Journal of cardiology
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Journal of cardiology · Sep 1989
Comparative Study[Out-of-hospital sudden cardiac death: a comparative study spanning 10 years].
Incidence, etiology and time zones of sudden cardiac deaths were compared for 1986 and 1976. Totals of 1,140 cases of acute endogeneous deaths, 590 in 1986 and 550 in 1976, were sent for coroner's inquest in Kanagawa Prefecture. These were the materials for the present study. ⋯ In ischemic heart disease, deaths most frequently occurred about midnight (from 12 a.m. to 1 a.m.) or in the evening (from 5 p.m. to 6 p.m.), and deaths due to acute cardiac failure occurred during sleep. Time zones of evening deaths in ischemic heart disease corresponded to the report of Muller et al., but, the peak about midnight was not reported. This difference may be explained by the circadian rhythm theory, however, heavy alcohol intake and spasmogenicity in the Japanese people may also play roles in midnight deaths.
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Journal of cardiology · Sep 1989
[The relationship between mitral regurgitation and asynergy of the left ventricle in old myocardial infarction].
To elucidate the mechanism of mitral regurgitation (MR) in patients with old myocardial infarction, two-dimensional (2D) and 2D Doppler echocardiographic examinations were performed in 92 patients. According to the sites of asynergy in the short-axis view of the left ventricle at the papillary muscle level, the patients were classified in three groups; i.e., anteroseptal (AS) group (49 cases), inferoposterior (IP) group (29 cases), and the AS + IP group (14 cases). The existence and severity of MR were evaluated by 2D Doppler echocardiography and the presence of mitral valve prolapse (MPV), by 2D echocardiography. ⋯ In these groups, mitral valve ring diameters were significantly larger in patients with MR than in those without MR (AS group: 32 +/- 3 mm with MR vs 24 +/- 2 mm without MR; p less than 0.01, IP group: 26 +/- 2 mm with MR vs 25 +/- 2 mm without MR; NS, AS + IP group: 30 +/- 3 mm with MR vs 24 +/- 1 mm without MR; p less than 0.05). Mitral valve ring diameters in the IP group with MR (26 +/- 2 mm) were smaller than in those in the AS and AS + IP groups with MR, and did not differ from those in the IP group without MR (25 +/- 2 mm). In conclusion, posterior papillary muscle dysfunction was mainly responsible for MR in the inferoposterior infarction and the dilatation of the mitral valve ring in the infarction involving the anteroseptal wall.