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A Shiina

Publications and source records attributed to A Shiina.

31 records · Page 2Linked to original sources
PubMed1984

Two-dimensional echocardiographic spectrum of Ebstein's anomaly: detailed anatomic assessment.

This report details the two-dimensional echocardiographic assessment of 41 patients with Ebstein's anomaly. The anatomic spectrum of Ebstein's anomaly is correlated with surgical and autopsy observations in 66% of these patients. Morphologic abnormalities of the tricuspid valve and right heart structures were uniquely assessed by noninvasive two-dimensional echocardiographic examination. Features of the tricuspid valve that best related to decreased functional capacity were: 1) absence of the septal leaflet, and 2) pronounced tethering, restriction of motion and displacement of the anterior leaflet of the tricuspid valve. This 4 1/2 year experience suggests that two-dimensional echocardiography can replace angiography as the procedure of choice for diagnostic and morphologic assessment of Ebstein's anomaly. Cardiac catheterization is necessary only when specific hemodynamic questions or clinical inconsistencies exist.

Adolescent↗
PubMed1983

Two-dimensional echocardiographic--surgical correlation in Ebstein's anomaly: preoperative determination of patients requiring tricuspid valve plication vs replacement.

Two-dimensional echocardiographic features were correlated with surgical findings in 25 patients with Ebstein's anomaly (age 7 days to 71 years). There was excellent agreement between echocardiographic and surgical findings. Echocardiographic observations of anterior leaflet tethering and restriction of motion, as well as small functional right ventricle, were the strongest noninvasively obtained indicators for valve replacement surgery. Plication/annuloplasty (plastic repair) was performed in 17 patients. This group differed from the group needing valve-excision surgery in that the anterior leaflet was elongated, was not tethered, and showed large excursion. These observations support the use of two-dimensional echocardiography as an excellent means for preoperative anatomic assessment of Ebstein's anomaly. This method allowed us to determine which patients were amenable to tricuspid valve excision or plastic repair. A noninvasively derived index of anatomic severity is proposed for easier recognition of patient subgroups.

Adolescent↗
PubMed1982

[Hemodynamic significance of the A/E ratio and B-B' step formation on the mitral valve echogram in patients with myocardial infarction].

We evaluated the hemodynamic significance of a B-B' step (shoulder) formation and the A/E ratio of the mitral valve echogram in 31 cases with myocardial infarction. Left ventricular (LV) motion and pressures were analyzed by cardiac catheterization, and were compared with the value of the A/E ratio and the presence or absence of the B-B' step. The B-B' step with its ratio to A wave of 0.5 or more in height was regarded as abnormal: 1) A LV pressure increase by atrial contraction was greater than 10 mmHg in 10 cases with abnormal B-B' step, whereas it was smaller than 9 mmHg in 14 cases without the abnormal B-B' step. 2) While the abnormal B-B' step was recognized in all seven cases who showed akinesis of the LV wall motion in both the anterior and apical portions, it was not seen in 12 of 13 cases who showed hypokinesis in both areas. The B-B' step was also seen in four of six cases who showed diffuse hypokinesis (more than 3 areas of LV wall segments by definition of the American Heart Association). 3) The B-B' step was not seen in any cases with the A/E ratio greater than 0.85 and all these cases had hypokinetic areas less than two segments. In contrast, the B-B' step was recognized in five of six cases with the A/E ratio smaller than 0.7. They had extensive hypokinetic areas more than three segments. We conclude that a B-B' step and the A/E ratio of the mitral valve echogram would be valuable indicators suggesting decreased left ventricular diastolic compliance and is useful in predicting the severity and extent of myocardial asynergy in cases with myocardial infarction.

Blood Pressure↗
PubMed1981

[Echocardiographic evaluation of the left ventricular contraction in cases with atrial fibrillation (author's transl)].

Echocardiographic studies were performed in order to examine the effect of preceding R-R interval (PI) and pre-preceding R-R interval (PPI) on the changes in end-diastolic and end-systolic dimensions (Dd and Ds) in 12 patients with atrial fibrillation. As PI prolonged, Dd increased and Ds decreased, however, these were constant at the PI of more than 0.80 up to 1.20 sec. At the PI of less than 0.80 sec, Dd and Ds showed a wider range of distribution. When PPI remained constant, Dd increased and Ds decreased with the prolongation of PI. When PI was kept constant, Dd increased and Ds decreased as PPI became shorter. The greater the degree of PPI shortening and PI prolongation, the larger the increase of Dd and decrease Ds. Thus, the change of contractile state of the left ventricle in atrial fibrillation was affected not only by the preload of the individual PI, but also by that of the PPI. This is thought to be the same mechanism as in post-extrasystolic potentiation.

Adult↗
PubMed1981

[Evaluation of systolic motion of the pulmonic valve with special reference to pulmonary arterial pressure and flow velocity (author's transl)].

