Journal of cardiology
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Journal of cardiology · Mar 2000
Comparative Study[Usefulness of rapid bedside cardiac troponin T assay for the diagnosis of acute myocardial infarction].
Cardiac troponin T(cTnT) is one of the most myocardial-specific markers for the diagnosis of acute myocardial infarction(AMI). Recently, the rapid bedside cTnT assay(Trop T rapid assay sensitive version), which can provide qualitative determinations within 15 min, has been developed for the emergency clinical setting. To evaluate the usefulness of rapid bedside cTnT assay, we performed the Trop T test and measured serum levels of myoglobin(Mb), creatine kinase MB isoenzyme(CK-MB) and cTnT in 256 consecutive emergency patients with suspected AMI(65 found to have AMI and 191 without AMI). ⋯ Furthermore, Trop T in patients admitted > 6 hr had significantly(p < 0.01) higher sensitivity compared with CK-MB(69%). The mortality rate in the non-AMI group during hospitalization in patients with positive Trop T test(39%) was significantly(p < 0.001) higher than that in patients with negative test(9%). When the positive Trop T test was regarded as > or = 0.10 ng/ml of serum cTnT, Trop T test had the best concordance of 92% with a quantitative of cTnT assay.
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Journal of cardiology · Oct 1999
Case Reports[Minimally invasive surgery for single valvular heart disease].
Two patients underwent valve surgery using the minimally invasive approach. A 51-year-old man underwent mitral valve repair for chronic mitral regurgitation due to prolapse of the posterior mitral leaflet. The left-half of his sternum was cut in "C" shape below the level of the second intercostal space, and all of the arterial or venous cannulas were inserted via this single access. ⋯ The median skin incisions were as small as 12 and 9 cm. Postoperative recovery was very smooth. Minimally invasive approach using selected partial sternotomy provides acceptable results with a good exposure, and is an alternative approach to valve surgery.
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Journal of cardiology · Mar 1999
Review[Historical perspectives on the mechanism of atrial fibrillation].
A number of experimental studies have been proposed to show that reentry is an important electrophysiological mechanism related to the development of atrial fibrillation. The beginning of the computer era enabled us to analyze the atrial activation during atrial fibrillation. The results of these studies were fascinating and allow for the development of theories and speculations on the mechanism of atrial fibrillation. ⋯ Spiral wave for ventricular fibrillation was also proposed for the atrial activation mechanism during atrial fibrillation in the experimental model. The evidence available at the moment warrants the statement that atrial fibrillation is caused by multiple wavelet reentry. These studies will allow a better understanding of the relative importance of wavelength and structural inhomogeneities in the genesis of atrial fibrillation.
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Journal of cardiology · Mar 1999
Review[The role of angioscopy and intravascular ultrasound imaging in acute coronary syndrome].
Evaluation of the severity of coronary atherosclerosis by intracoronary imaging may be closely relevant with the prevention and treatment of acute coronary syndromes. Coronary angioscopy as one of the innovative methods of imaging and intravascular ultrasound makes the insight visualization of coronary vessel wall and histological recognition possible recently. Yellow plaques rich in lipid materials and covered by thin membrane are more often ruptured than white ones to cause acute coronary syndromes. ⋯ More precise evaluation of plaque histology may be a clue to predict the occurrence of acute coronary syndrome. Intravascular ultrasound is not so useful enough to diagnose thrombosis. In conclusion, the applications of intravascular imaging technologies, such as angioscopy and intravascular ultrasound, may play a critical role in the diagnosis and treatment of acute coronary syndromes.