著者

Matsumori Akira Ohashi Naohiro Nishio Ryosuke Kakio Tadashi Hara Masatake Furukawa Yutaka Ono Koh Shioi Tetsuo Hasegawa Koji Sasayama Shigetake

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.63, no.6, pp.433-438, 1999-05-20

被引用文献数

2 23

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The familial of hypertrophic cardiomyopathy(HCM)is attributed to mutations in the genes for contractile proteins, but the etiology of non-familial form remains unknown. This study was designed to examine the clinical features, histopathologic changes, and hepatitis C virus(HCV)genomes in patients with HCM associated with HCV infection. Anti-HCV antibody was present in the sera of 9 of 65 patients(13.8%)with HCM versus 2.41% in a control population of voluntary blood donors in Japan, a statistically significant difference (p<0.0001). Among these 9 patients, 6 had ace-of-spades-spaped deformities of the left ventricle with apical hypertrophy. Myocardial fibrosis was found in all patients, and mild cellular infiltration was observed in 5patients. Type 1b HCV RNA was present in the sera of 5 of the 9 patients. The copy number of HCV was 5.5×10^3-8.6×10^5 genomes/ml serum, and multiple clones of HCV were detected in the sera of each patient by an analysis of the hypervariable regions using fluorescent single-strand conformation polymorphism. Positive strands of HCV were found in the hearts of 5 patients, and negative strands in the hearts of 2 patients. A high prevalence of HCV infection was found in patients with HCM, particularly of the apical variety, suggesting that HCV is an important causal agent in the pathogenesis of the disease.

著者

前田 雅人 中尾 正一郎 宮里 浩高 瀬戸口 学 有馬 新一 田中 弘允 樋口 逸郎 納 光弘

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.58, 1994-04-20

著者

TOYAMA J. HONJO HARUO OSAKA TOSHIYUKI ANNO TAKAFUMI HIRAI MAKOTO OHTA TOSHIKI KODAMA ITSUO YAMADA KAZUO

出版者

社団法人日本循環器学会

雑誌

Jpn. Circ. J. (ISSN:00471828)

巻号頁・発行日

vol.51, pp.163-171, 1987

被引用文献数

1

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In order to clarify the role of Purkinje fibers in the occurrence of reperfusion arrhythmias, endocardial mapping was performed on perfused canine hearts by attaching 42 close bipolar electrodes to the endocardial surface of the left ventricular septum. Reperfusion with oxygenated Krebs-Ringer solution following 30 min of coronary occulusion induced ventricular tachycardia (VT) in 14 out of 23 preparations. These VT degenerated into ventricular fibrillation (VF) within 1 min after the reperfusion in all but 3 cases. Endocardial mapping revealed that the excitations during VT were always initiated by the Purkinje activities and that myocardial excitations were expanded in a centrifugal manner through Purkinje-muscle junctional area. Furthermore, this excitation pattern was preserved, in the early phase of VT, even though the propagation pattern was distorted. VF was always induced by reperfusion following 30 min of ischemic condition, that is, coronary perfusion with a hyperkalemic (K=10 mM), acidic (pH=6.8) and hypoxic (PO_2=20-40 mmHg) solution (4/4 cases). Elimination of hyperkalemia from the ischemic condition markedly prevented occurrence of VF (1/6 cases) during reperfusion but it did not affect occurrence of VT (4/6 cases); this implies that hyperkalemia causes the onset of VF but has less effect on the occurrence of VT. It has been separately confirmed by micro-electrode experiment, using the dissected papillary muscle of the canine right ventricle, that abnormal impulse formation during re-oxygenation was triggered in Purkinje fibers around Purkinje-muscle junction.

著者

TOCHIKUBO O. MIYAZAKI Naomichi KANEKO Yoshihiro OCHIAI Hisao

出版者

社団法人日本循環器学会

雑誌

Jpn Circ J (ISSN:00471828)

