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K Machii

Publications and source records attributed to K Machii.

At least 109 records · Page 6Linked to original sources
PubMed1983

[Two-dimensional echocardiographic observation of a rapidly growing floating left atrial ball thrombus: report of a case with mitral stenosis].

This report dealt with a rapidly growing ball thrombus floating in the left atrium in a case with mitral stenosis detected by serial two-dimensional echocardiography and confirmed at operation. A 45-year-old female was admitted to our hospital on January 7, 1982 because of dyspnea, orthopnea and fever. On admission she had typical auscultatory signs of mitral stenosis, and her chest roentgenogram revealed slight pulmonary venous congestion and marked left atrial enlargement. Laboratory findings including complete blood counts, coagulation studies and blood chemistry were normal except a positive CRP test. Two-dimensional echocardiography performed on January 8 revealed a tight mitral stenosis with the mitral orifice area of about 0.9 cm2, and a floating ball thrombus in the left atrium, which was 2.5 X 3 cm in size. Fuzzy echoes flowing slowly around the thrombus were also observed. Intravenous administration of heparin was started immediately. In the next morning (January 9), the two-dimensional echocardiography was reexamined, which revealed a markedly growing thrombus which became 4 X 4 cm in size. Several hours after the reexamination mitral valve replacement was performed. The removed thrombus was 5.5 X 7 cm in size and consisted of three laminated structures. This finding was consistent with the echocardiographic observations. Coagulation studies made just before operation showed increased coagulability. Increased stagnation of blood in the left atrium due to heart failure and a transient increase of blood cell aggregation and coagulability induced by preceding infection might be responsible for the genesis of such a thrombus.

Echocardiography↗
PubMed1982

Quantitative estimation of the right ventricular overloading by thallium-201 myocardial scintigraphy.

Thallium-201 myocardial scintigraphy was performed on 55 patients with various types of right ventricular overloading. The right ventricular (RV) free wall was visualized in 39 out of the 55 patients (71%). The mean values of right ventricular systolic pressure (RVSP) and pulmonary artery mean pressure (PAMP) in the visualized cases (uptakers) were 54.6 +/- 24.1 and 30.5 +/- 15.3 mmHg, respectively. These values were significantly higher than those of the non-visualized cases (non-uptakers). There were 12 RVSP-"normotensive" uptakers and 15 PAMP-"normotensive" uptakers. The RV free wall images were classified into three types according to their morphological features. Type I was predominantly seen in cases of RV pressure overloading, type II in RV volume overloading and type III in combined ventricular overloading. RVSP in the type III group was significantly higher than that in other two groups. The radioactivity ratio in RV free well and interventricular septum (IVS), the RV/IVS uptake ratio was calculated using left anterior oblique (LAO) view images. The RV/IVS uptake ratio closely correlated with RVSP and PAMP (r = 0.88 and 0.82, respectively). In each group of RV free wall image, there were also close correlations between the RV/IVS uptake ratio and both RVSP and PAMP. Our results indicate that the RV/IVS uptake ratio can be used as a parameter for the semi-quantitative estimation of right ventricular overloading.

Adolescent↗
PubMed1982

[Effects of beta-blockers and Ca antagonists on diastolic function of the hypertrophied left ventricle: an echocardiographic study].

Left ventricular (LV) relaxation was studied in patients with hypertensive heart disease with LV hypertrophy (HHD, n = 25) and hypertrophic cardiomyopathy (HCM, n = 9), and these data were compared with that of normal controls (n = 20). The effects of oral administration of propranolol (n = 11), pindolol (n = 3), nifedipine (n = 6) and diltiazem (n = 5) in patients with HHD and that of propranolol (n = 9) in patients with HCM were also studied. Isovolumic relaxation time (IRT) was measured using dual M-mode echocardiography and peak normalized rate of change of the LV cavity in early diastole (peak dD/dt/D) was calculated by M-mode echocardiography using a digitizer and microcomputer system. IRT was significantly longer in HHD (112 +/- 24 msec, p less than 0.001) and in HCM (85 +/- 40 msec, p less than 0.05) compared with that of normal subjects (64 +/- 24 msec). The normal value of peak dD/dt/D was 3.8 +/- 0.7 sec-1, and it was significantly lower in HHD (2.7 +/- 0.8 sec-1, p less than 0.001). It was also lower in HCM (3.2 +/- 0.8 sec-1), but without a statistical significance. In HHD there was a significant relationship (r = -0.611, p less than 0.01) between peak dD/dt/D and wall thickness of the LV (interventricular septum + LV posterior wall). There was no significant change in IRT before and after the administration of beta-blockers and calcium antagonists except nifedipine in HHD (before: 116 +/- 28 msec, after: 80 +/- 14 msec, p less than 0.005). It was probably due to the effect of an accompanied decrease in heart rate. However, peak dD/dt/D was significantly increased in both HHD and HCM groups after the administration of propranolol, pindolol, nifedipine and diltiazem. These data show that LV relaxation is abnormal in the hypertrophied LV. Although the genesis of this abnormality is not clear, there seems to be a close relationship between the relaxation abnormality and increased LV mass in HHD. Oral administration of propranolol, pindolol and diltiazem for patients with HHD and propranolol for patients with HCM seems to improve the abnormal LV relaxation of each disease.

