[A case of stunned myocardium: dual SPECT findings similar to acute myocardial infarction (AMI)].

Emergent cardiac catheterization was performed on a 70-year-old female patient who was admitted for further evaluation of acute myocardial infarction. Coronary angiography didn't reveal any significant stenotic lesion, but levogram showed extensively abnormal contractility around the center of the apex region. On the second hospital day, 99mTc-PYP/201TlCl dual SPECT gave findings similar to those found in acute myocardial infarction, but myocardium--released enzyme stayed within the normal range.

[Transthoracic Doppler color imaging of the blood flows in the left coronary septal branches].

This study characterized blood flow signals derived from the left coronary septal branches by transthoracic Doppler color flow imaging. In the anterior ventricular septum, the signal was detected in 7 of 13 patients with aortic stenosis, 8 of 34 with hypertrophic cardiomyopathy, and 5 of 144 patients with other diseased states. The peak diastolic flow velocity assessed by a pulsed Doppler technique ranged 21-115 cm/s (mean 57).

[The relation between the anaerobic threshold and exercise-induced myocardial ischemia in patients with ischemic heart disease].

The aim of this study was to clarify whether the anaerobic threshold (AT) in patients with ischemic heart disease is determined by exercise-induced myocardial ischemia. A) The reproducibility of the VO2 at the AT (AT VO2) were studied. In 13 patients with exercise-induced myocardial ischemia, submaximal Treadmill exercise tests were performed twice using a cardiopulmonary monitoring system.

[Electrophysiologic effects of flecainide on guinea pig atrium].

We investigated the effects of flecainide on guinea pig atrial muscle. Using Langendorff's method, the whole heart of a guinea pig was perfused with Tyrode's solution containing acetylcholine (3 x 10(-7) M). Then, with right atrial extrastimulus and high frequency pacing method, the following values were measured before and after administration of flecainide (10(-7)-10(-5) M).

Percutaneous transluminal coronary angioplasty in a patient with Kawasaki disease. A case report of an unsuccessful angioplasty.

A 13-year-old boy with severe coronary stenosis due to Kawasaki disease underwent percutaneous transluminal coronary angioplasty (PTCA). The guide wire and the balloon catheter easily passed through the stenosis in the left anterior descending artery. However, effective dilatation could not be achieved even when the balloon size was increased to 2.

[Ultrasonic tissue characterization in hypertrophic cardiomyopathy: analysis of three-layered appearance of the ventricular septum by apical approach].

In normal hearts, two-dimensional echocardiography from the apical window displays the left ventricular wall as a three-layered appearance (TLA): central bright layer and bilateral sonolucent zones. The TLA is considered to reflect the normal myocardial architecture: the predominant latitudinal fiber bundles of the midwall layer, and longitudinal or oblique ones on both sides. We analysed the TLA of the ventricular septum in 20 normal subjects, 20 patients with left ventricular hypertrophy due to pressure load (LVH), and 81 patients with hypertrophic cardiomyopathy (HCM).

Echocardiographic determination of stroke volume during rapid atrial pacing and volume loading in normal rats.

Objective: The aim was to validate echocardiographic assessment of acute changes of left ventricular stroke volume in normal rats.

Methods: By transthoracic use of a 7.5 MHz ultrasonic transducer, the left ventricular dimensions were determined before and during rapid atrial pacing and saline infusion in seven Wistar rats weighing 310-470 g.

Echo/Doppler diagnosis of tetralogy of Fallot, ventricular septal defect, pulmonary valve dysplasia, and hypertrophic cardiomyopathy in WKY/NCrj rats.

We examined the hearts of 97 WKY/NCrj rats, a strain which spontaneously develops congenital cardiac malformations, by means of echocardiography with a pulsed Doppler ultrasound, and compared the results with those of 20 WKY/Ta rats and 30 normal Wistar rats. Dissection of these WKY/NCrj rats revealed a ventricular septal defect (VSD) in 20 and pulmonary valve dysplasia (PVD) in 41, both VSD and PVD occurring together in 18. VSD was readily diagnosed in vivo by the jet flow signal derived from the left-to-right shunt near the membranous portion, with a sensitivity of 85% and a specificity of 99%.

