Noninvasive evaluation of left ventricular performance with a new systolic time interval, the Q-V peak, and comparison with established systolic time intervals.
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Aged↗
Biomedical subjects
T Fujinami
Publications and source records attributed to T Fujinami.
Short- and long-term effects of cigarette smoking on heart rate variability.
The short- and long-term effects of cigarette smoking on autonomic cardiac regulation were investigated by power spectral analysis of heart rate variability under controlled respiration (15/min). The short-term effects were examined in 9 smokers without evidence of cardiopulmonary disorders after an overnight abstinence from smoking. The heart rate spectral component reflecting the respiratory sinus arrhythmia (0.25 Hz), a quantitative index of vagal cardiac control, decreased 3 minutes after smoking 1 cigarette (p = 0.0061) and the component reflecting Mayer wave sinus arrhythmia (0.04 to 0.15 Hz), which includes sympathetically mediated activity, increased after 10 to 17 minutes (p = 0.0124). The long-term effects were examined in 81 normal subjects comprising 25 nonsmokers, 31 moderate (1 to 24 cigarettes/day) smokers and 25 heavy (greater than 25 cigarettes/day) smokers after an overnight abstinence. Although the magnitude of the Mayer wave component was unaffected by the smoking status, the respiratory component in the supine position was smaller in the young (less than or equal to 30 years) heavy smokers than in the young nonsmokers or moderate smokers (p = 0.0078). Also, postural changes in the components, a decrease in the respiratory component and an increase in the Mayer wave component with standing, were observed in the nonsmokers but not in the heavy smokers. These results suggest that smoking causes an acute and transient decrease in vagal cardiac control, and that heavy smoking causes long-term reduction in vagal cardiac control in young people and blunted postural responses in autonomic cardiac regulation.
Adult↗
Diurnal variations in vagal and sympathetic cardiac control.
To investigate the diurnal variation in autonomic cardiac control, the magnitudes of the power spectral components of supine and standing heart rate variability were measured during controlled respiration (15 breaths/min). Examination was performed hourly between 0700 and 2300 h in eight male subjects whose activities and food intake were controlled for 24 h in the laboratory. The respiratory component (0.25 Hz) was greater in the morning than in the late afternoon (P less than 0.05) and decreased 30 min after food intake (P less than 0.01) in the supine position, but it was unaffected by the time of day or food intake while in the standing position. The Mayer wave component (0.03-0.15 Hz) did not change with the time of day, but it increased 90 min after food intake in both supine and standing positions (P less than 0.01 and P less than 0.05, respectively). These data suggest that supine vagal cardiac control during the waking period increases in the morning and decreases 30 min after food intake and that sympathetic cardiac control increases 90 min after food intake.
Adult↗
Decreased magnitude of heart rate spectral components in coronary artery disease. Its relation to angiographic severity.
We analyzed the spectral components of RR interval variability under controlled respiration (15 breaths/min) in 56 patients (age range, 35-73 years) referred for coronary angiography; 14 patients had multivessel disease (group M), 21 had one-vessel disease (group S), and 21 had nonsignificant disease or normal coronary artery (group N). There were 43 healthy controls (age range, 36-71 years) (group C). The patients had no clinical evidence of heart failure, hypertension, diabetes mellitus, or acute stage of infarction and had taken no medication for 3 days. The autoregressive power spectral density of RR interval variability contains two major components, respiratory sinus arrhythmia (RSA) (0.25 Hz) and Mayer wave-like sinus arrhythmia (MWSA) (0.04-0.15 Hz), which have magnitudes that are quantitative markers of cardiac vagal activity and sympathetic activity with vagal modulation, respectively. We represented the magnitudes by the coefficient of component variance (CCV), which provided the amplitude relative to the mean RR interval. The age- and sex-adjusted mean of CCVRSA significantly decreased with advancing angiographic severity (1.64 +/- 0.09%, 1.66 +/- 0.12%, 1.22 +/- 0.13%, and 0.81 +/- 0.16% for groups C, N, S, and M, respectively) (p = 0.0001). The CCVRSA was unrelated to left ventricular function, previous myocardial infarction, or stenosis of any specific artery including the sinoatrial and atrioventricular node arteries. The CCVMWSA decreased only in group M (p = 0.0462). These results indicate that coronary artery disease is associated with vagal dominant impairment in autonomic cardiac function and that reduction in the vagal cardiac function correlates with the angiographic severity.
Adult↗
Isolation of Staphylococcus species from the tonsils of healthy cattle and phage patterns of isolates.
