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Biomedical subjects

N Haneda

Publications and source records attributed to N Haneda.

At least 37 records · Page 2Linked to original sources

Relation between blood pressure, left ventricular mass and pulsed Doppler parameters in healthy school children.

We analyzed the relations between blood pressure in sitting and supine positions, left ventricular mass (LVM) and Doppler aortic, pulmonary and mitral flow velocity measurements in 163 healthy school children. Systolic blood pressure in a supine position correlated significantly with aortic acceleration (ATc) and ejection time (ETc), corrected by the square of R-R interval, pulmonary AT and peak flow velocities. Moreover, the systolic blood pressure in a sitting position correlated with pulmonary AT and LVM. LVM correlated with pulmonary ATc, the ratio of AT to ET and average acceleration, and aortic ETc and peak flow velocity. These data suggest the following: (1) the posture influences the relation between blood pressure and flow velocity, (2) pulmonary hemodynamics are influenced by systemic blood pressure in healthy children and (3) the development of LVM may be dependent not only on blood pressure but also on cardiac work in childhood.

Aorta↗

Changes of left ventricular isovolumic relaxation time with growth in children.

We investigated the changes of left ventricular isovolumic relaxation time (LVIRT) with growth and the factors influencing them during childhood, in a 10-year follow-up study. We measured the body height (BH), body weight (BW), lean body weight (LBW), heart rate (HR), blood pressure (BP), left ventricular muscle volume index (LVMVI), and LVIRT corrected by the preceding R-R interval (IRT/R-R), of 187 healthy children at 3-year intervals (6, 9, 12, 15 years old). IRT/R-R were prolonged with growth in boys and girls. At the ages of 12 and 15, the IRT/R-R of girls were longer than those of boys. Significant correlation coefficients for IRT/R-R on systolic and diastolic, BW, and LVMVI were 0.28, 0.31, 0.20, 0.28, respectively. These data suggest that (1) IRT/R-R is mainly determined by the diastolic BP, (2) left ventricular diastolic function of children develops with growth of body size, especially BW, and (3) left ventricular early diastolic function in adolescents is related to sexual maturation.

Blood Pressure↗

Left ventricular diastolic function of children in high blood pressure tracking group.

The purpose of this study was to determine whether left ventricular (LV) diastolic function in children with high blood pressure (BP) is abnormal. We measured the corrected LV isovolumic relaxation time (IRT), peak velocity of increase in LV dimension (dD/dt) and the LV muscle volume in a high systolic BP tracking group (10 boys and 22 girls) and a low BP tracking group (22 boys and 11 girls) at 3-year intervals from the ages of 6 to 15. The corrected IRT of the high BP tracking group was significantly longer than the low BP tracking group. Left ventricular dD/dt/D of the high BP tracking group was significantly lower than the low BP tracking group from the ages of 12 in boys and 9 in girls. The left ventricular muscle volume index of both groups, however, was not significantly different. Both corrected IRT and dD/dt/D were well correlated with diastolic BP. These data suggest that children in the high BP tracking group might have LV diastolic abnormalities from age 12 or 15, in contrast to children of the low BP tracking group, without increased LV muscle volume. Therefore, it might be useful to examine BP and LV function of children from ages 12 or 15 for prevention of hypertension.

Blood Pressure↗

Japan: perspectives in school health.

In Japan, the original Law of School Health was established some 65 years ago to improve the environment and to prevent infectious diseases in school. Most recently, new environmental problems and behavioral issues have emerged. In addition to environmental health and health education, a major aspect of school health has been the development of a mass screening system both to detect present problems and to prevent adult diseases. In this article, the school health system in Japan is described and the application of mass screening by reference to heart disease as detected in Shimane Prefecture is illustrated. In the future, mass screening may be combined with a computer-based analysis system for managing data on new kinds of problems. New disciplines may become involved and improved programs developed, based on the lessons already learned from mass screening.

