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Biomedical subjects

S Nezuo

Publications and source records attributed to S Nezuo.

At least 37 records · Page 2Linked to original sources
PubMed1989

[The effect of bunazosin vs captopril on hemodynamic and neurohumoral parameters in patients with congestive heart failure].

The hemodynamic parameters (right atrial pressure, mean pulmonary artery pressure, pulmonary capillary wedge pressure, cardiac index, heart rate, blood pressure) and neurohumoral responses (alpha-ANP, plasma renin activity, aldosterone, angiotensin II) of Captopril, oral ACE inhibitor, and Bunazosin, oral alpha 1-blocker, were investigated in 28 patients with congestive heart failure at rest and after exercise. These data were analysed in both acute and chronic phases. 1) Acute effect. Captopril produced significant improvement of neurohumoral factors at rest and also after exercise. Bunazosin reduced alpha-ANP, but other neurohumoral factors did not change. Bunazosin produced significant hemodynamic improvement both at rest and after exercise. 2) Chronic effect. Captopril produced significant hemodynamic improvement both at rest and after exercise. Improvement of neurohumoral factors in acute phase was also preserved at chronic phase. On Bunazosin, improvement of hemodynamics at acute phase was also preserved at chronic phase without deterioration of neurohumoral factors.

Adrenergic alpha-Antagonists↗
PubMed1989

[Significance of decreased washout rate in hypertrophic cardiomyopathy by exercise Tl-201 myocardial scintigraphy].

UNLABELLED: A clinical significance of decreased washout rate (WR) in hypertrophic cardiomyopathy by exercise thallium-201 myocardial scintigraphy was evaluated. Thirty-six patients with hypertrophic cardiomyopathy and normal coronary angiogram were categorized into 3 groups according to initial distribution (ID) and WR: decreased ID group (17 patients, ID group), normal ID but decreased WR group (9 patients, WR group) and normal ID and normal WR group (10 patients, N group). RESULTS: (1) Cardio-thoracic-ratio and left ventricular end-diastolic pressure were higher in WR group than in other 2 groups. (2) Resting ejection fraction and left ventricular end-diastolic volume index did not differ in three groups. (3) Exercise ejection fraction was increased in N group, whereas it was not increased in ID or WR groups. It was increased in 47% of ID group, but were decreased or not changed in all patients of WR group. In conclusion, decreased WR in patients with hypertrophic cardiomyopathy may strongly suggest left ventricular myocardial damage.

Adolescent↗
PubMed1989

[Severe hyponatremia associated with captopril therapy in dilated cardiomyopathy: a case report].

A 47-year-old man, with dilated cardiomyopathy developed severe hyponatremia and hypoosmolarity during captopril therapy. He also had an inappropriate elevation of antidiuretic hormone and urine osmolarity, but no evidence of dehydration, renal or suprarenal disturbances. The hyponatremia and hypoosmolarity improved after withdrawal of captopril alone, and recurred after readministration of captopril. We conclude that the hyponatremia may be caused by high secretion of prostagrandin and bradykinin associated with captopril therapy.

Bradykinin↗
PubMed1989

[A marked Hegglin syndrome in pheochromocytoma].

A 46-year-old man was hospitalized with paroxysmal headache and chest discomfort. His blood pressure varied, occasionally being up to 300/160 mmHg. Cardiac examination revealed a decrescendo type of diastolic murmur (aortic regurgitation) and S4 gallop. Both blood and urine catecholamine levels were extremely high. Electrocardiogram and echocardiogram showed severe left ventricular hypertrophy pattern presenting hypertrophic cardiomyopathic changes. The phonocardiogram showed marked Hegglin syndrome (QT; 450 msec and QII; 310 msec). Right adrenal tumor, pheochromocytoma was found on the abdominal CT scanning and 131I-metaiodobenzylguanidine (MIBG). In the post-operative period, Hegglin syndrome was completely abolished (QT; 360 msec and QII; 345 msec,), and also electrocardiographic left ventricular hypertrophy pattern improved immediately after surgical removal of the pheochromocytoma.

Adrenal Gland Neoplasms↗
PubMed1989

[Pulmonary hypertension due to glycogen storage disease type II (Pompe's disease): a case report].

A rare case of pulmonary hypertension due to glycogen storage disease type II (Pompe's disease) was reported. An 18-year-old girl was admitted to Kawasaki Medical School Hospital because of cyanosis, dyspnea on exertion and amenorrhea. She was 149 cm in height and 29 kg in body weight. Clinical examination revealed that pulmonary artery pulse and right ventricular heave were palpable over the precordium. On auscultation, an accentuated pulmonic second heart sound, pulmonic ejection sound and diastolic decrescendo murmur (Levine III/VI) were heard in the second intercostal space at the right sternal border. Her skeletal muscles, especially her intercostal muscles were generally weak and atrophic. Her electrocardiogram showed a pulmonary P-wave and right ventricular hypertrophy. The chest X-ray revealed right ventricular enlargement and a dilated pulmonary trunk. On echocardiography, the right ventricle and the main pulmonary artery were dilated, and a systolic notch of the pulmonary valve was found. Swan-Ganz catheterization disclosed that pulmonary artery pressure, right ventricular pressure and mean pulmonary capillary wedge pressure were 76/35 (50) mmHg, 76/12 mmHg and 10 mmHg, respectively. Respiratory function tests showed severe restrictive ventilatory impairment with hypercapnea and hypoxemia. On biopsy of the left quadriceps femoris muscle, the most striking finding was numerous intracytoplasmic vacuoles. The small vacuoles were stained with PAS and acid phosphatase. Electron microscopy showed massive glycogen accumulation in the sarcoplasm and membrane bound vacuoles (glycogenosome). Alpha-1, 4-glucosidase activity in the peripheral lymphocytes was definitely decreased. Her pulmonary hypertension resulted from respiratory muscular atrophy and alveolar hypoventilation caused by Pompe's disease.

