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E Inoue

Publications and source records attributed to E Inoue.

At least 55 records · Page 3Linked to original sources

An adult case of arrhythmogenic right ventricular dysplasia.

A forty-year-old man was admitted to our hospital because of dizziness, palpitations and an oppressive feeling in the precordium. Physical examination was normal. A chest roentgenogram revealed mild cardiomegaly and the electrocardiogram showed ventricular tachycardia of a left bundle branch block configuration which was terminated by the intravenous injection of procainamide. During sinus rhythm the electrocardiogram showed incomplete right bundle branch block, PQ prolongation and inverted T waves in leads V1 through V3. Two-dimensional echocardiography revealed only moderate right ventricular dilatation. Right ventricular angiography showed severe right ventricular dilatation and hypokinesis of the right ventricular apex and pulmonary artery infundibulum. From these characteristics signs we concluded that this adult patient had arrhythmogenic right ventricular dysplasia (ARVD), suggesting that this condition is not confined to children but may occur in adults as well.

Adult

[Cardiac manifestation of the mucopolysaccharidoses: periodical echocardiographic evaluation in six cases].

Serial non-invasive studies including echocardiography were performed for the evaluation and follow-up of the cardiac lesions in six cases with genetic mucopolysaccharidoses. These cases were classified by the enzyme assay into one case of Scheie syndrome, three of Hunter syndrome, one of Sanfilippo syndrome and one of Maroteaux-Lamy syndrome. The echocardiographic examination revealed the most striking change in the mitral valve, which was progressive with increase of the age in most cases. The mitral valve echo was dense and multilayered with a decreased diastolic descent rate (DDR) in the M-mode echocardiogram, and its thick leaflets showed diminished opening on the two-dimensional echocardiogram. The aortic valve echo was also dense in three cases inducing one case with the prolapse of the non-coronary cusp into the left ventricular (LV) cavity. The pulmonary and tricuspid valves showed an unremarkable change, although the echocardiographic signs of pulmonary hypertension was observed in two cases. Diffuse hypertrophy of the interventricular septum and LV posterior wall was observed in five cases and apical hypertrophy was found in a case of Hunter syndrome (Case 2). Parameters of the LV contractility showed almost normal values but the distensibility of the LV posterior wall was impaired in two cases, suggesting stiffness of the cardiac muscle. Although no ischemic change was observed on the electrocardiogram, the echo density of coronary artery wall was not uniform on the two-dimensional echocardiogram and dilated coronary artery was found in two cases. Phonocardiograms disclosed an aortic regurgitant murmur in one case and an apical mitral regurgitant murmur in two cases. In one case of Scheie syndrome, a pansystolic murmur (Levine 3/6) and a mid-diastolic rumble (Levine 2/6) were present at the age of 15 and 16, but after the transient increase in the loudness these disappeared at the age of 18 and only an ejection systolic murmur is audible at the present time, while the mitral valve showed a progressive limitation of the movement on the two-dimensional echocardiogram. Contrary to the reduced DDR and diminished opening of the mitral valve in 3 cases, neither diastolic rumble nor opening snap was recognized in the phonocardiogram. The echocardiographic findings seemed to reflect the patho-anatomical manifestation of this disease, and thus, the periodical echocardiographic evaluation is rewarding to assess the cardiac lesions and their progression in mucopolysaccharidoses.

Adolescent

Multivariate analysis using a linear discriminant function for predicting the prognosis of congestive heart failure.

Some of cases of congestive heart failure (CHF) are intractable or refractory and respond poorly to conventional treatment. We have examined factors which may influence the clinical course and prognosis. The subjects were 114 hospitalized patients with CHF. Of these, 77 had a good response to treatment and were classified as the curative group (Group C) while the remaining 37 who were difficult to treat, including those with poor prognosis, were designated the refractory group (Group R). Of the various clinical background factors including the findings of laboratory and other examinations, the following 8 variables made a significant contribution to differentiation between the 2 groups: 1) heart rate (X1), 2) hemoglobin content (X2), 3) serum K (X3), 4) serum total protein (X4), 5) A/G (X5), 6) BUN (X6), 7) grade of hepatomegaly (X7), and 8) number of previous CHF episodes (X8). The linear discriminant function represented by the following equation using these 8 variables showed an excellent result in differentiating the 2 groups. Y = - 9.64 - 0.0686X1 + 0.345X2 + 1.351X3 + 1.513X4 + + 1.988X5 - 0.0876X6 - 0.792X7 - 0.737X8. When Y value is over 0, Group C is judged. When Y value is under 0, group R is judged. We concluded that the discriminant equation covering these 8 factors is a useful means of predicting the prognosis in CHF and the response to treatment.

Adult

Antihypertensive effects of the calcium antagonistic agent nifedipine.