Delivery of Health Care↗

Quantitative analysis of systolic blood pressure tracking during childhood and adolescence using a tracking index: the Shimane Heart Study.

We used a tracking index to carry out a quantitative analysis of blood pressure tracking in children and adolescents. The index was calculated according to changes in blood pressure quintiles for the whole population during the observation period. The study population consisted of 463 Japanese children living in Izumo, who were examined every 3 years from 6 to 12 years of age in cohort 1, and from 9 to 15 years of age in cohort 2. In both sexes, the tracking index decreased transiently during the period from 9 to 12 years of age and increased again thereafter. The index was higher in girls than in boys except for the period from 12 to 15 years. Correlation coefficients between blood pressure at the first and that at the second examination increased with age in both sexes. We conclude that the tracking index could quantify the degree of tracking. Systolic blood pressure tracked well during childhood and adolescence, and the degree of tracking increased after the age of 12 years in both sexes.

Adolescent↗

Determination of left to right shunt by thermodilution in patients with ventricular septal defect.

A modified thermodilution technique was used to determine the quantity of shunt in patients suffering from congenital heart disease with a left to right shunt. In our modification, the thermistor was placed within the pulmonary artery and an indicator was injected into both sides of the heart. In a series of 33 cardiac catheterizations in children (1-17 years) with ventricular septal defect (VSD), pulmonary blood flow (Qp), systemic blood flow (Qs) and the ratio of Qp to Qs (Qp/Qs) were determined by this and ordinary oximetry (Fick) methods. Correlation coefficients between indexes obtained by these methods were 0.54 (Qp), 0.78 (Qs), and 0.75 (Qp/Qs). The estimates of Qp and Qp/Qs obtained by thermodilution were smaller than those obtained by the Fick method. This modification of thermodilution is simple, rapid, and useful in clinical practice.

Adult↗

Effect of heart rate on the end-systolic wall stress-mean velocity of circumferential fiber shortening relation.

The correlation of left ventricular end-systolic wall stress (ESS) with the mean velocity of fiber shortening (mVcf) is an index of the myocardial contractile state, independent of the ventricular loading conditions (afterload). However, there have been few reported estimates of the effect of changes in the heart rate on the ESS-mVcf relationship. In the present study, 25 subjects with histories of Kawasaki disease (mucocutaneous lymph node syndrome: MCLS) were evaluated for the effects of changes in heart rate, afterload and preload, on the ESS-mVcf relationship. The latter was independent of afterload. After atrial pacing, ESS decreased and mVcf increased, both significantly, compared to those of subjects at rest. The change of the ESS-mVcf relationship induced by atrial pacing approximately paralleled the mean regression line obtained in the resting state. However, the shift induced by preload was not parallel to the mean regression line for the resting population. These data suggest that the ESS-mVcf relationship is independent of any change in heart rate, and that it may depend on preload.

Cardiac Catheterization↗

Diastolic left ventricular function in normal children: the maximal positive dD/dt compared with the E/A ratio of mitral flow pattern.

The normal values for left ventricular diastolic function in children are influenced by numerous factors. As an index of this function, the maximum velocity of left ventricular internal dimension expansion (+ max dD/dt) was calculated from M-mode echocardiography for 33 normal persons who ranged in age from seven days to 18 years. This index showed a linear correlation with left ventricular end-diastolic dimension in the resting state. This index was compared with the E/A ratio which is ordinarily used as the diastolic functional index for children. Considering changes in physical development during childhood, both indices showed similar trends in relation to body surface area. The E/A ratio was strongly influenced by heart rate, but + max dD/dt was not. This was the major difference between two indices.

Adolescent↗

A case of acute rheumatic fever: echocardiographic findings for mitral regurgitation in acute rheumatic carditis.

An eight-year-old girl with mitral regurgitation in acute rheumatic fever was examined by echocardiography. The examination showed posterior displacement of the coaptation point of the anterior mitral leaflet, i.e. anterior mitral prolapse, and did not indicate signs of edematous change or verrucous fibrin deposits on the valves. Mitral valve prolapse is thought to be one of the causes of mitral regurgitation in acute rheumatic carditis.

