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Kazuhiro Tatsumi

Publications and source records attributed to Kazuhiro Tatsumi.

7 recordsLinked to original sources

Improved regional myocardial diastolic function assessed by strain rate imaging in patients with coronary artery disease undergoing percutaneous coronary intervention.

This study investigated the effects of percutaneous coronary intervention (PCI) on global and regional left ventricular diastolic function, as assessed by strain rate (SR) imaging. In 27 patients with coronary artery disease, we performed echocardiography before and after PCI to obtain segmental peak systolic SR and peak early diastolic SR (E(SR)). PCI did not significantly change peak systolic SR in the ischemic (1.59 +/- 0.59-1.66 +/- 0.52/s) and nonischemic (1.64 +/- 0.59-1.61 +/- 0.53/s) segments. E(SR) in the ischemic segments was significantly smaller than that in the nonischemic segments at rest (1.82 +/- 0.71 vs 2.03 +/- 0.64/s, P < .01). PCI caused a significant increase in E(SR) from 1.82 +/- 0.71 to 2.29 +/- 0.92/s in the ischemic (P < .001), but not in the nonischemic, segments. The peak early diastolic transmitral flow velocities after PCI were improved in patients with greater extent of improvement of E(SR) in the ischemic segments. These findings suggest that the improvement in left ventricular early diastolic filling after PCI may be associated with the degree of improvement in impaired regional myocardial relaxation.

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Surgical treatment for Löffler's endocarditis with left ventricular thrombus and severe mitral regurgitation: a case report.

A 65-year-old female was admitted to our hospital because of dyspnea. Laboratory examinations revealed hypereosinophilia at a local hospital. Transthoracic and transesophageal echocardiography showed normal left ventricular dimension and function. The left ventricular apex was obliterated and the posterior and lateral walls were thickened by an abnormal mass. The posterior mitral leaflet was encapsulated by this abnormal mass. The limited motion of the posterior mitral leaflet caused mitral malcoaptation, resulting in severe mitral regurgitation. Hypereosinophilia was considered to be idiopathic, as no other disorders known to cause secondary eosinophilia were found. No other organ dysfunction was associated with the condition. Thus, the diagnosis was Loffler's endocarditis associated with hypereosinophilic syndrome. The patient was given conservative medical treatment immediately on admission. However, heart failure caused by mitral regurgitation would be difficult to treat with conservative medical treatment, so we chose a surgical strategy. The symptoms obviously improved after valve replacement and removal of the abnormal mass, and the patient was discharged. However, she died of cerebral infarction at a local hospital 3 months later.

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Myocardial contrast echocardiography with 1.5-harmonic imaging in the diagnosis of cardiac malignant lymphoma.

We applied myocardial contrast echocardiography with 1.5-harmonic imaging to an atrioventricular groove tumor in a patient with malignant lymphoma. Contrast echocardiography initially showed one centric legion and some patchy echogenic foci within the tumor, all of which were indicative of arterial components. Subsequently, the tumor was enhanced homogenously, reflecting parenchymal hyperperfusion. These findings were consistent with previous observations of malignant lymphoma using color Doppler. We believe that myocardial contrast echocardiography could afford an important clue to the histologic diagnosis of cardiac tumors.

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Retrievable Günther Tulip filter complicated by sepsis and retroperitoneal hemorrhage: successful management by filter retrieval.

We encountered complications of septic shock and retroperitoneal hemorrhage which occurred after implantation of a retrievable Günther Tulip filter. A 79-year-old woman was diagnosed as right femoral vein thrombosis, and a retrievable Günther Tulip filter was deployed prior to a total knee replacement surgery. However, the patient developed septicemia due to Citrobacter freundii, followed by thrombocytopenia and retroperitoneal hemorrhage. A large hematoma was formed along the lateral side of the filter struts. We considered that the filter should be removed to control retroperitoneal hemorrhage and prevent secondary infection of the hematoma. Removal of the retrievable filter was effective in managing these complications.

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[Usefulness of dobutamine stress echocardiography in a patient with aortic valve stenosis and left ventricular dysfunction: a case report].

A 76-year-old man with previous antero-septal myocardial infarction and aorto-coronary bypass surgery developed exertional dyspnea. Echocardiography revealed diffuse left ventricular hypokinesis and aortic stenosis with a mean pressure gradient of 29 mmHg. Coronary angiography showed no significant lesions in the bypass grafts and total occlusions of the proximal left anterior descending artery and mid circumflex artery. Dobutamine stress echocardiography was performed to evaluate the severity of aortic stenosis and left ventricular functional reversibility. Administration of dobutamine increased the mean pressure gradients to 48 mmHg and increased the stroke volume by 28% without change in aortic valve area of about 0.5 cm2. We considered that our patient had severe aortic stenosis with contractile reserve. After aortic valve replacement, he improved with better left ventricular function.

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[Isolated left ventricular noncompaction in the elderly: a case report].

A 83-year-old man with an implanted pacemaker was admitted to our hospital for dyspnea. Echocardiography revealed left ventricular dilation and diffuse hypokinesis mimicking dilated cardiomyopathy. Multiple trabeculations and deep intertrabecular recesses were prominent in the apical and posterior walls. Computed tomography with contrast medium also showed prominent trabeculations. Thallium-201 and iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid scintigraphy demonstrated fixed defects in the inferior wall. These findings were consistent with isolated noncompaction of the ventricular myocardium. The patient's symptoms of heart failure improved in response to treatment, including carvedilol. Isolated noncompaction of the ventricular myocardium is recognized as a rare congenital disorder of infancy with fatal outcomes, with some reports of cases in adults. The present patient is the most elderly described to date.

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[Reversible left ventricular dysfunction manifesting as hyperkinesis of the basal and the apical areas with akinesis of the mid portion: a case report].

A 60-year-old man underwent emergent cardiac catheterization because of anterior chest oppression. He had been treated with calcium antagonist and nitrate. Coronary angiography showed no organic stenosis. However, left ventriculography revealed that the basal and the apical areas were hyperkinetic and the mid portion was akinetic. Echocardiography showed that the bizarre-shaped left ventricular dysfunction had completely recovered after a week. Serial electrocardiography demonstrated initial ST-segment elevation in the precordial leads followed by T-wave inversion in II, III, a VF and V4-V6. Coronary artery spasm provocation tests were negative. Endomyocardial biopsy revealed focal myocardial depletion and mild fibrosis. The present case may be an atypical form of tako-tsubo-like left ventricular dysfunction in which the left ventricular contraction is symmetric with both hyperkinetic and akinetic areas.

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