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Biomedical subjects

R Kusukawa

Publications and source records attributed to R Kusukawa.

At least 91 records · Page 5Linked to original sources
PubMed1986

The false positive exercise test: usefulness of sublingual nitroglycerin exercise test and cardiac scintigraphy for differentiating from patients with coronary artery disease.

Exercise tests with sublingual nitroglycerin were performed on 7 patients with true positive and 8 patients with false positive exercise test results. Four of 7 patients with true positive changes and 8 patients with false positive changes underwent exercise cardiac scintigraphy. Scintigrams showed perfusion defects in 4 patients with true positive outcomes, and no perfusion defect in 8 patients with false positive outcomes. Exercise tests with sublingual nitroglycerin were performed with the same load as that without nitroglycerin. In all 7 patients with true positive exercise test results, ST segment depression observed in the control exercise test was not observed in the nitroglycerin exercise test. In the false positive patients, ST segment depression observed in the control exercise test remained unchanged in 7 of 8 patients receiving nitroglycerin. Exercise tests with sublingual nitroglycerin as well as exercise cardiac scintigraphy are valuable tods in differentiating false positive from true positive patients. Furthermore, these data suggest that ST segment depression in the false positive patients may not be related to myocardial ischemia.

Administration, Oral↗
PubMed1986

Study on lymphocyte subsets and NK cell function in patients with dilated cardiomyopathy.

An acquired defect or damage of a subpopulation of suppressor T lymphocytes is reported in connection with autoimmune diseases. In the present study, the role of immunity was examined in 7 patients with dilated cardiomyopathy (DCM). The frequency of lymphocyte subsets using monoclonal antibodies and natural killer (NK) cell activity was evaluated to determine whether DCM patients had lymphocyte abnormalities that would support the hypothesis that the pathological mechanism of DCM is an immune disturbance. The peripheral lymphocyte counts were significantly lower in patients with DCM and higher in patients with ischemic heart disease (IHD) than in normal controls (NC) (p less than 0.01). The percentage of T cells, B cells, OKT4 and OKT8 positive cells was not statistically different among the three groups studied here, whereas the percentage of T gamma cells was significantly reduced in DCM patients (p less than 0.05). NK cell functional activity as tested in DCM and IHD patients was frequently deficient (22.1 +/- 19.3% in DCM, 13.8 +/- 3.0% in IHD, 37.4 +/- 12.7% in NC). Our results suggest that an imbalance in cellular immune reactions partly explain the pathogenesis of DCM.

Adult↗
PubMed1986

Atrial filling fraction obtained by aortic root echocardiogram in man.

Atrial filling fraction obtained by left ventricular echocardiogram (AFF by LV echo) is considered to be a reliable measure of AFF of LV. However, in patients with LV asynergy, AFF by LV echo cannot be evaluated correctly by this method. To obtain AFF, we devised a new echocardiographic index of AFF, obtained from the aortic-left atrial echogram (AFF by Ao echo), and examined the significance of this index in 9 normal subjects (Normals) and 49 patients with various heart diseases. The correlation between AFF by Ao echo and left ventricular end-diastolic pressure (LVEDP) also was examined. In an additional 20 patients with acute myocardial infarction (acute MI), the relationship between AFF by Ao echo and pulmonary arterial end-diastolic pressure (PAEDP) was studied for several days following the onset of MI. Results were as follows: In Normal patients and patients without asynergy, a significant correlation was seen between AFF by LV echo and AFF by Ao echo (r = 0.710, p less than 0.001). The value of AFF by Ao echo was always greater than that by LV echo. AFF by Ao echo in patients with hypertensive heart disease (HHD), angina pectoris (AP) and old myocardial infarction (old MI) was significantly higher than that in Normal patients. A significant curvilinear correlation was seen between AFF by Ao echo and LVEDP (r = 0.673, p less than 0.005). In patients with acute MI, AFF by Ao echo correlated well with PAEDP.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Angina pectoris before and during acute myocardial infarction: relation to degree of physical activity.