The beta-adrenergic receptor/adenylate cyclase system in the cardiac ventricles of a hypertrophic cardiomyopathy rat model.

The WKY/NCrj rat strain is considered to be a good animal model for hypertrophic cardiomyopathy (HCM). The purpose of this study was to examine the beta-adrenergic receptor/adenylate cyclase system in the cardiac ventricles of these rats. beta-adrenergic receptor density (Bmax) in the right ventricle (RV) was higher in WKY/NCrj than in Wistar rats.

Slow kinetic property of mexiletine in guinea pig atrium.

We studied the onset and offset of use-dependent block (UDB) of maximum rate of rise of action potential (Vmax) with 3 x 10(-5)M mexilietine in guinea pig left atrium. A large decrease of Vmax was observed between the first and the second excitation when the preparations were stimulated at 4Hz after two minutes of rest period. UDB after the second excitation developed slowly to reach steady state within 30 sec.

Disuse atrophy of the left ventricle in chronically bedridden elderly people.

In the elderly cardiac size and function are determined by their level of physical activity. In this study, we assessed by echocardiography, the anatomic and physiologic changes of the heart in 28 elderly patients who had no cardiac disease and who were chronically bedridden. The data obtained were compared to those obtained from a control group of 38 age and sex matched elderly people whose activities had not been restricted.

Diastolic paradoxic jet flow in patients with hypertrophic cardiomyopathy: evidence of concealed apical asynergy with cavity obliteration.

In 20 of 198 patients with hypertrophic cardiomyopathy, Doppler color flow imaging revealed diastolic paradoxic jet flow across the obliterated left ventricular apex toward the base that suggested the presence of a discrete apical chamber. This prospective study characterized echocardiographic, ventriculographic and scintigraphic findings in these patients, as well as their clinical features. Although echocardiography did not directly show the apical chamber in 13 of the 20 patients, left ventriculography always revealed a small apical outpouching separated from the major basal cavity.

[Clinical evaluation of 123I-BMIPP myocardial scintigraphy in patients with hypertrophic cardiomyopathy].

123I-BMIPP myocardial scintigraphy was performed in 13 patients with hypertrophic cardiomyopathy and compared with 201Tl myocardial scintigraphy performed within 3 months for evaluating the clinical significance of 123I-BMIPP myocardial scintigraphy. SPECT images were divided into 13 segments and segmental images were visually scored on a 4 (increased tracer uptake) to 0 (severely decreased tracer uptake) scale according to the tracer uptake. In comparison of 123I-BMIPP early images and 201Tl perfusion images, mismatches were seen in about 70% of all segments.

The effect of percutaneous transluminal coronary angioplasty on anaerobic threshold in patients with angina pectoris.

The anaerobic threshold (AT) is regarded an objective parameter for evaluating exercise tolerance, but its relationship to the improvement of myocardial ischemia remains uncertain. To investigate this relationship, submaximal treadmill exercise tests were performed for 15 consecutive patients with angina pectoris who had undergone successful percutaneous transluminal coronary angioplasty (PTCA). Before and after PTCA, the AT was determined using cardiorespiratory monitoring, while the patients were receiving their usual vasodilator medications.

[Extent and degree of coronary flow reserve in hypertrophic cardiomyopathy assessed by delta Fract map unfolding coronary flow reserve index].

Patients with hypertrophic cardiomyopathy (HCM) are known to have ischemic events and decreased coronary flow reserve, but the variabilities in the site and degree of fall between patients with this disease have not been clarified. To elucidate these variabilities, we performed exercise myocardial single photon emission computed tomography (SPECT) using double dose method in 30 patients with HCM (6 with obstruction, 17 with non-obstruction, 7 with apical hypertrophy) and 10 normals. Then, the delta Fract (coronary flow reserve index) map was obtained for each subject.