巻号頁・発行日

vol.50, pp.808-817, 1986

被引用文献数

5

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For statistical analysis of 24-hour recordings of arterial pressure (AP) and heart rate (HR), it is necessary to establish a theoretical probability density function of the distributions. In the present study, 24-hour recordings of direct AP and HR were performed in 15 normotensives (NT) and 39 patients with essential hypertension (EH) by means of a new portable device with a digital memory for analyzing frequency histograms. In both NT and EH, frequency histograms of AP(systolic and diastolic AP) and HR during a 24-hour period showed bi-modal curves, whereas those made during sleep and waking produced asymmetrical patterns resembling Gamma distribution. From the AP and HR histograms made fro each subject during sleep and waking, such parameters as mean (M), standard deviation, mode(Mo), skewness (Sk), kurtosis (K) and minimum values (Mi) were calculated. The Sk and M minus Mo were positive, and K was greater than 3 in both HR and AP histograms ; the AP and HR histograms during sleep can be more correctly analyzed with Gamma distribution (mean parameter errors were less than 7.3%) than with Gaussian distribution (in this : S=0, M minus Mo=0, K=3). The Mi would accord with the location parameter of the Gamma distribution.

著者

Kinji Ishikawa Ken Kanamasa Iwao Ogawa Toshihiko Takenaka Takeo Naito Noriaki Kamata Tadahiko Yamamoto Shoji Nakai Junkichi Hama Miki Oyaizu Akio Kimura Kentaro Yamamoto Naoko Aso Miyuki Arai Hiroshi Yabushita Ryo Katori on behalf of the Secondary Prevention Group

出版者

The Japanese Circulation Society

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.60, no.10, pp.779-788, 1996 (Released:2001-12-25)

参考文献数

27

被引用文献数

50 63

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Background Nitrates dilate coronary arteries, ameliorate myocardial ischemia, minimize left ventricular remodeling, and reduce mortality in patients with acute myocardial infarction. However, the effects of long-term treatment with nitrates on cardiac events in patients with healed myocardial infarction are not known. Methods and Results A total of 1,002 patients with healed myocardial infarction (789 male and 213 female) were randomly divided into 2 groups: treatment with nitrates or nontreatment. The mean observation period was 18.0 ±19.9 months. Primary end points were nonfatal and fatal recurrent myocardial infarction, death from congestive heart failure, and sudden death. Baseline characteristics of the 2 groups were also compared to determine any effects on outcome. Among the 621 cases treated with nitrates, 41 cases (6.6%) experienced cardiac events during the observation period, whereas only 12 of the 381 cases that were not treated with nitrates (3.1%) had cardiac events. This difference was statistically significant (p<0.05; odds ratio 2.17; 95% confidence interval 1.13-4.19). There were no differences in the incidence of noncardiac death or being lost to follow-up between the 2 groups. Although the precise mechanism of this increase in the occurrence of cardiac events by long-term treatment with nitrates is not clear, nitrate tolerance with possible rebound and neurohormonal effects may be involved. Conclusion Long-term treatment with nitrates increased cardiac events in patients with healed myocardial infarction. (Jpn Circ J 1996; 60: 779 - 788)

著者

向原 直木 安部 行弘 武田 光 藤井 章伸

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.51, 1988-02-10

著者

宮崎 學

出版者

社団法人日本循環器学会

雑誌

日本循環器學誌 (ISSN:00471828)

巻号頁・発行日

vol.22, no.11, pp.822-831, 1959-02-20

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The CERO_2,composite factor of the balance of supply and demand of oxygen in the brain, not only expresses the presence and intensity of cerebral anoxia objectively but also seems to be an important compensatory factor in the maintenance of the normal cerebral function. The circulation and metabolic function in the brain were regulated in two ways by the blood flow regulating mechanism in and outside of the brain and by the compensatory change in CERO_2 of the cerebral tissue itself. The metabolic disturbance of the brain appears to be evoked by the insufficient compensation of CERO_2. Taking into consideration that the results obtained by N_2O method which state that the decrease in cerebral metabolism of the aged people is a secondary phenomenon of the decrease in oxygen supply to the brain, mainly the decrease in CBF, it is supposed that CERO_2 in the aged people should be greater than normal young people. Usually an inverse correlation is assumed between CBF and CERO_2. As the CBF of the aged is mainly due to the asteriosclerosis of the brain, a certain kind of correlation is inferred between CERO_2 and cerebral arteriosclerosis.The present author, to study the correlation between CERO_2 and cerebral arteriosclerosis, has measured CERO_2 in healthy and anemic aged subjects, examined the clinical significance of CERO_2 by comparing to the results obtained by N_2O method, retinal findings, cerebral symptoms and autoptical findings, and obtained the following results.1. The increase in CERO_2 was observed in about 70% of healthy aged subjects. Such frequent cerebral anoxia in healthy older people suggests the possibility of cerebral anoxia and cerebral metabolic disturbance in the aged.2. The assumption that the difference in CERO_2 in healthy aged subjects in caused by the abnormality of cerebral hemodynamics (decrease in CBF and increase in CVR) was confirmed experimentally and by the results obtained by N_2O method.3. The fact that this increase in CVR reflects mainly the attitude of the sclerotic cerebral arteries was examined by the correlation between retinal findings, cerebral symptoms and CERO_2.4. From the above stated results it is inferred that CERO_2 may be applied clinically as a measure of the intensity of cerebral arteriosclerosis.5. However, when anemia, disturbance in pulmonary function, abnormality of cerebral oxygen supply due to other CBF diminishing factors than cerebral arteriosclerosis, or primary metabolic abnormality of the brain is present, some considerations to such abnormal conditions are required.6. In anemic aged people, when the abnormality of the cerebral circulation is intense, anemia acts facilitatory to cerebral anoxia.7. Therefore, in this case, it is supposed that the CBF estimated from CERO_2 takes a value lower than the actual level and that CVR and the intensity of arteriosclerosis take higher levels.8. The intensity of cerebral arteriosclerosis increased in parallel with CERO_2 in the autoptical findings and the hypertensive subjects who increased in CERO_2 has a tendency of cerebral apoplexy. From this results it is inferred that CERO_2 may be applied as a critical signal of cerebral apoplexy too.

