Biomedical subjects

H Noike

Publications and source records attributed to H Noike.

7 recordsLinked to original sources

PubMed1998

Preventive effects of an antiallergic drug, pemirolast potassium, on restenosis after percutaneous transluminal coronary angioplasty.

BACKGROUND: We recently confirmed that pemirolast potassium, an antiallergic agent, markedly inhibits migration and proliferation of vascular smooth muscle cells. It has also been reported that pemirolast inhibits intimal hyperplasia in animal experiments. METHODS AND RESULTS: To elucidate the preventive effects of pemirolast on restenosis after percutaneous transluminal coronary angioplasty (PTCA), 227 patients were enrolled in this prospective, randomized trial. A total of 205 patients who were compatible with the protocol were analyzed (pemirolast group, 104 patients with 140 lesions; control group, 101 patients with 133 lesions). Patients in the pemirolast group received 20 mg/d of pemirolast from 1 week before PTCA until the time of follow-up angiography (4 months after PTCA). Angiographic restenosis was defined as diameter stenosis >/=50% at follow-up. Restenosis rates were significantly lower in the pemirolast group than in the control group (24.0% vs 46.5% of patients, 18.6% vs 35.3% of lesions, P <.01, respectively). During 8 months of follow-up, there were no coronary events (death, myocardial infarction, coronary artery bypass surgery, or repeated PTCA) in 81.7% of the pemirolast group and in 63.4% of the control group (P =.013). CONCLUSIONS: This study suggested that pemirolast would be useful in the clinical setting to prevent restenosis after PTCA.

Aged↗

PubMed1997

[Effects of repetitive myocardial ischemia on collateral circulation, ST deviation and epicardial wall motion].

The effects of repetitive myocardial ischemia on collateral circulation, ST deviation and epicardial wall motion were examined in 12 patients undergoing percutaneous transluminal coronary angioplasty (PTCA) for single left anterior descending artery disease. Rentrop collateral filling grade was assessed using contrast injection to the contralateral artery during the first and final episodes of coronary occlusion. ST deviation was measured by intracoronary electrocardiography. Epicardial wall motion (%pre PTCA) was measured by guide wire motion analysis according to the centerline method. Collateral filling grade was assessed 30 sec after balloon inflation. The ST segment and the epicardial wall motion were measured 60 sec after balloon inflation and deflation, respectively. There was no change in the collateral filling grade between the first and final episode of coronary occlusion. Patients with collateral filling grade I (R-I group, n = 4), II (R-II group, n = 3) and III (R-III group, n = 5) during coronary occlusion showed mean ST segment shifts of 13.2, 9.4, and 0.9 mm, respectively, and mean epicardial wall motion of 41.4%, 67.2%, and 78.5%, respectively. The collateral filling grade correlated with ST deviation and epicardial wall motion, and there was a significant correlation between epicardial wall motion and ST deviation (r = -0.67). Comparison of the R-I group or severe ischemia (n = 4) and the R-III group or slight ischemia (n = 4) during coronary occlusion for the fourth time showed the effect of preconditioning was obtained in R-I group. More R-III group patients than R-I group had hyperkinetic epicardial wall motion during coronary reperfusion. Stunned myocardium was demonstrated in both R-I group and R-III group patients. Epicardial wall motion was poorer in the R-I group than R-III group. We concluded the following: There is no change in the grade of collaterals during repetitive coronary occlusion, and there is a relationship between the grade of collateral and degree of myocardial protection; there is good correlation between ST segment and epicardial wall motion; ischemic preconditioning is obtained during repetitive severe myocardial ischemia; recovery from brief episodes of slight myocardial ischemia is associated with hyperkinesia of epicardial wall motion; the reduction of stunned myocardium is related to the degree of premyocardial ischemia; preconditioning is sufficient to cause myocardial stunning, but myocardial stunning is insufficient to cause preconditioning.

Aged↗

PubMed1995

Partial type of common atrioventricular canal defect associated with mitral stenosis.

We report a 63-year-old woman, with a partial type of common atrioventricular canal and mitral stenosis, who was hospitalized because of dyspnea on exertion. Two-dimensional echocardiogram showed an ostium primum atrial septal defect with two well-formed AV valves located at the same level. However, both anterior and posterior mitral leaflets were markedly thickened with a thickened subvalvular apparatus, and the commisures were fused. Echocardiographic measurements demonstrated a mitral valve area of 1.48 cm2 with mild mitral regurgitation. Cardiac catheterization demonstrated mild pulmonary artery hypertension with a large left to right shunt (72%) at the atrial level. The combination of the partial type of common atrioventricular canal and mitral stenosis is rare; only one similar case has been reported previously in the literature.

Female↗

PubMed1995

Dilated cardiomyopathy associated with hyperthyroidism.

