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Biomedical subjects

R Kusukawa

Publications and source records attributed to R Kusukawa.

At least 127 records · Page 7Linked to original sources
PubMed1981

[Exercise echocardiography: II. Interventricular septal wall dynamics in patients with left anterior descending coronary disease during recovery (author's transl)].

Supine ergometer exercise test was performed in 10 healthy subjects and 9 patients who had severe stenosis in the left anterior descending coronary artery [5 patients with stenosis proximal to the septal perforator (proximal LAD disease) and 4 patients with stenosis distal to the septal perforator (distal LAD disease)]. In healthy subjects and patients with distal LAD disease, the increment of septal excursion (IVS Ex) and percent systolic thickening of the septum (% delta Th) during exercise returned to the pre-exercise level with a few minutes after exercise. In patients with proximal LAD disease, IVS Ex decreased to 1.4 +/- 1.2 mm during exercise form the pre-exercise level (7.4 +/- 0.7 mm) and % delta Th decreased to 6.4 +/- 5.1% during exercise from the pre-exercise level (37.2 +/- 8.4%). After exercise, IVS Ex and % delta Th increased to 8.6 +/- 0.9 mm at 2 min and 38.0 +/- 9.8% at 3 min respectively and then returned to the pre-exercise level. End-diastolic wall thickness (WTh) did not change during and after exercise in healthy subjects and patients with distal LAD disease, while in patients with proximal LAD disease, WTh increased for a few minutes after exercise and returned to the pre-exercise level. The change of electrocardiogram and symptom of angina pectoris lasted longer than the abnormal wall motion.

Adult↗
PubMed1981

[Prediction of the location of left anterior descending coronary artery disease by anterior echocardiography and esophageal echocardiography (author's transl)].

In 11 normal subjects and 30 patients (pts) with left anterior descending coronary artery (LAD) lesion, the left ventricular anterolateral wall (LVAW) was investigated by esophageal echocardiography (Eso Echo) and the interventricular septum (IVS) by conventional anterior echocardiography (Ant Echo). The location of LAD obstruction, either proximal (20 pts; P-group) or distal (10 pts; D-group) to the first septal branch, was confirmed by coronary arteriography. Twenty-two of the 30 pts with LAD lesion had anteroseptal myocardial infarction (ASMI) and the remaining 8 had angina pectoris. Of the 30 pts, 20 pts including 13 pts with ASMI had normal systolic excursion of IVS. On the other hand, LVAW excursion was below 8 mm in 28 of the 30 pts with LAD lesion compared to the value of the normal subjects (10.8 +/- 1.7 mm; range = 8--13 mm). The sum of the values of IVS and LVAW excursions in the pts with ASMI was significantly lower in the P-group than those in the D-group (p less than 0.001). In the P-group, the beginning of both systolic IVS and LVAW excursion delayed significantly (IVS: 118 +/- 47 msec, LVAW: 121 +/- 44 msec from Q wave on ECG) than those of normal subjects, while in the D-group only LVAW excursion was delayed (142 +/- 23 msec) compared to that of IVS (84 +/- 32 msec). Thus, the analysis of the motion of IVS and LVAW obtained by Ant Echo and Eso Echo is useful in predicting the presence of absence as well as the location of LAD lesion.

Aged↗
PubMed1981

[The effect of the Valsalva and Müller maneuvers on right and left atrial dimensions in man studied by esophageal echocardiography (author's transl)].

The effect of the Valsalva (V) and Müller maneuvers (M) on the right and left atrial dimensions was evaluated by esophageal echocardiography in 8 normal male subjects. During V and M, the right atrial free wall (RAW), interatrial septum (IAS) and left atrial posterior wall were recorded by esophageal echocardiography simultaneously with intraairway pressure (Paw). Right (RAD) and left atrial dimensions (LAD) at atrial end-diastolic were measured at various phases during each maneuver. Mean expiratory effort of +40 mmHg Paw in V and mean inspiratory effort of -40 mmHg Paw in M were maintained for about 10 sec. Both atrial dimensions changed significantly during each maneuver. RAD began to decrease just after the onset of V, while LAD changed little during this phase, after which began to decrease progressively. The leftward displacement of IAS with the simultaneous outward displacement of RAW resulted in an increase of RAD and a decrease of LAD just after the onset of M and the release of V. LAD remained higher than resting value from the second (2--4 sec after the onset) to late phase (just before the release) during M. RAD decreased just after the release of M. Thus, esophageal echocardiography was useful to evaluate both atrial dimensions during V and M.

Adult↗
PubMed1981

[Significance of non-invasive parameter (PSP/ESVI) in assessing left ventricular contractility (author's transl)].

Since myocardial pump function is affected by preload or afterload, it is difficult to assess left ventricular (LV) contractility independently from these in clinical cardiology. In this study, we performed inotropic intervention by isoproterenol or propranolol, and changed afterload by angiotensin or nitroprusside, to estimate the usefulness of peak systolic pressure/end-systolic volume index (PSP/ESVI) as a parameter of LV contractility. The data were obtained by cuff method or catheter-tip manometer and echocardiography. We calculated PSP/ESVI in various heart diseases, and results were analyzed for a significant change using the t test. Ejection fraction, mean VCF (mVCF) were calculated simultaneously, and compared with PSP/ESVI. The results were as follows: 1) PSP/ESVI ratio significantly reflected inotropic intervention with isoproterenol and propranolol. 2) PSP/ESVI ratio was less affected by the change of peak systolic pressure than EF or mVCF. 3) There was a significant difference in PSP/ESVI among congestive cardiomyopathy, valvular heart diseases and normal controls. 4) There was also a significant difference in PSP/ESVI between patients of NYHA I and those of NYHA II--IV. 5) PSP/ESVI ratio, measured by non-invasive method, was thought to be a useful parameter to assess LV contractility.

