was increased by exposure to PDGF, but the effect was significantly suppressed in the presence of the MAb. The anti-LDL receptor MAb markedly inhibited LDL binding to the surface of normal rabbit VSMC. These results suggest that the LDL receptor influences the proliferation of VSMC and thus might be involved in the pathogenesis of atherosclerosis.

Animals↗

Noninvasive evaluation of the influence of aortic wave reflection on left ventricular ejection during auxotonic contraction.

To develop a noninvasive method for evaluating the influence of aortic wave reflection on left ventricular ejection, the carotid pulse wave and the pulsed Doppler wave in the left ventricular outflow tract were evaluated in 35 patients. Agreement between the pulsed Doppler waveform and the aortic flow velocity contour (obtained invasively) was verified by Fourier analysis. The carotid augmentation index was used to determine the magnitude of the aortic pressure wave reflection. A Doppler index named "DR1/3" was defined as the ratio of deceleration at the first one-third in the deceleration phase to the peak flow velocity of the pulsed Doppler. This index was validated by close correlation with the carotid augmentation index (n = 48, r = 0.70, P < 0.01). Both nitrates and nifedipine induced a significant decrease in DR1/3 (indicating an increase in left ventricular ejection flow) in relation to a reduction of the reflected pressure wave. The new noninvasive index, DR1/3, is useful in evaluating the influence of aortic wave reflection as part of the left ventricular afterload and in assessing the benefit of treatment aimed at reducing wave reflection.

Aorta↗