Biomedical subjects

A Hoshio

Publications and source records attributed to A Hoshio.

26 records · Page 2Linked to original sources

PubMed1989

Significance of coronary artery tone in patients with vasospastic angina.

To investigate the relation between basal coronary artery diameter and development of coronary artery spasm, the diameters of the proximal, middle and distal segments of the three major coronary artery branches, together with that of the left main trunk, were measured on a control angiogram and after ergonovine and nitrate administration in 30 patients with vasospastic angina without significant organic stenosis, and in 35 patients without ischemic heart disease. The percent change in coronary diameter after ergonovine and nitrate administration compared with the control diameter was used as an index of coronary vasoreactivity. In patients with vasospastic angina, coronary artery responses to both ergonovine and nitrate were greater in the spastic segments than in the other segments (p less than 0.05), and those of the coronary arteries without spasm were greater than those of the coronary arteries in patients without ischemic heart disease (p less than 0.01). There were no significant differences between the coronary artery diameters in the two groups after nitrate administration, and the control diameters were less in patients with vasospastic angina than in patients without ischemic heart disease. These observations indicate that a coronary vasomotion disorder, which involves increased basal coronary artery tone and hypersensitivity to vasoconstrictive stimuli, not only at a localized segment but also in the entire coronary artery tree, is present in patients with vasospastic angina. Clinically, evaluation of basal coronary artery tone may be useful for predicting the occurrence and location of coronary artery spasm.

Adult↗

PubMed1989

Transient QRS axis shift to the right during right coronary artery and/or left circumflex artery spasms.

The QRS axis was measured in 24 patients during ergonovine malate provocation test (EM test). Of 12 patients with significant spasm of the right coronary artery (RCA) and/or left circumflex artery (LCX), the QRS axis shifted to the right in 7 patients after the EM test (mean 8.2 degrees), and the axis shifted back to the left in 9 patients after nitroglycerin administration (mean -9.1 degrees). The sensitivity of right axis shift for RCA and LCX spasm was 58% and the specificity was 80%. Thus, right axis shift seems to be associated with myocardial ischemia due to RCA and LCX spasm and to be useful for the detection of RCA and/or LCX spasms.

Coronary Vasospasm↗

PubMed1989

Differences in urate metabolism between normouricemia and hyperuricemia in coronary heart disease in man.

We examined hyperuricemia in patients with coronary heart disease. In 85 patients with coronary sclerosis confirmed by coronary angiography, the serum urate level (6.08 +/- 1.60 mg/dL) was not different from that in subjects with normal coronary arteries (6.47 +/- 1.69 mg/dL). The incidence of hyperuricemia in patients with coronary sclerosis was 26%, and was significantly correlated with diuretics, obesity and hypertriglyceridemia, but not with hypertension or hypercholesterolemia. To elucidate the mechanism of urate metabolism in coronary sclerosis, we separated coronary sclerosis patients without complicating factors into hyperuricemics and normouricemics, and studied urate metabolism in comparison with subjects with normal coronary arteries. We found that normouricemics with coronary sclerosis had decreases in the filtered urate load and urate clearance with a normal urate-creatinine clearance ratio. Hyperuricemics with coronary sclerosis had decreases in urate clearance and urate-creatinine clearance ratios, but the filtered urate load was similar to that in normouricemics. It is suggested that in coronary sclerosis patients, normouricemics had a low glomerular filtration of urate with normal tubular urate transport, whereas hyperuricemics had enhanced tubular reabsorption of urate without any difference of urate filtration from normouricemics.

Coronary Disease↗

PubMed1988

The usefulness of exercise-induced QRS axis shift as a predictor of coronary artery disease.