One hundred ninety-seven patients with a history of acute myocardial infarction (AMI) were interviewed to evaluate the character of angina pectoris relative to physical activity before AMI and at the onset of AMI. Ninety-two patients had no angina before AMI and 105 had angina. Among the 105 patients with angina, 58 had chronic stable angina that did not change before AMI, 22 noted worsening of symptoms within 2 weeks before AMI, and 25 had onset of angina within 2 weeks before AMI. In the 92 patients without angina before AMI, AMI occurred during heavy exertion in 10 (11%), mild exertion in 43 (47%), at rest in 28 (30%), and during sleep in 11 (12%). In the 58 patients with chronic stable angina, 47 had angina during exertion, 7 during rest and 4 during both. However, subsequent AMI occurred during heavy exertion in 9 (15%), during mild exertion in 16 (28%), at rest in 25 (43%), and during sleep in 8 (14%). In the patients without angina, or with chronic stable angina without worsening of symptoms, AMI occurred unpredictably or differently from the mode of physical activity precipitating angina before AMI.

Angina Pectoris↗
PubMed1985

Transient appearance of collaterals during vasospastic occlusion in patients without obstructive coronary atherosclerosis.

Coronary angiography of both right and left coronary arteries, using the Sones technique, was performed during the attack of total spastic obstruction in 11 patients with clinically documented history of variant angina. None of the patients had more than 70% stenosis of organic atherosclerosis in any coronary artery and none had a history of myocardial infarction. Total spastic obstruction occurred spontaneously in 3 of 11 patients, and was provoked by ergonovine maleate in eight patients. Six patients had total spastic obstruction in the left anterior descending coronary artery, four patients had total obstruction in the right coronary artery, and one patient had total obstruction in the left anterior descending and right coronary arteries. In 7 of 11 patients, the coronary artery distal to the total spastic obstruction received collaterals from the nonspastic artery. The collaterals disappeared promptly when the spastic coronary artery was patent. These patients had ST segment elevation in the ECG during the attacks. In the remaining four patients, the spastic artery did not receive any collaterals from the nonspastic artery, associated with ST segment elevation during the attacks. These findings suggest that the brief, repetitive total occlusion of the coronary artery may stimulate the enlargement of collaterals. These collaterals may not always function to prevent the ischemia of the myocardium on the ECG.

Adult↗
PubMed1985

The effects of Ba-wei-wan (hachimijiogan) on plasma levels of high density lipoprotein-cholesterol and lipoperoxide in aged individuals.

Ba-wei-wan was administered for 7 months to 24 aged, non-hospitalized subjects. Laboratory examinations showed an improvement in serum or plasma levels of total lipid, LPO and HDL-C. Other blood examinations were shown to be unaffected by the treatment. To reconfirm the effects of Ba-wei-wan on lipid metabolism, the three step administration of the drug was employed. The elevation of HDL-C levels and the decrease of LPO levels were obtained by this treatment. The discontinuation of this drug induced the converse effect on the plasma levels; decreased HDL-C and increased LPO. It could be concluded from these results that Ba-wei-wan administration improved the lipid metabolism in the aged subjects.

Aged↗
PubMed1985

Severity of the regional wall motion and its effects on global left ventricular diastolic filling in patients with single-vessel coronary artery disease and previous myocardial infarction: assessment with radionuclide ventriculography.

The severity of the regional wall motion and its effects on the global left ventricular diastolic filling were analyzed with use of radionuclide techniques in 19 patients with isolated disease of the left anterior descending coronary artery with previous myocardial infarction. Regional maximum inward movements in the noninfarcted lateral region occurred at a time close to the global end-systole, but occurred far beyond the global end-systole in the infarcted septal and apical regions, resulting in the occurrence of the regional asynchronous wall motion between the infarcted and noninfarcted regions after the global end-systole. A positive correlation between this end-systolic asynchronous wall motion and the asynchronous filling in early diastole was found (r = 0.69, p less than 0.001). A negative correlation between the asynchronous filling in early diastole and the global peak filling rate was also found (r = -0.58, p less than 0.01). Thus, the end-systolic regional asynchronous wall motion causes the subsequent regional asynchronous filling in early diastole, which may cause impairment of the global left ventricular filling in patients with single-vessel coronary artery disease with previous myocardial infarction.