著者

Shozo Sueda Takaaki Ochi Kazuo Yano Kazuaki Mineoi Tadashi Kondou Naoto Ochi Yutaka Hayashi Hitoshi Kukita Shouzou Matsuda Hiroyuki Kawada Takashi Tsuruoka Tadao Uraoka

出版者

日本循環器学会

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.64, no.8, pp.559-565, 0001-01-01 (Released:2001-05-31)

参考文献数

30

被引用文献数

16 24

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The incidence of provoked coronary spasm with the standard single spasm provocation test has been relatively low in patients with rest angina. The present study examined the clinical usefulness of a newly designed spasm provocation test, an intracoronary injection of acetylcholine (ACh) following an ergonovine (ER) test, in patients with rest angina who demonstrated low disease activity and atypical chest pain. Triple sequential spasm provocation tests were performed in 24 patients with atypical chest pain who had no ischemia and in 40 patients with rest angina who had distinct ischemia. Initially, an ACh test (20-100μg) and then an ER test (40-64μg) were performed and then, if no spasm was provoked, an intracoronary injection of ACh was given after the ER test to evaluate coronary spasm. Coronary spasm was defined as total or subtotal occlusion. In the 24 patients with atypical chest pain, no spasm was provoked by intracoronary injection of either ACh or ER, but coronary spasms were induced in 2 patients using the new method, with the remaining 22 not experiencing spasm (specificity of new method, 92%). In the 40 patients with rest angina, intracoronary injection of ACh induced coronary spasm in 22 patients (group I) and 6 (group II) demonstrated spasm with intracoronary injection of ER. Coronary spasm was not induced by either the ACh test or the ER test in 12 patients (group III). The intracoronary administration of ACh after the ER test provoked spasm in 11 of 12 patients. Diffuse spasms were provoked in 10 of 11 patients. In patients with rest angina, the frequency of chest pain attacks in 1 month experienced by patients in group III (0.8±0.8) was significantly lower than that of patients in group I (7.0±5.3, p<0.01) or II (3.5±2.3, p<0.05). No serious or irreversible complications related to this new combined method were observed. In conclusion, this method was safe and reliable for the induction of coronary spasm in patients with rest angina who may have low disease activity.