Acute Disease↗

Quantification of blood pressure tracking of children by tracking index: the Shimane Heart Study.

The tracking of systolic blood pressure (SBP) was analyzed in a cohort of children. The study population consisted of 1009 Japanese children in Izumo City, a rural community in the northwest of Honshu. There were 252 subjects in cohort (C)-1, 235 in C-2, 286 in C-3, 131 in C-4 and 105 in C-5. Follow-up periods were from 6 to 9 years of age in C-1, 9 to 12 in C-2, 12 to 15 in C-3, 6 to 12 in C-4 and 9 to 15 in C-5. BP was measured by conventional method. Tracking index (TI) was calculated as follows: TI = (2x + y - z)/N/.24; x, y and z are numbers of subjects who remained at the same quintile, who moved to the next quintile and who moved to a remote quintile, respectively; N = x + y + z; TI becomes 1.0 when SBP changes randomly. SBP tracking was apparent in both sexes of C-1 (TI = 2.4 in boys, 2.5 in girls), in girls of C-2 (TI = 3.5), in both sexes of C-3 (TI = 3.2 in boys, 2.7 in girls) and in girls of C-4 (TI = 4.1) and C-5 (TI = 3.3). TI agreed well with the tracking phenomena visualized by distribution bar graph. We conclude that TI can assess the degree of tracking quantitatively and can be applied to analysis of the tracking phenomena of BP and its related factors.

Blood Pressure↗

Tracking of blood pressure, height, weight and left ventricular muscle volume in children--the Shimane Heart Study.

Two cohorts of Japanese children were studied longitudinally at 3-year intervals, at ages 6 and 9 years in cohort 1 and 9 and 12 years in cohort 2. There were 252 children in cohort 1 and 235 in cohort 2. The examinations performed were blood pressure, height, weight, skin fold thickness, upper arm length and circumference, ECG, VCG, M-mode echocardiography, serum cholesterol, hemoglobin and urinalysis. The subjects were divided into 5 quintile groups by their systolic blood pressure (SBP) percentiles calculated at each examination. SBP was tracked in each cohort throughout the follow-up period. Percentages remained in the highest SBP quintile group at both examinations were 43.5% (boys) and 59.1% (girls) in cohort 1, and 25.0% (boys) and 56.5% (girls) in cohort 2. The tracking of SBP was defined by body mass (height and weight) in most children. In some children, however, it was not defined by body mass tracking. Left ventricular muscle volume and its index were large in boys in the highest SBP tracking group. This indicates that the cardiac muscle is hypertrophied already, before the development of hypertension.

Adolescent↗

Heart diseases discovered by mass screening in the schools of Shimane Prefecture over a period of 5 years.

Mass screening by ECG for heart diseases in pupils and students was performed in Shimane Prefecture; all the children had primary screening and were under the supervision of a pediatric cardiologist in all phases, from primary to precise (tertiary) examination. The precise examination was performed with 2D echo, exercise ECG and/or cardiac catheterization when indicated, and an important feature of this mass screening was the ability to carry out an accurate follow-up in all the phases from primary to precise examination. The number of subjects in the primary screening from 1980 to 1984 was 50758 primary school pupils, 44216 junior high school students and 33480 senior high school students; organic heart diseases not under the supervision of the pediatric cardiologist at the time of mass screening were found in 22 primary school pupils (0.04% of participants in the primary screening), 14 junior high school students (0.03%) and 5 senior high school students (0.01%). Clinically significant arrhythmias without underlying organic heart diseases were discovered by mass screening in 8 primary school pupils (0.02%), 13 junior high school students (0.02%) and 16 senior high school students (0.05%).

Adolescent↗

Mass survey for coronary lesions in school children with history of Kawasaki disease in Shimane Prefecture.