Adolescent↗
PubMed1981

[A simple method for enhancing interatrial right-to-left shunt in the diagnosis of small atrial septal defect using contrast echocardiography (author's transl)].

Commonly used contrast echocardiography is often inadequate to detect a small right-to-left (R--L) shunt in minimum atrial septal defect (ASD). We found that the diagnostic accuracy in ASD could be significantly improved by simply employing a Valsalva maneuver immediately followed by a Müller maneuver to enhance the R--L shunt. This procedure enabled contrast echo to be more clearly detected in both the left atrium and left ventricle, compared with conventional contrast echocardiography. The new technique was successful in diagnosing ASD in 5 patients with Qp/Qs ratio less than 2 determined by right heart cardiac catheterization. In conclusion, the diagnosis of a small ASD is greatly improved by simply employing this new procedure of a Valsalva-Müller maneuver during contrast echocardiography.

Adult↗
PubMed1981

[Exercise echocardiography: relationship between interventricular septal wall dynamics and electrocardiographic changes during ischemia (author's transl)].

The relationship between interventricular septal (IVS) wall motion assessed by the echocardiogram and surface electrocardiogram was investigated in 11 patients (pts) with proximal left anterior descending coronary artery disease (LADd) during ergometer exercise. A specially devises transducer was used to obtain the echocardiograms. During exercise, 6 pts had transient ST segment depression (Group 1), whereas 5 pts had transient ST segment elevation (Group 2). During exercise-induced ischemia, the ST segment depression occurred prior to abnormal wall motion in Group 1, and lasted longer than the latter. On the other hand, the ST segment elevation was preceded by abnormal wall motion in Group 2, and returned to the control earlier than the latter. In conclusion, exercise echocardiography is useful to assess the relationship between interventricular wall dynamics and electrocardiographic changes during ischemia.

Angina Pectoris↗
PubMed1981

[Left ventricular end-systolic pressure and wall thickness relation for the assessment of regional myocardial contractility in man (author's transl)].

In 28 patients (pts) (5 normal subjects (N), 12 pts with valvular heart disease, 6 with cardiomyopathy, and 5 with ischemic heart disease), left ventricular (LV) pressure was measured using Millar's catheter tip transducer simultaneously with LV posterior wall thickness (W) by echocardiography. After the control recording, LV peak systolic pressure was altered by about 30 mmHg from the control level by angiotensin (20 ng/kg/min) or nitroprusside (1 gamma/kg/min) to attain two (18 pts) or three (10 pts) different end-systolic pressure points, determined after the steady state was achieved. LV end-systolic pressure and wall thickness (P-W) relation a the three different end-systolic pressure points was found to be linear (r = 0.996) in each of the 10 pts, suggesting that end-systolic P-W relation is independent of afterload. Isoproterenol infused in 4 pts, which led to an increase in peak positive (+) dp/dt by a mean of 28%, increased the slope of the P-W relation by 43.4% of the control value (P less than 0.001), while propranolol, which led to a decrease in peak (+) dp/dt by a mean of 16.7%, reduced the slope by 27.3% (p less than 0.001). This indicates the sensitiveness of the slope of P-W relation to the inotropic change of the myocardium. In N, the slope of the P-W relation was -29.7 +/0 6.0 mmHg/mm (mean +/- SD), while the value in 4 pts with decreased functional capacity (NYHA III or IV) was significantly lower (-13.7 +/- 2.9 mmHg/mm; p less than 0.001). Thus, the present study suggests that the slope of the end-systolic P-W relation is useful in assessing regional myocardial contractility in man.

Adult↗
PubMed1980

Malignant fibrous histiocytoma of the heart.

A 33-year-old woman presented signs and symptoms which suggested mitral stenosis and insufficiency. Subsequent echocardiographic and angiographic testing demonstrated a left atrial tumor which was suspected clinically to be a left atrial myxoma. At surgery, the tumor was partially resected and histological examination revealed that the mass to be a malignant fibrous histiocytoma. At autopsy, the tumor was found to be localized in the heart, and there was no metastasis.

Adult↗
PubMed1980

Experimental myocarditis. I. Cardiac lesions in rats induced by immunization with homologous heart extracts.

The production of myocardial lesions and circulating anti-heart antibodies has been studied in rats injected with homologous heart extracts emulsified with the Freund's complete adjuvant and the DTP vaccine. Six of 7 rats showed lesions of focal myocarditis, while only in one of them circulating anti-heart antibodies were detected. There was no correlation between the presence of circulating anti-heart antibodies and that of myocardial lesions. These findings suggested that the circulating anti-heart antibodies may play little or no role in the pathogenesis of this experimental myocarditis.

Animals↗