The calcium antagonist nifedipine (Adalat) was administered to 60 patients with essential hypertension and investigations were performed on acute and chronic hypotensive effects. The following results were obtained: 1. Acute hypotensive effects: Nifedipine (20 mg) was either orally or sublingually administered. Following oral administration, significant hypotensive effect was attained 20 min after administration and the maximum hypotensive response was obtained 2-4 h after administration. In cases of sublingual administration, significant hypotensive effect was notable 5 min after administration and blood pressure reached the lowest level 2-3 h after administration. The hypotensive effects lasted for a relatively longer period and significantly lower blood pressure than the control level was observed even 3 h after administration. 2. Chronic hypotensive effects: Nifedipine (30-60 mg/d) was orally administered consecutively. Significant hypotensive effect was attained in and after the 4th week of administration. The yearly changes in the long-term administration cases over 3 years demonstrated significant hypotensive effects. The cases who did not respond to single administration of thiazides or beta-blockers exhibited significant hypotensive response by the combined use of nifedipine. 3. Change in heart rate: In the acute study, heart rate increased after nifedipine administration and lasted for several hours. In the long-term administration cases, the changes in heart rate were not significant. 4. Side effects attributable to nifedipine such as headache in 2 cases, facial flushing, palpitation, warm sensation and nausea in 1 case each were observed early after the administration but there were no cases in whom administration was discontinued due to these side effects.

Administration, Oral

[Assessment of hypertrophic cardiomyopathy by ECG gated cardiac computed tomography (author's transl)].

The applicability of ECG gated cardiac computed tomography (CT) in 12 patients with hypertrophic cardiomyopathy was examined. Six of the 12 patients had hypertrophic obstructive cardiomyopathy, including one patient with mid-ventricular obstruction. Three of the 12 patients had hypertrophic non-obstructive cardiomyopathy, and three had apical hypertrophic cardiomyopathy. The diagnosis of hypertrophic cardiomyopathy was confirmed by the angiocardiogram in all patients. Cardiac CT was performed after intravenous administration of contrast media usually given as a bolus injection. The gantry was set with positive 20 degree tilt angle. In all patients with hypertrophic obstructive cardiomyopathy except for mid-ventricular obstruction, the hypertrophied interventricular septum in the basal and mid portions was observed, and the left ventricular cavity was narrowed in systole. In a patient with mid-ventricular obstruction, the marked hypertrophied interventricular septum and antero-lateral papillary muscle were observed. In diastole, the left ventricular cavity was narrow and divided into two parts. The apical cavity was completely disappeared in systole. In all patients with hypertrophic non-obstructive cardiomyopathy, the diffuse hypertrophied interventricular septum was observed in diastole. In systole, the apical portion of the left ventricular cavity was markedly narrow and anterio-lateral papillary muscle was hypertrophic. In all patients with apical hypertrophic cardiomyopathy, the marked apical hypertrophy of the left ventricular wall was observed in diastole. It is concluded that ECG gated cardiac CT could estimate myocardial wall motion and thickness and differentiate the types of hypertrophic cardiomyopathy each other.

Adult

[Clinical usefulness of RI angiography using amplitude image and phase image by Fourier analysis for the detection of anteroseptal myocardial infarction (author's transl)].

In 19 patients with anteroseptal myocardial infarction, the wall motion of interventricular septum was analyzed by RI angiography using the amplitude image and the phase image. Both images were obtained from ECG gated blood pool data by Fourier analysis. Namely, from the first harmonic in the Fourier series, the heart motion was detected as the amplitude and phase of time-activity curve in each pixel. The distribution of the amplitudes and phases were displayed in color scale, and then both the amplitude and phase images were acquired. Those images allowed us visualization of the ischemic area, even if the scar was parallel to the detector. Moreover, we were able to assess the wall motion of the entire interventricular septum and to distinguish hypokinetic region and dyskinetic region from the hypokinetic region with shift of phase estimated by conventional method. Abnormal region detected by those images closely corresponded with the region of decreased radioisotope concentration in thallium-201 myocardial scintigram.

Adult

[Evaluation of myocardial infarction by ECG gated cardiac computed tomography (author's transl)].

ECG gated cardiac computed tomography (cardiac (T) was performed in 9 cases with old myocardial infarction. Seven of these had anterio-septal infarction, one had inferior wall infarction and the remaining one had posterior wall infarction. All were investigated by left ventriculography and coronary arteriography. Cardiac CT was performed after intravenous administration of contrast medium usually given as a bolus injection. The infarcted myocardium was thin and showed abnormal wall motion in cardiac CT, but the motion did not always coincide with left ventricular cineangiographic findings. In 3 cases, mural thrombi at the left ventricular apex were observed by cardiac CT, and in 2 of which the thrombi were confirmed by left ventriculography. In 2 cases, cardiac CT showed stasis of contrast medium and aneurysmal formation in the left ventricular cavity and the aneurysms were confirmed by left ventriculography. Sequential 8 mm thick non-ECG gated cardiac CT scans from the cardiac apex to the base were performed in 7 cases with anterio-septal infarction, and the infarcted area were observed in the anterior interventricular septum in 6 cases. We concluded that cardiac CT was a useful noninvasive method to detect abnormal wall motion, abnormally thin wall, mural thrombus and left ventricular aneurysm in old myocardial infarction.

Adult

[Twins. 2].

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Female