The QRS axis of 101 patients with coronary artery disease (CAD) and 57 normal subjects without CAD who underwent coronary arteriograms were measured before and after exercise testing. There was no improvement in the sensitivity of positive axis shifts (15 degrees or greater) for CAD (18%) when compared to the value of positive ST depression (61%). However, the specificity of positive axis shifts for CAD was significantly increased (98%) when compared to the value of positive ST depression (77%). In addition, 39% of those patients with CAD (39 of 101) showed false negative ST depression, but 18% of these patients (7 of 39) showed a positive axis shift. In normal subjects 21% (12 of 57) showed false positive ST depression, but all of the 21% (12 of 12) showed negative axis shift. There was no significant difference in the increments of heart rate between positive ST depression, positive axis shift, and negative ST depression, negative axis shift. No statistical differences in the sensitivity of ST depression and an axis shift for one-, two- and three-vessel diseases were noted. The specificity of left-axis shift for the left anterior descending artery lesion was 98% and the specificity of right-axis shift for the right coronary artery and/or left circumflex artery lesion was 91%. Therefore, the axis shift response is no more sensitive for the detection of CAD than ST depression. However, when a positive axis shift is observed, one can predict two things: the CAD and the localization of the coronary stenosis.

Arrhythmias, Cardiac↗

PubMed1988

Two cases of coronary artery spasm induced by indocyanine green.

There is no evidence in the literature that coronary artery spasm is induced by indocyanine green (ICG). In the present report, we describe 2 cases who developed chest pain with transient ST elevation on electrocardiograms after intravenous administration of ICG.

Aged↗

PubMed1988

[Coronary artery tone assessed by the administration of ergonovine maleate and nitrates].

Angiographic changes caused by administering ergonovine maleate (EM) and nitrates were quantitated in 136 patients without significant coronary artery disease. Percent coronary artery (CA) narrowing was calculated in 67 patients with a negative EM test (Group A) and 69 patients with a positive EM test (Group B) as follows: (Formula; see text) In both groups, coronary artery narrowing before and after EM did not differ among the proximal, middle or distal segments of each coronary artery. The measurements of the right coronary artery were greater than those of the left anterior descending artery (p less than 0.01 after EM, p less than 0.05 before EM), and those of the left main trunk were markedly less than those of the other coronary arteries (p less than 0.01). In both groups, coronary narrowing after EM administration was greater than before administration (p less than 0.01). Initial coronary narrowing in Group B was also greater than in Group A (p less than 0.01), similar to the responses for EM. In 19 patients with coronary artery spasm provoked by EM coronary artery narrowing before and after EM was 37 +/- 12% and 69 +/- 23% for coronary arteries with spasm, and 30 +/- 13% and 42 +/- 16% for those without spasm. Not only after, but also before EM administration, coronary narrowing was greater in the arteries with spasm than in those without spasm (p less than 0.01). Furthermore, the arteries without spasm showed greater sensitivity to EM and nitrates than did the arteries of the control patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Vessels↗

PubMed1987

Cardiac involvement in a patient with limb-girdle muscular dystrophy.

A case of limb-girdle muscular dystrophy with cardiomegaly, electrocardiographic abnormalities, and paroxysmal ventricular tachycardia was described. Some of the interesting electrocardiographic features were discussed, and the importance of serial electrocardiograms for the detection of cardiac involvement is emphasized, since acute disturbances in cardiac rhythm may indicate that the patient is in immediate danger of sudden death.

Cardiomegaly↗

PubMedDate not supplied

Ebstein's anomaly with non-patent ductus arteriosus aneurysm and bradycardiac atrial fibrillation in an 80-year-old man.

An 80-year-old man with Ebstein's anomaly and ductus arteriosus aneurysm is reported. He was admitted with bradycardiac atrial fibrillation and right ventricular failure. For the control of brady-arrhythmia, a permanent pacemaker was implanted. Two-dimensional echocardiogram revealed distal displacement of the septal tricuspid valve. Aortography and computed tomography showed ductus arteriosus aneurysm. This is the first report of the association of Ebstein's anomaly and non-patent ductus arteriosus aneurysm.

Aged↗