In 1981, a mass survey for Kawasaki disease was performed in Shimane Prefecture. The incidence of the disease was 0.3% in elementary and 0.1% in junior high schools, respectively. The number of children with a past history of Kawasaki disease was 40. Selective coronary arteriography (S-CAG) was performed on 37 children by December 1983 and 3 cases having coronary lesions were detected. In all these 3 children, more than 8 years had elapsed since the onset of the disease and in one of them there were severe stenotic changes in the coronary artery, with coexisting mitral incompetence. Two-dimensional echocardiography (2D echo) was able to detect dilatatory coronary lesions, but it failed to delineate stenotic changes adequately in these 3 cases. The present data indicate that 2D echo cannot demonstrate the stenotic segments of the coronary artery and therefore S-CAG is necessary for that purpose. We suggest coronary arteriography (CAG) for school children with a past history of Kawasaki disease.

Adolescent↗

Transmural conduction velosity index in healthy schoolchildren.

Transmural conduction velosity index (TCVI) was obtained in 174 healthy children. TCVI was defined as the echocardiographically determined interventricular septal thickness (IVST) divided by the ventricular activation time (VAT) measured by body surface potential mapping. TCVI ranged from 14 to 49 cm/sec and was highly correlated with IVST (r = 0.75, TCVI = 3.25 X IVST + 0.56). It was concluded that the left ventricular hypertrophy with muscular thickness does cause the greater conduction velosity in healthy children.

Adolescent↗

The relationship between blood pressure and left ventricular muscle volume in normal children and adolescents--the Shimane Heart study.

Blood pressure (BP) and left ventricular muscle volume (LVMV) were measured in 408 children and adolescents aged 9-15 years. LVMV was determined by M-mode echocardiography. Lean body weight was approximately calculated using body weight, upper arm circumference and triceps skin fold thickness. Lean-BSA was obtained by substituting lean body weight for body weight in the formula for BSA. Subjects were divided into the high and the low BP percentile groups according to their BP percentile values. LVMVI (= LVMV/BSA) and lean-LVMVI (= LVMV/L-BSA) were compared between the two groups. LVMVI and L-LVMVI were larger in the high BP percentile group than in the low one. Regression lines of LVMV to BSA were also compared between the two groups. Regression lines of the high BP percentile group were located in a higher position than those of the low percentile group. These results suggest that LVMV are larger in the high BP percentile group than in the low percentile group even if their BSAs are equal. We concluded that left ventricular hypertrophy has been already initiated in the pre-hypertensive stage of human beings as observed in spontaneously hypertensive rats.

Adolescent↗

Computer analysis of frank vectorcardiograms in normal children--maximal spatial QRS vector.

Frank vectorcardiograms recorded on magnetic tape were analyzed by a computer. The study population was 835 normal children aged from 6 to 16. Magnitudes, angles (azimuth, elevation) of the maximal spatial QRS vector and QRS duration were calculated. The magnitude of maximal spatial QRS vector increased significantly in males compared to those in females at ages 9-10, 11-12 (p less than 0.01) and 15-16 (p less than 0.001). Though there was no significant difference of elevation in either sex, azimuth tended to move more anteriorly in females than in males. QRS duration in males became longer with increasing age, while in females at age 15-16, it decreased (p less than 0.001).

Adolescent↗

A network data base system for children with cardiac disease--echocardiographic data of MCLS.

We developed a computer-assisted network data base system for children with cardiac diseases. It aims at storage and exchange of medical information from many hospitals to prevent school children from sudden death caused by heart diseases. The computer system used was PANAFACOM U-1500 introduced at Shimane Medical University Hospital in 1980. The format of the questionnaire is designed to standardize the computer-assisted data-entry method among different hospitals. The entries of questionnaires are composed of basic information about the patient and laboratory information. The former is identification data of the patient, and the latter principally the values of M-mode echocardiographic measurement. Two types of output-tables were made from the data base. One is a table of each disease, and the other each hospital.

Child↗