Japanese heart journal
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Japanese heart journal · Jul 1983
Cardiac function and peripheral circulatory adjustments in patients with acute myocardial infarction. Observations during the early stage of AMI.
Since little is known concerning the effect of different types of cardiac dysfunction on the peripheral circulation in acute myocardial infarction, cardiac and peripheral circulatory hemodynamics were measured simultaneously and sequentially in the Coronary Care Unit in 40 patients with acute myocardial infarction (AMI) using a Swan-Ganz catheter and venous occlusion plethysmography. Patients were classified by clinical assessment (Killip) and into four hemodynamic subsets (HS) according to pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) measures obtained by invasive central hemodynamic monitoring (Forrester): uncomplicated AMI, HS-I (PCWP less than or equal to 18 mmHg, CI greater than 2.2 L/min/m2) 15; pulmonary congestion, HS-II (PCWP greater than 18 mmHg, CI greater than 2.2 L/min/m2) 15; peripheral hypoperfusion, HS-III (PCWP less than or equal to 18 mmHg, CI less than or equal to 2.2 L/min/m2) 4; cardiogenic shock, HS-IV (PCWP greater than 18 mmHg, CI less than or equal to 2.2 L/min/m2) 6. Measurements taken within 48 hours after the onset of AMI showed significantly lower calf blood flow (p less than 0.05) and calf venous capacitance (p less than 0.01) and higher calf vascular resistance (p less than 0.05) in all AMI classifications compared to 10 normal subjects. ⋯ In patients with AMI complicated by poor peripheral perfusion (HS-III), the peripheral changes did not show significant differences from those seen in uncomplicated AMI (HS-I). Significant correlations were found between calf blood flow and PCWP (r = -0.37, p less than 0.05) and CVP (r = -0.31, p less than 0.05); calf vascular resistance and PCWP (r = +0.36, p less than 0.05) and systemic vascular resistance (r = +0.43, p less than 0.01). Sequential daily peripheral hemodynamic changes in 14 H-I patients not requiring specific therapy showed that calf blood flow took 5 days, calf vascular resistance 3 days and calf venous capacitance 7 days to return to within normal levels.(ABSTRACT TRUNCATED AT 400 WORDS)
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Japanese heart journal · Jul 1982
Reliability of telephone transmission facilities for computerized electrocardiogram analysis in Japan.
The reliability of telephone electrocardiogram (ECG) transmission facilities was assessed in order to carry out the computerized ECG analysis using the IBM-Bonner program. Simulated ECGs were transmitted repeatedly over telephones from an internal laboratory and from an external hospital which was 1,000 Km distant. The simulated ECG was transmitted in a highly reproducible state and with no appreciable distortion. The telephone ECG transmission facilities using the public telephone network in Japan proved to reliable for computerized ECG analysis.
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Japanese heart journal · Jul 1982
A clinical study on the role of the renin-angiotensin-aldosterone system and catecholamines in chronic congestive heart failure.
In order to evaluate the roles of the renin-angiotensin-aldosterone system and of catecholamines in 117 normotensive patients with chronic congestive heart failure (CHF), a study was made of the relationships between plasma concentrations, hepatic extraction of these humoral factors and hemodynamic parameters. In 6 patients with moderate to severe CHF, the acute effect of oral; administration of angiotensin I converting enzyme inhibitor, SQ 14225 (captopril), on mean arterial pressure (MAP), peripheral venous pressure (VP) and these humoral factors was investigated. In patients with CHF of Class III-IV (according to NYHA classification), the urinary norepinephrine (U-NE) excretion increased. ⋯ These findings suggest that the sympathetic nervous system contributes to the elevation of SVR and PWP even before frank heart failure develops. The rise of P-NE seems to be due to increased norepinephrine release from sympathetic nerve beds, whereas a decrease in hepatic extraction and renal clearance probably has only a minor effect. The renin-angiotensin system also seems to contribute to elevation of SVR, to maintain effective arterial pressure by enhanced sympathetic activity, and the renin-angiotensin system seems to be a main determinant of PA in CHF.
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Japanese heart journal · Nov 1978
Comparative StudyHemodynamic effects of the concomitant use of intra-aortic balloon pumping and venoarterial bypass without oxygenation in cardiogenic shock.
The concomitant use of INTRA-AORTIC BALLOON PUMPING (IABP) and venoarterial bypass (VAB) without oxygenation (VABsO) was performed in 10 experiments using 6 dogs in cardiogenic shock. VABsO was accomplished with the cricuit from the right atrium to the femoral artery and bypass flow rates were set at approximately one third of the baseline cardiac output. ⋯ The following findings were obtained: (1) In the concomitant use, left ventricular afterload decreased, while mean aortic root pressure increased. Increase in total perfusion flow, decrease in mean left atrial pressure and decrease in left ventricular stroke work were shown more effective than each of the single uses. (2) These results suggest that the concomitant use of IABP and VABsO can be used as a second step assisted circulation when IABP is shown uneffective in the case of severe cardiogenic shock.
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Japanese heart journal · Jan 1977
Reappraisal of jugular phlebogram in the diagnosis of tricuspid regurgitation. Relationship between echocardiographic interventricular septal motion and jugular phlebogram.
Little information is available concerning the relationship between the pattern of the jugular phlebogram and interventricular septal motion. We studied 250 patients with various conditons. Abnormal septal motion was observed in only 33% of the patients with tricuspid regurgitation. ⋯ On the other hand, only 20 to 30% of the patients whose septal motion was normal had the jugular pattern of tricuspid regurgitation. Furthermore, all of the 3 patients with coronary artery disease having paradoxical motion of the entire septum had the jugular pattern of tricuspid regurgitation, as well. We conclude that the jugular pattern of tricuspid regurgitation and echocardiographic septal motion abnormality are related to each other and that tricuspid regurgitation should not be diagnosed by jugular phlebogram unless echocardiographic septal motion is examined.