Staphylococci were found in the tonsils of 121 (75.2%) of 161 cattle. There were 15 different species, 10 belonging to novobiocin-sensitive species. The most predominant species was S. simulans (79.3% of the 121 carriers), followed by S. aureus (20.7%), S. chromogenes (10.7%) and S. epidermidis (8.3%). The other 11 species were present in 0.8 to 5.8%. Twenty-six unidentifiable isolates were isolated from 26 (21.5%) carriers. Sixty-two (51.2%) of the 121 carriers yielded two to five Staphylococcus species together while only one species could be found in each of the other 59 (48.8%). Combinations of S. simulans and other species were most frequently encountered in 50 (41.3%) of the 121 carriers. Twenty-four (96.0%) out of 25 S. aureus isolates, 3 (42.9%) of 7 S. hyicus isolates and 45 (25.4%) of 177 coagulase-negative staphylococci (13 species and unidentifiable isolates) isolates were phage typable. Most of S. aureus isolates were lysed by bovine phages 119 (n = 16) or 116 (n = 5). Thirty-three (25.4%) of 45 coagulase-negative staphylococci typable isolates with Pulverer's phage set showed the phage pattern ph5/ph9/ph10/ph12/ph13/U4/U14/U16/++ +U20/U46. The tonsils of cattle thus appear to be a suitable environment for Staphylococcus species, particularly novobiocin-sensitive species.
Animals↗
[Noninvasive evaluation of left ventricular function using new systolic time intervals obtained from continuous-wave Doppler echocardiography].
Left ventricular function was evaluated using parameters derived from the flow velocity waveforms at the ascending aorta as obtained at the suprasternal notch by continuous-wave Doppler echocardiography in 39 patients; 12 with chest pain but without coronary stenosis, eight with angina pectoris; and 19 with myocardial infarction. Peak flow velocity and the time interval from the beginning of the Q wave of lead II of the ECG to peak flow velocity (Q-V peak) correlated with specific invasive hemodynamic parameters, such as max dp/dt and (max dp/dt)/IP (IP: total left ventricular pressure at the same instant) during isometric contraction of the left ventricle measured with a catheter tip manometer, and left ventricular ejection fraction (LVEF) obtained by bi-plane cineangiography (using the area-length method). There was no correlation between the peak flow velocity and the invasive hemodynamic parameters. However, significant negative correlations were observed between the Q-V peak time and max dp/dt, with r = 0.40 (p less than 0.05), and between the Q-V peak time and (max dp/dt)/IP with r = -0.61 (p less than 0.01). A negative correlation was obtained between the Q-V peak time and LVEF (r = -0.75, p less than 0.01). The regression equation was LVEF = -0.67 x (Q-V peak) + 176. To compare the effectiveness for predicting LVEF between the Q-V peak and the established systolic time intervals as PEP and PEP/ET, these time intervals were measured from flow velocity waveforms invasively obtained with a catheter-type electromagnetic flowmeter inserted into the ascending aorta in 14 patients selected from the original subjects.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Nodular glomerulosclerosis in a patient showing impaired glucose tolerance.
We report a case showing typical diabetic nodular glomerulosclerosis without retinopathy or other apparent clinical findings of DM except for impaired glucose tolerance. The 57-year-old man had a family history but no personal history of DM. In an extensive examination for DM, the results of funduscopy, daily profile of serum glucose and hemoglobin Alc were entirely within normal limits. However, the oral glucose tolerance test was abnormal. A renal biopsy showed typical nodular lesions (Kimmelstiel-Wilson's lesions). Previously, the interesting feature of transient proteinuria had been recognized. Although hypocellular nodular lesions by light microscopy are characteristic of diabetic nephropathy, renal amyloidosis, carbon disulfide intoxication, multiple myeloma and light chain disease, we concluded that the present lesions had resulted from diabetic nephropathy based on the family history, patient history, impaired glucose tolerance, immunofluorescent findings and electron microscopic observations.
Diabetic Nephropathies↗
Reduction in blood viscosity by treatment with coenzyme Q10 in patients with ischemic heart disease.
The effects of coenzyme Q10 (CoQ10) on blood viscosity were studied in twelve patients (mean age 49 +/- 16 years) with ischemic heart disease. Twenty mg of CoQ10 was orally administered three times daily for two months (total dose 60 mg per day). Blood viscosity was measured with a cone-plate type viscometer at the shear rates of 37.5, 75, 150, and 375 s-1. Yield shear stress was calculated from Casson's plot. Blood viscosity decreased at each shear rate after the administration of CoQ10. Yield shear stress decreased significantly by the treatment with CoQ10. Hematocrit and fibrinogen were also measured, but showed no significant change. These results suggest that CoQ10 decreases the blood viscosity, i.e., improves the rheological properties of blood in ischemic heart disease.
Administration, Oral↗
[A case of chronic recurrent pulmonary embolism treated by pulmonary embolectomy and Günther vena caval filter implantation].