Adrenergic beta-Antagonists↗
PubMed1982

[Comparative studies on right ventricular pressure and volume overloading by thallium-201 myocardial scintigraphy].

Thallium-201 myocardial scintigraphy was performed in 44 patients with various heart diseases including mitral stenosis (MS), atrial septal defect (ASD), primary pulmonary hypertension (PPH), and left atrial myxoma. The morphological findings of right ventricular (RV) free wall on the scintigram and RV/IVS (interventricular septum) uptake ratio of the images obtained from the left anterior oblique projection were studied in the patients with RV pressure or volume overloading. The RV free wall was visualize by scintigraphy in 13 out of 22 patients (59%) with MS, and in 15 out of 17 patients (88%) with ASD. In 5 patients with PPH or left atrial myxoma, the RV free wall was visualized in all cases. The patterns of RV free wall image were classified into three types. Type I with the smaller right ventricle than left ventricle was mainly seen in cases of MS, and type II with the dilated right ventricle was seen in cases of ASD and PPH. The RV free wall was visualized in most of the patients with MS whose RV systolic pressure (RVSP) was higher than 35 mmHg and mean pulmonary artery pressure (PAMP) was 20 mmHg or more, and with ASD whose RVSP was higher than 30 mmHg and PAMP was 10 mmHg or more. The ratio of radioactivity on the RV free wall and interventricular septum (RV/IVS uptake ratio) was calculated using 45 degree left anterior oblique view images. The RV/IVS uptake ratio ranged from 0.38 to 0.73 in the cases with MS, from 0.40 to 0.77 in the cases with ASD, and from 0.64 to 0.79 in the cases with PPH. In two cases with left atrial myxoma, the ratio was 0.50 and 0.55, respectively. The RV/IVS uptake ratio was compared to various hemodynamic parameters in right ventricular overloading. In the cases with MS, the RV/IVS uptake ratio was closely correlated with RVSP (r = 0.93: p less than 0.001), PAMP (r = 0.92; p less than 0.001), pulmonary capillary wedge pressure (PCWP) (r = 0.83: p less than 0.01), RV work index (RVWI) (r = 0.82: p less than 0.001), and pulmonary vascular resistance (PVR) (r = 0.71: p less than 0.01), respectively. In the cases with ASD, the RV/IVS uptake ratio was closely correlated with RVSP (r = 0.89: p less than 0.001), PAMP (r = 0.68: p less than 0.01), PVR (r = 0.77: p less than 0.01), and a left-to-right shunt ratio (r = 0.785: p less than 0.001). It was concluded that the analysis of thallium-201 myocardial scintigraphy is valuable as a non-invasive technique for the qualitative and quantitative estimation of RV pressure or volume over-loading.U

Adult↗
PubMed1982

[Evaluation of left ventricular asynergy by parasternal and subcostal M-mode echocardiography].

In 47 patients with old myocardial infarction (MI), parasternal and subcostal M-mode echocardiograms (M-mode) guided by the two-dimensional echocardiogram (2D) were recorded to evaluate left ventricular asynergy quantitatively, and were compared with 2D findings. By placing the transducer at the left sternal border, the short-axis views of the left ventricle (LV) by 2D at the level of the chorda tendineae and papillary muscle were recorded. The LV wall was divided into 4 segments; including (1) anterior wall (AW) and anterior septum (AS), (2) lateral wall (LW), (3) posterior wall (PW), and (0) inferior wall (IW) and posterior septum (PS), and asynergy was analyzed on moving images. The AS and PW were recorded by parasternal M-mode, and the PS and LW were recorded by subcostal approach. Asynergy by M-mode was defined when septal amplitude was less than 3 mm, LW or PW amplitude was less than 9 mm, % systolic thickening (% ST) of the septum was less than 17%, and % ST of the LW or PW was less than 25%. Of 25 patients with anterior MI, asynergy of the AW and AS wass s present in 19, LW asynergy in 10, PW asynergy in 2, and IW and PS asynergy in 1 by 2D, meanwhile, M-mode detected asynergy of AS in 21, and LW asynergy in 15. Of 15 patients with inferior MI, asynergy of the PW and PS was present in 4 and 7, respectively by 2D, but by M-mode asynergy was present in 11 and 14, respectively. In 31 patients underwent left ventricular cineangiography, detection rate of asynergy by angiography was compared with that by echocardiography. In 124 segments by cineangiography, wall motion characteristics were correctly identified in 83% by 2D and 91% by M-mode. Of 25 patients with anterior MI, amplitude of the AS was 3 approximately -5 mm in 19, and %ST of the AS wa 0 approximately 6% in 2, but amplitude of the PS was within normal range in 24. Of 15 patients with inferior MI, amplitude of the AS was within normal range in all, and amplitude of PS was 3 approximately -8 mm in 13 and %ST of PS was 10% in 1. This study shows that combined use of parasternal and subcostal M-mode detects asynergy more sensitively than 2D alone even in its quantitative sense, and therefore, not only 2D but M-mode in essential for evaluation of LV asynergy. Asynergy of PS was present in inferior MI, and this segment was not injured in anterior MI, while AS asynergy was present in anterior MI. When analysing asynergy of the interventricular septum, it should be subdivided into two parts including AS and PS. Subcostal M-mode detected PS asynergy that was not visualized by routine cineangiography. In inferior MI, subcostal M-mode is recommended for detection of PS asynergy.