[Regional myocardial coronary blood flow reserve in hypertrophic cardiomyopathy assessed by digital subtraction coronary angiography].

Using digital subtraction coronary angiography (DSA), we evaluated the regional myocardial coronary blood flow reserve (rMFR) in 18 patients with hypertrophic cardiomyopathy (HCM). There were 13 patients with asymmetrical septal hypertrophy (ASH), and 5 with asymmetrical apical hypertrophy (AAH). Eight subjects without apparent cardiac abnormality served as controls.

Electrophysiological effects of sodium channel blockers on guinea pig left atrium.

The electrophysiological effects of five sodium channel blockers (mexiletine, lidocaine, disopyramide, aprindine and flecainide) on the guinea pig left atrium were investigated by recording the action potential and its maximum rate of rise (Vmax). The onset and offset kinetics of use-dependent block of Vmax were analyzed. Lidocaine, aprindine and flecainide were classified clearly as fast, intermediate and slow, respectively.

[Effect of age on visualization of right atrium by thallium-201 myocardial scintigraphy].

With Thallium-201 (Tl) myocardial scintigraphy, right atrial (RA) myocardium has been visible in the disease involving the right side of the heart. We have found RA visualization in the elderly patients without the evidence of right heart disease. Therefore, we studied the relation of age to the RA visualization with Tl myocardial scintigraphy performed at rest.

[Electrophysiological effect of verapamil on human atrium].

To investigate the effect of verapamil on atrial vulnerability, the following measurements were performed before and after the intravenous administration of verapamil (0.15 mg/kg) in 10 subjects with paroxysmal atrial fibrillation (Paf), and 10 subjects without Paf (non-Paf). During the sinus rhythm, 1) intra-/interatrial conduction time (Intra-/Inter- ACT); the initial deflection of high right atrium (HRA) to that of His bundel/coronary sinus were measured.

[A case of hypertrophic cardiomyopathy with progressive cavity dilatation--a review of serial 201Tl myocardial imaging].

We reviewed 201Tl images of a 32 year old man with dilated hypertrophic cardiomyopathy (DHCM). At 22 years of age, when he was diagnosed as having nonobstructive hypertrophic cardiomyopathy (HCM)IVST; 20mm, Dd; 44mm, EF; 62%), 201Tl images showed only a small defect in the anteroseptal segment. At 27 years of age, when he had the first cardiac symptom as palpitation on exertion, his perfusion defect of 201Tl became wider.

Visualization of the heart and determination of left ventricular mass in rats by echocardiography.

A high-frequency transducer was used to determine the optimal parameters for visualizing the heart in 40 normal Wistar, 15 SHR, and 10 aorta-banded rats. The rats were 5 to 30 weeks old and weighed between 105 and 705 grams. Two-dimensional and M-mode views of the ventricles, atria, valves, and great arteries were obtained by placing the transducer beneath the rats through the left or right parasternal window in either the prone or the right decubitus positions, respectively.

Effect of cardiac sympathetic nerve stimulation on acutely ischemic myocardium--a comparison with the response to exogenous noradrenaline.

To assess the integrity of an adrenergic nervous function in acute myocardial ischemia, the contractile response of the ischemic region to cardiac sympathetic nervous stimulation (CSNS) was measured in comparison that with to exogenous noradrenaline (NA) infusion. In 13 anesthetized open chest mongrel dogs, haemodynamic changes, segmental wall motion, and the concentration of NA in the efferent coronary vein were measured. CSNS was performed by electrically stimulating the left ansa subclavia.

[Evaluation of coronary arterial stenosis before and after PTCA: visual estimation versus computer-assisted analysis].

Coronary arteriogram of 34 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) were evaluated visually and by computer-assisted analysis, that employed an edge detection method and cine-videodensitometry. The results of visual estimation were in general agreement with those of computer-assisted analysis for determination of percent area of stenosis in severe stenosis, and percent diameter of stenosis in slightly stenotic lesions. Before PTCA, the findings obtained by densitometry agreed with those using the edge detection method.