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Biomedical subjects

S Tadaoka

Publications and source records attributed to S Tadaoka.

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

Effect of packed cell volume on diastolic coronary artery pressure-flow relations in the dog.

To elucidate the role of the haemorheological properties of the perfusate in the coronary circulation, the diastolic pressure-flow relation was studied in nine open chest heart blocked dogs with minimal vasomotor tone when blood with various packed cell volumes (12-67%) was used as perfusate. An electrical analogue model with proximal resistance R1, capacitance C, distal resistance R2, and the zero flow pressure intercept Pint was derived from the observation of the pressure-flow relation to support the data analysis. The diastolic pressure decay was then determined after the perfusion line had been clamped to calculate stop flow coronary artery pressure (Psf). The stop flow coronary artery pressure decreased in relation to packed cell volume (r = 0.45, p less than 0.01), and the value for the lowest packed cell volume (10-29%) was slightly higher than the great cardiac vein pressure (about 3 mmHg). The zero flow pressure intercept of the steady state pressure-flow relation showed a close correlation with the stop flow coronary artery pressure (r = 0.87, p less than 0.001). The value of R1 + R2, which reflects the inverse of the steady state pressure-flow slope, decreased simultaneously with the packed cell volume (r = 0.62, p less than 0.001). The resistance ratio R2/(R1 + R2) by our model prediction decreased in relation to packed cell volume (r = 0.5, p less than 0.001). The values of stop flow coronary artery pressure, zero flow pressure intercept, and R1 + R2 for the highest packed cell volume (50-69%) were 17.8(1.1) mmHg, 25.1(1.3) mmHg, and 0.48(0.05) mmHg.ml-1.min.100 g-1 respectively, whereas those for the lowest packed cell volume (10-29%) were 13.4(0.8) mmHg, 19.7(1.0) mmHg, and 0.24(0.02) mmHg.ml-1.min.100 g-1. The pressure difference between the stop flow coronary artery pressure and the zero flow pressure intercept may be due to the non-linearity in the pressure-flow relation at a low perfusion pressure. The left ventricular end diastolic pressure and great cardiac vein pressure did not change in relation to the packed cell volume of the coronary perfusate. Thus it is concluded that packed cell volume is one factor determining the high zero flow pressure.

Animals↗
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

Analysis of flow characteristics in poststenotic regions of the human coronary artery during bypass graft surgery.

Poststenotic blood flow velocities were evaluated in nine patients with 75% to 99% stenosis of the left anterior descending coronary artery (LAD) during coronary artery bypass graft surgery. We used the 20 MHz 80-channel pulsed Doppler velocimeter developed in our laboratory. An operator placed a specially designed probe on the native LAD with his fingers. Before induction of extracorporeal circulation, LAD blood velocities were measured at several locations distal to the stenosis. The poststenotic flow velocities were rich in systolic flow component with reduced diastolic component. The velocity configuration in the poststenotic portions was characterized by the presence of reverse flow velocities and/or irregularity of the velocity pattern near the vessel wall, indicating the existence of flow separation and recirculation in the regions. The broadening of the velocity spectrum observed at central axial regions suggested the occurrence of flow disturbances. After grafting, the velocity waveform in the LAD beyond a vein bypass graft changed to a diastolic-predominant pattern with a relatively small systolic component. A transient bypass graft occlusion caused a marked reduction in diastolic flow velocity. The systolic-to-diastolic velocity ratio increased from 0.27 +/- 0.07 to 1.50 +/- 0.50 (p less than .01) by the graft occlusion.

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↗
PubMed1986

Functional characteristics of intramyocardial capacitance vessels during diastole in the dog.

In order to evaluate the functional characteristics of the intramyocardial capacitance vessels during prolonged diastole, we analyzed the response of coronary vein flow after stepwise changes of coronary artery pressure in anesthetized open-chest dogs by using our newly developed laser Doppler velocimeter with an optical fiber. The peripheral portion of the great cardiac vein was isolated and the optical fiber tip was inserted into the vessel. The left anterior descending coronary artery was cannulated and connected to a reservoir to regulate coronary perfusion pressure. Intracoronary adenosine administration was carried out to avoid any change in coronary vasomotor tone. After 15 seconds of occlusion of the perfusion route, the heart was arrested by pacing-off. Two seconds later, coronary perfusion pressure was increased stepwise to a preset target pressure. This procedure was repeated by changing target pressure at 4 (or 5) different pressure levels (31-105 mm Hg). The great cardiac vein flow became zero due to the cardiac arrest and remained at zero for a moment (dead time) after the initiation of reperfusion. Then the flow reappeared and increased with first order time delay. The presence of dead time indicates the existence of unstressed volume, and the first order time delay represents the product of resistance and capacitance. The unstressed volume with a minimal vasomotor tone for perfusion pressure of 60-90 mm Hg was 5.2 +/- 2.2 ml per 100 g left ventricle, which is comparable to coronary blood flow for several beats. The capacitance at perfusion pressure of 60-90 mm Hg was 0.08 +/- 0.04 ml/mm Hg per 100 g left ventricle, while that at low perfusion pressure (30-50 mm Hg) was 0.14 +/- 0.09 ml/mm Hg per 100 g left ventricle. These results indicate that the intramyocardial capacitance vessels have two functional components, and that the phasic nature of coronary vein flow is solely the result of the myocardial squeezing of the blood in the capacitance vessels.

Animals↗
PubMed1986

Evaluation of human coronary blood flow with an 80 channel 20 MHz pulsed Doppler velocimeter and zero-cross and Fourier transform methods during cardiac surgery.

To evaluate local blood flow velocities accurately at many sampling points in small vessels, especially in human coronary arteries, we have developed an 80 channel 20 MHz pulsed Doppler velocimeter. Doppler signals from 80 channels are detected by a zero-cross method and a signal from an optional channel is analyzed by a fast-Fourier transform method, both in real time. Basic experiments using a model and animals have demonstrated the accuracy and utility of our method of measurement of blood flow velocity for both nondisturbed and disturbed flow. Velocity waveforms in a native coronary artery beyond a vein bypass graft insertion were measured during cardiac surgery. They showed a diastolic-predominant pattern with a small systolic component. During transient graft occlusion, the waveforms changed to a systolic-predominant pattern in a patient with severe stenosis and to a to-and-fro pattern in a patient with total occlusion. In a patient with severe aortic regurgitation, the coronary arterial velocity waveforms exhibited a systolic-predominant pattern with a broad velocity spectrum. After aortic valve replacement, however, a diastolic-predominant pattern with a narrow spectrum was observed.

Blood Flow Velocity↗