A case report of chronic recurrent pulmonary embolism treated by embolectomy and Günther vena caval filter. A 62-year-old man had suffered from dyspnea on effort for 4 years, and his feeling of dyspnea had gradually increased during the past 3 months. On the day of admission he was in a preshock state, and his pulmonary artery pressure was very high at 90/30 mmHg. Pulmonary blood perfusion scintigraphy showed multiple defects of isotope uptake. Immediately after the scintigraphy, pulmonary embolectomy was performed while using extracorporeal circulation. The operation was successful and his physical activity was markedly improved. After the operation, anti-coagulant and anti-platelet therapies were continued, but recurrence of pulmonary emboli was detected by scintigraphy, and some thrombi were found by venography in deep veins of the lower parts of both legs. To prevent recurrent pulmonary embolism, a Günther vena caval filter was inserted into the inferior vena cava. We considered this case as an acute worsening of chronic recurrent pulmonary embolism and we had the impression that pulmonary embolectomy is a very effective therapeutic method for serious pulmonary embolism, and that insertion of the Günther vena caval filter is a very easy and safe procedure.
Chronic Disease↗
[A case report of IgD myeloma with acute renal failure and deposition of lambda light chain along the tubular basement membrane].
A case of IgD lambda type multiple myeloma that developed acute renal failure was presented. Histopathologic studies revealed apparent myeloma cast nephropathy with typical giant cells and light chain deposition along tubular basement membrane and inter-peritubular interstitium. Glomerular deposits of light chain were absent by electron and immunofluorescent microgram. The presented case showed a very uncommon histopathologic findings of unusual deposits of light chain, to tubulo-interstitium except for glomeruli, in addition to vertically rare IgD myeloma. A sixty-year old female who was suffered from acute renal failure and treated by hemodialysis for one month was admitted to our institute. Physical examinations revealed ill-apparent and emaciated uremic patient on admission. Laboratory and radiological studies demonstrated IgD lambda type monoclonal protein and numerous punched out appearance of skull bone. The diagnosis of IgD lambda myeloma was confirmed with aspiration bone marrow test. Anti-myeloma therapy of melphalan and prednisolone have started, however, fatal arrhythmia suddenly suffered the patient and resuscitation attempts failed to get any success one week after admission. Renal necropsy was performed and specimens were studied by light, immunofluorescent and electron microscope.(ABSTRACT TRUNCATED AT 250 WORDS)
Acute Kidney Injury↗
Impedance cardiography for the assessment of cardiac function during exercise.
1. Impedance cardiography proved valuable to estimate the stroke volume and other cardiac parameters noninvasively, when the electrical resistivity of the blood was corrected with hematocrit. 2. Cardiac response to graded exercise on a bicycle ergometer up to the maximal load in healthy young and active middle-aged subjects was divided into four phases from the changes in cardiac parameters such as stroke volume, cardiac output, ejection index and height of the atrial wave. 3. The ischemic patients did not tolerate well the exercise after the second phase or drift phase of exercise. 4. Physical training enhanced the cardiac function in work through increase in cardiac output and work load.
Adult↗
Impedance cardiography for estimating cardiac output during submaximal and maximal work.
Impedance cardiography was used to estimate cardiac output in 10 men during rest and within 5 s after exercise on a bicycle ergometer, including work up to and including maximal aerobic capacity. An indwelling venous catheter permitted simultaneous sampling of venous blood for observing changes in hematocrit associated with each exercise level. Cardiac output, calculated from a standard equation which assumes a constant value of 150 omega.cm for the electrical resistivity of blood, was compared with corresponding calculations in which blood resistivity was individually determined as a function of hematocrit. It is concluded that many of the discrepancies in the literature related to values for cardiac output obtained during exercise by the impedance method may be inherent in calculations that do not consider the changing electrical resistivity of the blood with a changing hematocrit.
Adult↗
Clinical study of "A waves" (atrial waves) in impedance cardiograms.
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Atrial Fibrillation↗
[Proceedings: P wave in electrocardiography and the pulse wave in ischemic heart diseases].
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Coronary Disease↗
[Proceedings: Some clinical problems in permanently installed pacemakers].
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Humans↗
[Proceedings: Myocardial sarcoidosis--2 autopsy cases with artificial pacemaker implantation].
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Aged↗
Coronary risk factors in angiographically defined patients with chest pain.
Coronary risk factors were assessed in 186 consecutive patients who received coronary angiography. The severity of coronary luminal narrowing was scored as the coronary sclerosis index (CSI). Patients were divided into normal coronary arteries (N, n = 72), coronary sclerosis without infarction (C, n = 73) and previous myocardial infarction (MI, n = 41). The CSI increased with age. A significant difference in serum triglycerides, HDL cholesterol and atherogenic index was observed between Groups C or MI and N. Multivariate analysis revealed that CSI had correlated with total- and HDL-cholesterol, uric acid and age in subjects under 55 years; and with age, blood sugar, factor H and HDL cholesterol in those of 55 years or over. When patients were classified by their total and LDL cholesterol level, a significantly different CSI was found between the desirable and high cholesterol levels in subjects under the age of 55, but it was not significant in those over 55. Therefore, disorders in lipid metabolism should be corrected in early middle age.
Adult↗