Journal of cardiology
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Journal of cardiology · Aug 1996
Review[How and to what extent has beta-blocker treatment been established for chronic heart failure?].
Over the past 20 years, the concept of chronic heart failure has changed. The activation of neurohumoral system is important in worsening the chronic heart failure. Therefore, it is reasonable to block the effect of the renin-angiotensin system and sympathetic nervous system on the heart for treatment of heart failure. ⋯ Some investigators are proposing the use of beta-blockers in chronic heart failure to ameliorate the harmful effect of excess sympathetic stimulation, but the exact mechanisms of beta-blockers are uncertain. Although a large number of studies have demonstrated the usefulness of beta-blocker treatment for chronic heart failure, many unsolved problems such as the exact mechanisms of beneficial effect, usefulness for ischemic heart disease, and the optimal agent and dose for treatment remain. Further studies are needed to establish this treatment.
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Journal of cardiology · Mar 1996
[Aortic inner surface morphology in aortic disease by three-dimensional transesophageal echocardiography].
Aortic inner surface morphology in various pathologies was investigated using three-dimensional (3D) transesophageal echocardiography to clarify the feasibility and limitations for clinical application. Transesophageal echocardiography was performed in 16 patients with aortic disease (12 aortic dissection, 4 aortic sclerosis) and 5 with normal aorta. The transesophageal transverse view of the descending aorta was taken every 2 mm by manually withdrawing the probe. ⋯ In aortic dissection, 3D reconstruction provided information regarding the spatial anatomy of the dissection in 10 of 12 patients, accurate shape and location of the intimal tears in 3 of 5 patients, and movement of the intimal flap in 9 of 12 patients. However, reconstruction of the false lumen failed in two patients who had false lumens filled with spontaneous contrast echo. Three-dimensional transesophageal echocardiography is potentially useful for estimating the inner surface morphology and spatial extent and actual location of the aortic abnormalities, but there are limitations in evaluating tissue characterization and reconstructing the lumen with spontaneous contrast echo.
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Journal of cardiology · Oct 1995
Case Reports[Treatment of refractory hypoxemia due to right-to-left interatrial shunt complicating right ventricular infarction: successful short-term percutaneous catheter closure of the patent foramen ovale].
Refractory hypoxemia as a complication of right ventricular infarction is rare. A 74-year-old man developed persistent hypoxemia due to right-to-left interatrial shunting through a patent foramen ovale during the acute phase of right ventricular infarction. Short-term percutaneous transvenous closure of the patent foramen ovale with a large balloon occlusion catheter was life-saving.
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Journal of cardiology · Oct 1995
Clinical Trial[Assessment of right ventricular function by magnetic resonance imaging of old myocardial infarction].
The usefulness of magnetic resonance imaging (MRI) for estimating right ventricular function and the influence of left ventricular dysfunction on the performance of the right ventricle were assessed in 43 patients with chronic myocardial infarction (MI) and 14 control subjects (N) using electrocardiography-gated MRI and cardiac catheterization. Patients with MI were divided into three groups according to the location of the coronary lesions; 22 patients with left coronary artery lesion (LCA group), 13 with right coronary artery lesion (RCA group), and 8 with both left and right coronary artery lesions (L+R group). The right ventricular end-diastolic volume (RVEDV) and right ventricular ejection fraction (RVEF) were measured by Simpson's rule algorithm on transverse images of the right ventricle obtained at the end-systolic and end-diastolic phases. ⋯ The RVEF and RVEDV determined from MRI were significantly correlated with those from the thermodilution method (RVEF: r = 0.56, RVEDV: r = 0.52). There was no difference in right ventricular end-diastolic volume index in any patient group. The RVEF was decreased in the L+R (41.0 +/- 4.5%, p < 0.01) and RCA (45.9 +/- 6.6%) groups, but there was no difference between the LCA (50.6 +/- 6.6%) and N (48.9 +/- 4.3%) groups.(ABSTRACT TRUNCATED AT 250 WORDS)