著者

吉田 忠正

出版者

The Japanese Circulation Society

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.28, no.9, pp.704-711, 1964

被引用文献数

1

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Recently, the hepatic circulation in hemorrhagic shock has been investigated by HEINEMANN, BRADLEY, SELKURT, FRANK and others. However, the opinions among the authors have not yet been in agreement but rather controversial, par icularly, as to the relationship between hepatic blood flow and cardiac output. HEINEMANN reported that hepatic blood flow fell sharply following hemorrhage and then returned spontaneously the control level in absence of the restoration of blood pressure. While, the others reported that hepatic blood flow did not recovered and remained in decreased level, having the same trend in blood pressure change. It seems likely that such a controversy will be partly due to the difference of the methods employed in measuring hepatic blood flow and partly to the confusion in recognizing the stage of shock, because the sequence of respective hemodynamic phenomenon is considerably different at the period of observation in this condition. The purpose of the present paper is to classify the relationship of hepatic blood flow and cardiac output throughout the entire course of hemorrhagic shock and its bearing on the irreversibility of shock. Oxygen utilization in the splanchnic viscera was also studied. The Relationship between Hepatic Blood Flow and Cardiac Output 1) Methods : Hepatic blood flow was measured by modified Frank's method. Twenty-two dogs ranging in weight from 8 to 20 kg were used and anesthetized with intravenous pentobarbital sodium of 25 mg/kg. A polyethylene catheter was passed through a right external jugular vein into the hepatic vein and then wedged into one of hepatic lobar veins. The outer end of the catheter in the hepatic vein was fixed at the level of the vena cava and allowed to drain continuously. The rate of hepatic outflow was measured by a graduated cylinder and stop watch. The blood collected was returned by transfer to an elevated burette draining into a left external jugular vein. Heparin (3-5 mg/kg) was given intravenously during the experiments. Cardiac output was calculated from indicator dilution curves according to the STEWART-HAMILTON principle. Two different procedures were used. In one method <SUP>32</SUP>P labelled red cells were used as an indicator and injected intravenously. Blood samples were collected successively from the femoral artery. In another cases, radio-iodinated serum albumin (RISA) was injected as an indicator. Cardiac output was calculated from radio-cardiograms by using a scintillation detector at the heart region and a rate-meter. 2) Results : We could distinguish the following two stages in hemorrhagic shock in relation to hepatic blood flow and cardiac output. a) The first stage : In the early stage of shock, hepatic blood flow decreases in parallel with the changes in cardiac output. b) The second stage : After same delay from the initial bleeding, hepatic blood flow decreases progressively without marked reduction in cardiac output. Consequently, a difference or "gap" appears in percentile changes of hepatic blood flow and cardiac output. c) Effects of transfusion : Complete recovery of arterial pressure, cardiac output and hepatic blood flow can be obtained by a transfusion performed in the first stage. Whereas, the transfusion made in the second stage give rise only transient recovery of arterial pressure and cardiac output.

著者

大澤 正義

出版者

社団法人日本循環器学会

雑誌

日本循環器學誌 (ISSN:00471828)

巻号頁・発行日

vol.23, no.8, pp.1183-1192, 1959-11-20

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In preceding report III, the histological results of the Sino-Tawara system were reported as a few specific systems. In this report, the functions of these systems were confirmed physiologically by means of cutting and ligating examinations of these systems. These physiological results were reported by Tateishi. The author carried out the histological aspects in relation between the cut or ligated parts and specific pathways on 18 dogs.The summary of this study are as follows.1) In 9 cases, that confirmed the complete cut of the Systema septo-angularis anterior by histological examinations, the PQ intervals were prolonged prominently. And in some cases that were cut but a small part of this system, the PQ intervals were prolonged in near proportion to the cut extent. From these results, it could be supposed certainly that this system was a main pathway as the Sino-Tawara system.2) In 10 cases, that comfirmed the complete cut of the Systema septo-angularis posterior by histological examinations, the P Q intervals reduced rather than the former or prolonged a little. These results were not agreeable with the author's and past investigators' histological observations. The author asserted the opinions of Robb, Kaylor & Turman in relation between the specific muscular fibers and its function.3) The cut method of the Systema dextroatrii caudalis was difficult technically because it was along the Arteriola sini. But from the facts that the PQ intervals were prolonged by the cut of the right atrial bundle, it could be supported that this system had the function as the Sino-Tawara system.4) In 5 cases, that comfirmed the complete cut of the right atrial bundle, the PQ intervals were prolonged prominently. From these facts, it could be supposed that this bundle was very important as the final pathway connected with the Tawara node.5) In 2 cases cut one-third of the Tawara node, the PQ interval was prolonged prominently. But in this cut extent, the A-V blocks were not observed. The author discussed as to the relationship between its functioin and histological structure.6) The atrial parts, in which were not observed the specific muscular fibers as the Sino-Tawara system by histological examinations, were performed by the cut examinations. From these results, these cut parts were not recognized functionally as the significance as the Sino-Tawara conducting pathways. Particularly, in the Torus Loweri, the author did not observe the important value as the Sino-Tawara system by histological and physiological examinations.