Adolescent↗
PubMed1985

The influence of renal sympathetic nerves on renal hemodynamic and renin responses during hypercapnia in dogs.

Studies were conducted in anesthetized dogs to examine the influence of the renal sympathetic nerves on renal hemodynamic and renin responses during controlled hypercapnia. The dogs were subjected to unilateral denervation and tested for their responses to hypercapnia induced by inhalation of 15% CO2 in air. Simultaneous measurements of the responses from both the denervated and innervated kidneys allowed an assessment of the influence of the renal nerves on the responses during acute hypercapnia. The data indicate that reductions in renal blood flow and glomerular filtration rate and increases in renin of the renal vein during respiratory acidosis are dependent, in part, on the presence of intact renal nerves. Other factors, however, are probably also present.

Animals↗
PubMed1985

Inhomogeneous contribution of late diastolic filling to filling volume in patients with isolated disease of the left anterior descending coronary artery: assessment with radionuclide ventriculography.

Contributions of late diastolic filling (slow filling and atrial systolic phases) to total filling volume in both global and regional left ventricle were analyzed using radionuclide techniques in 21 patients with isolated left anterior descending coronary artery disease without previous myocardial infarction. A computer program subdivided the image of the left ventricle into four regions at a geometric center of the area. The time-activity and its first-derivative curves of the global and regional left ventricles were computed. In the global left ventricle, the percent contributions of late diastolic filling to total filling volume were significantly increased in patients with one-vessel disease than in control subjects (20 +/- 5%, 28 +/- 4%; p less than 0.001). In the regional left ventricle, in patients with one-vessel disease, the percent contributions of late diastolic filling to total filling volume were significantly increased in the septal (25 +/- 5%, 34 +/- 8%; p less than 0.001) and in the apical regions (21 +/- 4%, 28 +/- 4%; p less than 0.001) which were perfused by stenosed vessel. In contrast, there were no significant differences in this value between the two groups in the normally perfused lateral region (22 +/- 6%, 25 +/- 5%; p = NS). These results indicate that the late diastolic filing makes a larger contribution to the left ventricular filling in the affected regions than in the normally perfused regions, and that the increased late diastolic filling in the affected regions are the cause for the increased late diastolic filling in the global left ventricle in patients with one-vessel disease.

Adult↗
PubMed1984

Effects of the presence or absence of preceding angina pectoris on left ventricular function after acute myocardial infarction.

Left ventricular (LV) function was evaluated in 31 patients, who had total occlusion of the left anterior descending coronary artery and less than 70% stenosis of the other two major coronary arteries or any branch. Fifteen of 31 patients had a history of angina pectoris before acute myocardial infarction (AMI) and 16 of 31 patients had no history of angina pectoris before AMI. The patients with angina pectoris before AMI had a significantly better ejection fraction, percentage of abnormally contracting segment, and regional wall motion than those without angina pectoris before AMI. These data suggest that the symptom of angina pectoris before AMI could be a favorable sign in preserving LV function when the patients subsequently had AMI.

Adult↗
PubMed1984

Coronary angiography during exercise-induced angina with ECG changes.

Coronary angiography was performed at rest and during bicycle exercise immediately after the onset of angina and significant ST segment elevation or depression in the ECG. Of 11 patients, six showed significant reduction of coronary lumen diameter at the site of organic stenosis; mean values of stenosis (range) before and during exercise were 55% (25% to 88%) and 98% (89% to 100%), respectively. Five patients did not have any diameter change of the organic lesion; mean values of stenosis (range) before and during exercise were 84% (74% to 89%) and 84% (73% to 92%), respectively. Excluding the areas of these stenoses, diameters of left main coronary artery, proximal, middle, and distal left anterior descending, circumflex, and right coronary artery segments were measured before and during exercise. Diameter in each coronary artery segment during exercise was not significantly changed from that before exercise, both in the groups with and without diameter reduction. Exercise provoked a localized worsening of coronary artery stenosis without changing the diameter in the remaining artery. These findings suggest that the worsening of stenosis might be caused by a regional abnormality of the coronary artery that is not necessarily related to the degree of organic stenosis.