We report a case of dilated cardiomyopathy with hyperthyroidism. A 28-year-old man was admitted because of congestive heart failure and atrial fibrillation, and was newly diagnosed as having hyperthyroidism. Despite administration of antithyroid medication, he developed recurrent congestive heart failure. An echocardiogram revealed a moderately dilated left ventricle with diffuse hypokinesis. Though his thyroid function normalized, the patient's cardiac dysfunction did not improve. Beta-blocker therapy was begun with subsequent improvement in clinical symptoms. This suggests that beta-blocker treatment may be effective in patients with atrial fibrillation associated with cardiomyopathy and hyperthyroidism.

Adrenergic beta-Antagonists↗

PubMed1992

[Trial assessment of pain threshold].

To elucidate the pathological aspects of silent myocardial ischemia, we studied 24 patients with ischemic heart disease who had culprit lesions in the left anterior descending artery (LAD). We determined the presence of myocardial ischemia and measured coronary wedge pressures (CWP; mmHg) and collateral circulation and ST deviation on the ECG (intracoronary ECG: ic-ECG, and surface ECG; mm) after balloon inflation during PTCA intervention. The study subjects included 9 with exertional angina, 10 with post-infarction angina, and 5 with Cohn type II angina. During 78 balloon inflations, the group of ischemic symptoms (Group S) occurred in 40% of all cases, the group without ischemic symptoms (Group A) constituted 45%, and the Cohn type II specific for ischemic symptoms accounted for 15%. The relationship between CWP (X-axis) and ST deviation (Y-axis) of ic-ECG was: Y = -0.46X + 20.19 (r = -0.59; p < 0.01), and the relationship between CWP and ST deviation of the surface ECG was: Y = -0.12X + 6.58 (r = -0.42; p < 0.01). Thus, a negative correlation was confirmed between them. Furthermore, similar results were obtained for Groups S and A. Based on this relationship, the pain threshold was estimated. In Group S, CWP exceeded 34 mmHg, i.e., ischemia was expected to be mild because of good collateral circulation, but an average ST deviation accompanying ischemic symptoms was observed. However, in Group A, CWP was less than 24 mmHg, i.e., ischemia was expected to be severe due to poor collateral circulation, but an average ST deviation lacking ischemic symptoms was observed. Comparison of these results showed that the pain threshold observed from the ST deviation of ic-ECG was 6.0-6.5 mm and that of the surface ECG was 2.6-2.8 mm. From these threshold values, the ST deviations during 12 balloon inflations in the Cohn type II were evaluated. Because 100% of ic-ECG and 75% of surface ECG exhibited values exceeding the threshold values, it was concluded that the cause of the Cohn type II was an increase of the pain threshold. ST deviations of the ic-ECG for Group S and the Cohn type II were 12.0 +/- 6.7 and 9.8 +/- 2.7 mm, respectively, and ST deviations of the surface ECG were 4.7 +/- 2.4 and 3.5 +/- 1.7 mm, respectively. Since there were no significant differences between Group S and the Cohn type II, it was concluded that the ischemic degree of the Cohn type II was approximately the same as that of Group S.

Adult↗

PubMed1991

Multivessel PTCA using the hugging balloon technique based on single guide catheter and dual balloon-on-a-wire systems.

For percutaneous transluminal coronary angioplasty (PTCA) of oversized arteries, often-times a satisfactory dilatation cannot be achieved with conventional balloon systems due to the unavailability of adequately sized balloons. This fact has contributed to a higher restenosis rate for this group of patients. We were able to obtain a satisfactory dilatation result in an oversized right coronary artery with a shepherd's crook configuration and eccentric anatomy at the origin using two balloon-on-a-wire systems and an Amplatz type guiding catheter. Although such favorable dilatation of an oversized artery using this "hugging balloon technique" can be expected, issues do exist such as difficult maneuverability and estimation of the balloon size obtained through simultaneous dual balloon inflation wherein size does not simply equal the sum of the two balloon catheters. It is hoped that there will be further improvements of the technique and development of new systems. At this time, however, it is felt that this is the most effective and reasonable strategy to achieve a high chance of success in oversized vessel lesions.

Angioplasty, Balloon, Coronary↗

PubMed1982

[Mitral annular calcifications in patients with hypertrophic obstructive cardiomyopathy: an echocardiographic study].

From the echocardiographic files of 1,231 patients, eight revealed mitral annular calcification (MAC), in whom four had hypertrophic obstructive cardiomyopathy (HOCM). In the remaining four patients without HOCM, whose ages ranged from 69 to 80 years with a mean of 73 years, an additional calcification was observed in the either aorta or aortic valve. Therefore, MAC was thought to be a part of the aging process. Of the four patients with HOCM two were females (71 and 78 years, respectively) and two were males (50 and 51 years, respectively). The latter two younger male patients had MAC without another calcific lesion, and the cause of MAC was suspected as the pressure and/or mechanical strain on the mitral orifice due to excessive movements of either the chordae tendineae or papillary muscle.

Aged↗