Adolescent↗
PubMed1988

Right ventricular outflow obstruction secondary to post-infarction aneurysm: a possible new syndrome.

Two patients with extensive anterior myocardial infarction developed a hitherto unreported type of right ventricular outflow tract obstruction. A 71-year-old woman, who had had an acute infarction 10 years before, was admitted for sustained ventricular tachycardia. A loud ejection murmur was heard in the mid-precordium. The echocardiogram and left ventriculogram showed a septal aneurysm, with a systolic gradient of 21 mmHg between the right ventricular outflow tract and apex. The ejection murmur was detected in the outflow tract by intracardiac phonocardiography. The second patient was a 60-year-old man who had had an acute infarction at age 47. He was also referred because of ventricular tachycardia, and his clinical situation was almost the same as that of the first case. Our search of the literature failed to disclose any similar case with a loud ejection murmur confirmed by intracardiac phonocardiography to be due to an obstructive septal aneurysm.

Aged↗
PubMed1988

[Clinical significance of electrocardiographic P-terminal force in V1 in patients with hypertrophic cardiomyopathy].

The clinical usefulness of P-terminal force in lead V1 (P-TF) was evaluated in 49 patients with hypertrophic cardiomyopathy. These 49 patients were categorized as 17 with an abnormal P-wave (P-TF greater than or equal to 3.0 msec.mV: group A) and 32 with a normal P-wave (P-TF less than 3.0 msec.mV: group B). Systolic blood pressure response (delta SBP) during the treadmill exercise test was significantly less in the group A than in the group B (delta SBP: 36 +/- 22 mmHg, 58 +/- 26 mmHg, respectively). Left atrial dimension measured from the M-mode echocardiogram was 37.8 +/- 5.0 mm in the group A and 31.0 +/- 5.2 mm in the group B. These differences were statistically significant (p less than 0.05). Left ventricular end-diastolic pressure averaged 19.5 +/- 7.9 mmHg in the group A and 13.5 +/- 4.0 mmHg in the group B (p less than 0.05). When comparing the group A and B, negative dp/dt / positive dp/dt of the group A was significantly less (0.69 +/- 0.14, 0.90 +/- 0.18, respectively) and the time constant T of the group A was significantly prolonged (86 +/- 30 msec, 56 +/- 10 msec, respectively). According to classifications of hypertrophic cardiomyopathy, all patients with the obstructive type had an abnormal P-wave. On the contrary, the majority of patients with apical hypertrophy had a normal P-wave.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

[Clinical features and significance of hypertrophic cardiomyopathy with atrial fibrillation].

To elucidate the clinical features of hypertrophic cardiomyopathy (HCM) with atrial fibrillation (Af), the complications and prognosis of 18 patients with HCM complicated by Af (Af group) were compared with those of 20 patients without Af (non-Af group). The Af group was categorized depending on duration as 1. Af group I (four patients) with persistent Af at diagnosis, 2. Af group II (10 patients) with transient Af of more than five hours' duration, and 3. Af group III (four patients) with Af less than five hours' duration. The results were as follows: 1. During the follow-up period, among the 18 patients in the Af group, five including four patients in the Af group I, developed arterial embolism, 10 developed congestive heart failure, and three died suddenly. The patients in the non-Af group had excellent courses without serious complications. 2. Electrical cardioversion was performed in six patients in the Af group II, and sinus rhythm was restored in all of them, resulting in improved clinical courses. Thus, no complications developed in four patients whose sinus rhythm was maintained and whose clinical courses were favorable. 3. The P-terminal force in V1 prior to onset of Af in the Af groups II and III, left atrial dimension, and the cardiothoracic ratio in the Af group, were significantly greater than that of the non-Af group (p less than 0.01, p less than 0.05, p less than 0.05, respectively). In conclusion, HCM associated with Af has a poor prognosis, with severe complications such as heart failure, arterial embolism and sudden death. Cardioversion may be an effective method of choice of intervention in patients with recently-developed Af. P-terminal force in V1, left atrial dimension, and cardiothoracic ratio are regarded important factors in the development of Af.

Adult↗
PubMed1987

[Usefulness of measuring right ventricular anterior wall thickness in patients with right ventricular overload using M-mode echocardiography].

Right ventricular anterior wall thickness measured by M-mode echocardiography and right ventricular systolic pressure obtained by right heart catheterization were correlated in 62 patients with chronic right ventricular overload including congenital heart disease and primary pulmonary hypertension. The patients were divided into two groups; one, with right ventricular systolic pressures of 39 mmHg or less; the other, 40 mmHg or more. The following results were obtained. 1. The correlation coefficient for right ventricular anterior wall thickness and right ventricular systolic pressure was r = 0.90 (p less than 0.001), and the regression equation was y = 13.2x-1.3. 2. Right ventricular end-diastolic dimension increased significantly in both groups, but no statistically significant differences were detected between the two. Right ventricular anterior wall thickness increased significantly in the group with higher right ventricular pressures (7.1 +/- 0.5 mm vs 3.1 +/- 0.5 mm). 3. When right ventricular anterior wall thickness was more than 4.0 mm, pulmonary hypertension was detected, with a sensitivity of 97.5% and a specificity of 90.9%. In conclusion, measurements of right ventricular anterior wall thickness by M-mode echocardiography via the anterior chest wall proved to be potentially useful in predicting right ventricular systolic pressures in patients with chronic right ventricular overloads.

Adolescent↗