Adult↗
PubMed1981

[Scinti-angiographic investigation of aortic dissection (author's transl)].

We perform scinti-angiography regularly in suspected cases of dissecting aneurysms. In our experience, the dissection is well demonstrated by this method. In correctly selected cases, scinti-angiography is a method which is well tolerated by the patient and which carries very little risk, since the complications due to contrast media are absent.

Aortic Dissection↗
PubMed1981

[Two-dimensional echocardiographic observation of ruptured chordae tendineae of the mitral valve: Its localization and uneven development of papillary muscles (author's transl)].

Twenty-three cases with ruptured chordae tendineae (RCT) of the mitral valve and 9 normal control cases were studied by two-dimensional echocardiography. Mitral valve replacement (MVR) was performed in 13 of the 23 cases. The preoperative diagnosis of RCT was proven accurately at operation in all except 2 cases with bacterial endocarditis. Whether RCT occurred in the antero-lateral or in the postero-medial commissural side could be determined perfectly. RCT was observed in the postero-medial side more often than in the anterolateral side, i.e., postero-medial side in 16 (9 operated) and antero-lateral side in 5 (2 operated). This tendency has also been noted in other Japanese reports regardless of the cause of RCT. In the short axis view at the level of the papillary muscles, the area of the posterior papillary muscles was smaller than the area of the anterior papillary muscles in the RCT cases. It is speculated that the smaller size of the posterior papillary muscles has a certain relation with the more frequent RCT in the postero-medial commissural side.

Adolescent↗
PubMed1981

[Cross-sectional echocardiographic findings of a case with ruptured aneurysm of the sinus of Valsalva into the right atrium (author's transl)].

A case with ruptured aneurysm of the sinus of Valsalva into the right atrium directly visualized by cross-sectional echocardiography was reported. A 31-year-old male was referred to our hospital for evaluation of recently developed cardiac murmur. A systolic ejection murmur and diastolic blowing murmur were audible maximally at 3-4L and the latter one was also well audible at the right lower sternal border. Cardiac catheterization data revealed a large left-to-right shunt at the atrial level. The cross-sectional echocardiogram, obtained with a transducer at 5R towards the upwards and the medial direction, revealed a mass echo showing a pendulous motion through cardiac cycle in the right atrial cavity. Ruptured aneurysm of the sinus of Valsalva originated from the non-coronary sinus was demonstrated by aortography, and it showed the same motion as in echocardiography. From this angiographic finding and its disappearance after operation, the mass visualized by echocardiography was considered to be ruptured aneurysm itself. Thus, direct visualization of ruptured aneurysm of the sinus of Valsalva into the right atrium, as well as other types, was possible by cross-sectional echocardiography. In addition, multiple coronary A-V fistulae with a small shunt were demonstrated by coronary angiography in this case. Clinical significance of the complication has not been clarified.

Adult↗
PubMed1980

Cross-sectional echocardiographic observation of the short axis views of the left ventricle in hypertrophic cardiomyopathy.

Short axis views of the left ventricle were studied in 68 patients with hypertrophic cardiomyopathy (HCM) and 20 healthy persons using cross-sectional echocardiography. Configurations of the short axis view of the left ventricular cavity at the level of the papillary muscles in HCM were classified into 2 types, dumbbell and mushroom, which were formed by the position of papillary muscles. Antrior dislocation of the papillary muscles was seen in the dumbbell type, and marked hypertrophy of the papillary muscles in the proper position was seen in the mushroom type. Dumbbell shape (50 patients) was observed in the patients with marked hypertrophy in the basal protion of interventricular septum. Mushroom shape (18 patients) was seen in the patients with hypertrophy around the apex of the heart except for in a few patients. Areas of the papillary muscles (AP) and the left ventricular cavity (ALV) were measured and AP/ALV + AP ratio was calculated. The AP/ALV + AP ratio in HCM was significantly larger than that in the healthy persons, but no difference was seen between these 2 groups of HCM. It should be noted that the position of the hypertrophied papillary muscles is closely related to the distribution of hypertrophy in HCM.

Adult↗