著者

立石 圭太 村上 暎二 竹越 襄 松井 忍 村上 英徳 升谷 一宏 野村 正幸 藤田 静 辻 外幸 茶谷 隆 江本 二郎 津川 博一 橋本 明久 右田 哲也 的場 宗敏 岡田 真人 伊藤 順

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.46, 1982-11-01

著者

富田 籌夫 舘田 邦彦 本間 紀久雄 小林 毅 川合 栄邦 小野寺 壮吉 村尾 誠 黒田 練介 森山 良子 高畠 英敏

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.36, no.12, 1973-02-20

著者

鎌倉 充夫 松尾 仁司 岡田 邦博 松原 徹夫 松野 由紀彦 杉山 明 上野 勝己 小田 寛 琴尾 泰典 大橋 宏重 杉下 総吉 渡辺 佐知郎 滝谷 博志 小池 茂文 宇治 正二 河合 寿一

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.56, pp.534-535, 1992-05-20

著者

杉江 三郎 高橋 雅俊 工藤 武彦 古川 欽一 鳴海 康安 堀口 泰良 緒方 昭逸 島崎 和郎

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.25, no.4, 1961-04-15

著者

小谷 暢啓 菅森 峰 国澤 良嗣 太田 庸子 高橋 伸幸 井上 慎一 坂根 健志 中村 広 清水 優美 加藤 晴美 佐野 和也 村上 陽 石橋 豊 島田 俊夫 村上 林児

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.64, 2000-04-20

被引用文献数

1

著者

柴田 宣彦 恩地 豊志 野坂 修一

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.49, 1985-03-01

著者

深澤 隆治 小川 俊一 ラルフ ケリー ステファン フランツ ダグラス ソーヤー マーク マキオニ

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.64, 2000-03-01

著者

伊藤 誠 三ツ浪 健一 蜂須賀 正孝 尾藤 慶三 木之下 正彦 河北 成一

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.51, 1987-12-20

著者

Kiyoshi wakugami Kunitoshi Iseki Yorio Kimura Koichiro Okumura Yoshiharu lkemiya Hiromi Muratani Koshiro Fukiyama

出版者

日本循環器学会

雑誌

JAPANESE CIRCULATION JOURNAL (ISSN:00471828)

巻号頁・発行日

vol.62, no.1, pp.7-14, 1998 (Released:2001-11-25)

参考文献数

38

被引用文献数

33 40 52

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Coronary heart disease (CHD) is rare in Japanese subjects and serum cholesterol levels are low. However, no data have been published relating the effect of serum cholesterol levels to the incidence of acute myocardial infarction (AMI) in Japan. Data from a large community-based mass screening registry are available for the geographically isolated island of Okinawa, Japan (1980 census, 1.11 million). A total of 38,053 participants (17,859 men and 20,194 women) whose serum cholesterol levels were determined in the 1983 mass screening were examined to determine whether they had experienced AMI. Every case of AMI that occurred during a 3-year period (1 April 1988 to March 1991) throughout Okinawa was recorded in a separate registry. The total number of cases of AMI was 1,021 (674 men and 347 women). Of these, 65 patients (41 men and 24 women) were identified by name, sex, birth date, and zip code in the mass screening registry. The cumulative incidence of AMI increased with the serum level of cholesterol: 42.1 (serum cholesterol ≤ 167 mg/dl), 133.5 (serum cholesterol 168-191 mg/dl), 188.9 (serum cholesterol 192-217 mg/dl), and 323.0 (serum cholesterol ≥ 218 mg/dl) per 100,000 screened subjects. Multiple logistic analysis was conducted to examine the effect of serum cholesterol on the risk of AMI with adjustment for other variables such as sex, age, systolic and diastolic blood pressure, and proteinuria. The adjusted odds ratio (95% confidence interval) of the observed serum levels of cholesterol was 1.66 (1.29-2.15) with a reference serum cholesterol level of ≤ 167 mg/dl. The risk of AMI increased in proportion to the serum level of cholesterol. Serum cholesterol is an independent predictor of AMI in Okinawa, Japan. (Jpn Circ J 1998; 62: 7 - 14)

著者

小林 欣夫 中西 宣文 吉岡 公夫 岡野 嘉明 下村 克朗 小坂井 嘉夫

出版者

社団法人日本循環器学会

雑誌

Japanese circulation journal (ISSN:00471828)

巻号頁・発行日

vol.58, 1994-03-01