To predict pulmonary arterial pressure non-invasively, systolic motion of the pulmonic valve was evaluated in relation to flow velocity at the pulmonic valve measured by the electromagnetic catheter-tip flow velocity probe or by linear contrast echo. Seventy-five cases including 45 cases with pulmonary hypertension (PH) of mean pulmonary arterial pressure (PAP) above 25 mmHg were studied. On the basis of the presence and velocity of mid-systolic semi-closure, the reopening and fluttering of the PV, the systolic motion of the pulmonic valve was classified into the following 5 types: 1) rapid semi-closure followed by reopening, 2) rapid semi-closure without reopening, 3) slow semi-closure followed by slow reopening, 4) rough fluttering during whole systole, and 5) rapid opening without semi-closure. Results were as follows: (1) In all cases in which mean PAP was normal, PV motion could be classified as type 5, (2) In 45 PH cases, mean PAP was 50.2 +/- 8.3 mmHg in type 1, 38.4 +/- 5.5 mmHg type 5, mean PAP was 16.3 +/- 11.7 mmHg when 30 normal cases were added. Flow velocity at the PV orifice was maximum in type I and decreased in type 2, 3 and 4 in this order. In type 4, cardiac indices were minimum in all groups of pulmonary hypertension. In conclusion, 1) systolic pulmonic valve motion is of value to predict PAP, and 2) it was suggested that mid-systolic semi-closure of the PV is related to increase in flow velocity at the PV orifice.

Blood Flow Velocity↗
PubMed1980

Uremic pericardial effusion: detection and evaluation of uremic pericardial effusion by echocardiography.

Echocardiography (UCG) was performed prior to and during hemodialysis therapy to detect and evaluate volumetrically the grade of pericardial effusion in 150 patients with chronic renal failure. The actual incidence of uremic pericardial effusion during the observation period was 62% and was higher during the first 3 months of therapy than at later stages. Pericardial effusion was classified from grade 0 (no effusion) to grade 5 (massive effusion). We compared the grade of effusion with laboratory test results, blood pressure, cardiothoratic ratio, left atrial and ventricular dimensions, and thickness of the intraventricular septum and left ventricular posterior wall. Significant differences between the patients with and without effusion were detected in the degree of systolic hypertension, dilatation of the left atrial chamber, anemia and hypoproteinemia. There was no correlation between the grade of effusion and creatinine, uric acid and calcium levels and changes of body weight. Our results confirm that insufficient dialysis as indexed by the degree of hypoproteinemia, anemia, hypertension and central overhydration, may play a role in the etiology of uremic pericardial effusion.

Adolescent↗
PubMedDate not supplied

Predicting the severity of coronary lesions by the continuous recording method of exercise two-dimensional echocardiography.

We estimated the severity of coronary artery disease by the continuous-recording method of exercise two-dimensional echocardiography (Ex.2DE) in 56 patients with angiographically significant coronary artery stenosis ( > 50% diameter narrowing) who had undergone both Ex.2DE and coronary angiography. Patients were divided into two groups on the basis of findings of coronary angiography: group 1 had 50% to 89% stenosis (n = 24) and group 2 had 90% or greater stenosis (n = 32). The sensitivity and specificity of Ex.2DE for the detection of ischemic segments were 82% and 88%, respectively in the overall patient population. The sensitivity was 67% in group 1 and 94% in group 2. Hyperkinesis occurred at the beginning of exercise in 21 (88%) of 24 patients in group 1 and 15 (47%) of 32 patients in group 2 (p < 0.05). Our findings demonstrated that patients who did not show hyperkinesis at the beginning of exercise had more severe coronary artery disease. Careful observation of serial wall motion during exercise by the continuous-recording method may provide important information about myocardial ischemia.

Adult↗
PubMedDate not supplied

Prediction of prognosis of patients with idiopathic dilated cardiomyopathy: a comparison of echocardiography with cardiac catheterization.

The prognostic values of indices obtained by M-mode and two-dimensional echocardiography (Echo) and by cardiac catheterization (Cathe) were assessed in patients with idiopathic dilated cardiomyopathy. Fifty-one patients with this disorder (38 males and 13 females) were studied for an average of 4.2 years. Of those, 24 died of cardiac causes during follow-up. The overall 5-year survival rate was 49%. Significant differences between the surviving patients and the patients who died were noted in the following indices measured by Cathe: left ventricular end-diastolic volume (LVEDV), left ventricular end-diastolic pressure (LVEDP), ejection fraction (EF), and the cardiac index (CI). The 5-year survival rate in patients with the following index values measured by Cathe at the initial examination were: LVEDV greater than or equal to 150 ml/M2 - 29%; LVEDP greater than 12 mmHg - 35%, EF less than 30% - 21%, and CI less than 3.0 L/min/M2 - 29%. In contrast, the 5-year survival rate in patients with the following parameter values measured by Echo were: left ventricular end-diastolic dimension greater than or equal to 45 mm/M2 - 16%; left atrial dimension greater than or equal to 25 mm/M2 - 12%; ejection fraction less than 30% - 31%; and a relative wall thickness (a ratio of left ventricular posterior wall thickness to left ventricular end-diastolic dimension) less than or equal to 0.12 - 9%. In assessing the cumulative survival rate, the indices provided by Echo revealed similar values when compared with those obtained by Cathe. The relative wall thickness determined by Echo would be the most reliable parameter for forecasting the 5-year survival rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