Adult↗
PubMed1984

Regional left ventricular contraction abnormality during early systole in patients with angina pectoris. Assessment with radionuclide ventriculography.

To determine the presence and prevalence of regional contraction abnormalities in patients with angina pectoris, radionuclide ventriculography gated to an electrocardiogram was carried out in 22 control subjects (group 1) and in 22 patients with angina pectoris (group 2) with isolated stenosis of the left anterior descending coronary artery. No patients had had previous myocardial infarctions. A computer program subdivided the left ventricle into four regions at a geometric centre, and time-activity curves (30-40 ms/frame) of the global, septal, apical, and lateral regions were computed. There was no significant difference in the ejection fraction in the global or in any of the regions between the two groups. End systole in each region occurred close to global end systole in both groups. In the global region the percentage stroke volume ejected during the first third of systole was not significantly less in group 2 than in group 1. Regional analysis of the segments perfused by the stenosed vessel showed that the percentage stroke volume ejected during the first third of systole in group 2 was significantly less in the septal region and in the apical region compared with that in group 1. In contrast, in the normally perfused lateral region, there was no significant difference in the percentage stroke volume at the first third of systole between the two groups. This indicates that early contraction abnormalities are present in the region perfused by the stenosed vessel in patients with angina pectoris without previous myocardial infarction. Thus analysing the regional change in left ventricular volume during ejection in patients with coronary artery disease can show localised areas of contraction abnormalities during early systole that are not apparent when ventricular contraction is assessed as a whole.

Aged↗
PubMed1984

Immunological study of heart diseases with special reference to the cytotoxicity of the heterophile antibody against cultured myocardial cells.

In our previous study, a high rate of "heterophile antibody" was found in idiopathic cardiomyopathy. In the present investigation the cytotoxic activity of this antibody was examined in cultured myocardial cells. Trypsin treated cells cultured for 3 days were used in the two-step method of the complement dependent cytotoxicity test. The trypan blue dye-exclusion method was utilized to determine the percentage of surviving cells, and the cytotoxic effect was expressed by the cytotoxic index (CI). With fresh rabbit serum as complement, the mean CI value of the heterophile antibody positive sera was 20.7, which was in contrast to the value of anti-heart antibodies negative sera (p less than 0.01). As the cytotoxic effect to the heterophile antibody was absent without the complement, it may be complement dependent. Thus, our results suggest that the heterophile antibody may play a role in the pathogenesis or be an incremental factor of idiopathic cardiomyopathy.

Animals↗
PubMed1984

Hemodynamic effects of nitroprusside on cardiovascular system.

The effects of nitroprusside (NP) on hemodynamics, especially on venous flow velocity of the inferior vena cava (IVC) were evaluated in 20 remote myocardial infarction patients. NP was given beginning at 10 micrograms/min, with subsequent increments of 10 micrograms/min every 5 minutes until the systolic blood pressure was reduced to about 30 mmHg. Pressure was measured by a catheter-tip micromanometer. Flow velocity of IVC was measured by a catheter-tip flow velocity probe. NP significantly decreased left ventricular systolic pressure, left ventricular end-diastolic pressure, mean aortic pressure, right ventricular systolic pressure, right ventricular end-diastolic pressure, mean pulmonary arterial pressure, mean pulmonary capillary wedge pressure, systemic vascular resistance index (SVRI) and left ventricular volume. Cardiac index (CI) was unchanged and stroke volume index was decreased. IVC pressure was unchanged, while right atrial (RA) pressure decreased. Subsequently, the pressure difference between IVC and RA increased significantly. The amplitude of IVC flow velocity decreased significantly. Twenty patients were classified into two groups according to whether or not the CI increased by NP. CI increased in 9 patients (group I) and decreased in 11 patients (group D). Compared to group D, control CI and the slope of end-systolic pressure-volume relation were less and the difference between IVC pressure and RA pressure was greater in group I. The patients with higher control SVRI had greater increase in CI during NP. In our study, the greater the depression of cardiac performance and the higher the SVRI, the greater the improvement of left ventricular pumping function during NP.

Adult↗