著者

Tomoko Machino-Ohtsuka Kentaro Minami Hiro Yamasaki Tomofumi Nakatsukasa Naoto Kawamatsu Kimi Sato Masayoshi Yamamoto Kazushi Maruo Tomoko Ishizu Yasushi Kawakami Masaki Ieda

出版者

The Japanese Circulation Society

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-23-0271, (Released:2023-06-30)

参考文献数

26

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Background: In patients with atrial fibrillation (AF) and severe blood stasis in the left atrial appendage (LAA), dense spontaneous echo contrast (SEC) disturbs the distinct visualization of the LAA interior, thus making thrombus diagnosis inconclusive. We aimed to prospectively assess the efficacy and safety of a protocol for a low-dose isoproterenol (ISP) infusion to reduce SEC to exclude an LAA thrombus.Methods and Results: We enrolled 17 patients with AF and dense SEC (Grade 4 or sludge). ISP was infused with gradually increasing doses of 0.01, 0.02, and 0.03 μg/kg/min at 3-min intervals. After increasing the dose to 0.03 μg/kg/min for 3 min, or when the LAA interior was visible, the infusion was terminated. We reassessed the SEC grade, presence of an LAA thrombus, LAA function, and left ventricular ejection fraction (LVEF) within 1 min of ISP termination. Compared with baseline, ISP significantly increased LAA flow velocity, the LAA emptying fraction, LAA wall velocities, and LVEF (all P<0.01). ISP administration significantly reduced the SEC grade (median) from 4 to 1 (P<0.001). The SEC grade decreased to ≤2 in 15 (88%) patients, and the LAA thrombus was excluded. There were no adverse events.Conclusions: Low-dose ISP infusion may be effective and safe to reduce SEC and exclude an LAA thrombus by improving LAA function and LVEF.

著者

南 健太郎 Kentaro Minami

出版者

熊本大学

雑誌

熊本大学社会文化研究

巻号頁・発行日

vol.5, pp.193-211, 2007-02-28

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A lot of cultures flowed in from China and a Korean peninsula around northern part Kyushu in the age of Yayoi. The bronze mirror is one in this, Northern part of Kyushu has been mainly brought from first Han to post Han. Yayoi period circulates Chinese mirror, divided mirror and imitative mirror. The purpose of this thesis is to catch a time, spatial transition of the bronze mirror and the realities of the metal mirror circulation are clarified. The going side by side relation between Chinese mirror and imitative mirror clarified. And Chinese mirror and imitative mirror distribution situation were compared, and the feature brought together. Result of analysis the first stage Chinese mirror is shown limited distribution and Korean imitative mirror was distributed to the remote place. The second stage, the bronze mirror is produced in northern part Kyushu. The reason for the factor of the production beginning is that a new thing for people who were managing circulation to distribute it to the surrounding is needed. This is thought for the factor of the production beginning to have existed on not the one that originates in the lack of Chinese mirror and the expansion of the mirror holder layer but the side where circulation was managed to the end.