著者
日野原 重明 新村 正幸
出版者
社団法人日本循環器学会
雑誌
日本循環器病學
巻号頁・発行日
vol.5, no.2, pp.67-71, 1939-05-01
著者
Ehara Mariko Surmely Jean-Francois Kawai Masato Katoh Osamu Matsubara Tetsuo Terashima Mitsuyasu Tsuchikane Etsuo Kinoshita Yoshihisa Suzuki Tomomichi Ito Tatsuya Takeda Yoshihiro Nasu Kenya Tanaka Nobuyoshi Murata Akira Suzuki Yasuyuki Sato Koyo Suzuki Takahiko
出版者
社団法人日本循環器学会
雑誌
Circulation journal : official journal of the Japanese Circulation Society (ISSN:13469843)
巻号頁・発行日
vol.70, no.5, pp.564-571, 2006-04-20
参考文献数
23
被引用文献数
19 174

Background Multislice computed tomography (MSCT) is a promising noninvasive method of detecting coronary artery disease (CAD). However, most data have been obtained in selected series of patients. The purpose of the present study was to investigate the accuracy of 64-slice MSCT (64 MSCT) in daily practice, without any patient selection. Methods and Results Using 64-slice MSCT coronary angiography (CTA), 69 consecutive patients, 39 (57%) of whom had previously undergone stent implantation, were evaluated. The mean heart rate during scan was 72beats/min, scan time 13.6s and the amount of contrast media 72mL. The mean time span between invasive coronary angiography (ICAG) and CTA was 6 days. Significant stenosis was defined as a diameter reduction of >50%. Of 966 segments, 884 (92%) were assessable. Compared with ICAG, the sensitivity of CTA to diagnose significant stenosis was 90%, specificity 94%, positive predictive value (PPV) 89% and negative predictive value (NPV) 95%. With regard to 58 stented lesions, the sensitivity, specificity, PPV and NPV were 93%, 96%, 87% and 98%, respectively. On the patient-based analysis, the sensitivity, specificity, PPV and NPV of CTA to detect CAD were 98%, 86%, 98% and 86%, respectively. Eighty-two (8%) segments were not assessable because of irregular rhythm, calcification or tachycardia. Conclusion Sixty-four-MSCT has a high accuracy for the detection of significant CAD in an unselected patient population and therefore can be considered as a valuable noninvasive technique.
著者
北田 茂
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.5, pp.609-618, 1959

By the use of ballistocardiograph of modified von Wittern's table which has natural frequency of 0.6 cps. and is capable of taking simultaneous two directional records, longitudinal and lateral or sagital records were taken on 6 cases with pulmonary stenosis, 6 cases with patent ductus arteriousus, 11 cases with atrial septal defect, 8 cases with ventricular septal defect and 5 cases with coarctation of the aorta, and these records were analysed from the view points of hemodynamics studied by right heart catheterization. Thus the following results were gained.1. Pulmonary stenosis : Longitudinal IJ<SUB>M</SUB> showed a tendency to be decreased but Ra and IK/IJ ratio had a tendency to be decreased. In cases with elevated right ventricular pressure, as compared to those of low right ventricular pressure, the ratio of amplitude of lateral and sagital systolic wave complex to that of longitudinal IJ<SUB>M</SUB> tended to be increased. There was also a tendency for R-I interval to be shortened and for R-J interval to be prolonged.2. Patent ductus arteriosus : Longitudinal IJ<SUB>M</SUB>, Ra and JK/IJ ratio showed a tendency to be increased and HI/IJ ratio tended to be decreased. In cases with great shunt flow (shunt rate of more than 50%) and elevated pulmonary arterial pressure, lateral and sagital systolic wave complex showed a marked increase in the amplitude. R-J and R-K interval ahd a tendency to be shortened. On the other hand, they were prolonged in two post-oprative cases.3. Atrial septal defect : Longitudinal IJ<SUB>M</SUB> and Ra showed a tendency to be decreased. In cases with high shunt rate and elevated right ventricular pressure, lateral and sagital systolic wave complex showed a increased amplitude. R-I and R-J interval tended to be shortened.4. Ventricular septal defect : Longitudinal IJ<SUB>M</SUB> and Ra showed a tendency to be decreased. In cases with high shunt rate, there was an increase in amplitude of lateral and/or sagital systolic wave complex. The increase in the amplitude was slight in cases with right to left shunt.5. Coarctation of the aorta : Longitudinal IJ<SUB>M</SUB> and HI/IJ ratio tended to be increased and in all cases JK/IJ ratio showed a marked decrease.6. In deseases with left to right shunt flow (patent ductus arteriosus, atrial septal defect and ventricular septal defect), there was a positive correlation between shunt rate and the ratio of resultant force vector of lateral and sagital component to longitudinal force vector.
著者
斎藤 雅彦
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.39, no.12, pp.1345-1355, 1976

1.食用ガエル心房筋の摘出標本について,膜興奮から張力発生に至る過程への温度1の効果を2重隔絶膜電位固定法を用いて検討した.2.心房筋を高温(3℃)から(4℃)に冷却するとき,膜のわずかな脱分極,活動電位の振巾の増大とその持続時間の顕著な延一長にともない,静止張力の減少と,単収縮張力の著しい増大が出現し,加温すればいずれにおいても可逆的な復元が認められた.3.膜電位を静止電位レベルに維持し,数秒おきに1秒間の矩形波脱分極固定を行った場合にも,冷却により単収縮張力は増大し,静止張力は減少した.この所見は低温による単収縮張力の増強が活動電位の.単なる延長のみによるものでない事を示す.4.このさい,矩形波脱分極固定に対する終末電流ならびに容量性電流は減少し,また,活性内向き電流の経過は遅延し,外向き遅延電流は著しく抑制された.5.TTX(10<SUP>-7</SUP>g/ml)存在下でも低温により単収縮は増大し,静.上張力は減少した.また遅い内向き電流の増強ないし遅延電流の抑制も認められた.6.正常リンゲル液中の膜電位一電流特性から,冷却による遅い内向き電流の増強と,遅延電流の抑制は別個に出現する現象であることが推測された.また冷却により活動電位の振巾は増大し,内向き電流の逆転電位は上昇するが,さらに収縮の立上り速度の上昇,頂点時間の延長などの変化の所見から低一温ではI<SUB>Ca</SUB>による張力発生が主役を果すと考えられた.7.また矩形波脱分極と発生張力の関係から,冷却は膜電位一張力曲線を過分極側に移行せしめるとともに.収縮張力発生の閾値,張力飽和の飽和電位も過分極側へ移行することが認められた.8.以上の所見から,低温はおそらく膜結合のCaを増加し,これが膜抵抗, I<SUB>Ca</SUB>の増大をもたらし, I<SUB>Ca</SUB>の増大は単収縮張力を増強するという変力機構の存在に加えて,他方,膜抵枕の増大,外向きのI<SUB>K1</SUB>,I<SUB>X1</SUB>電流の抑制はいずれも活動電位の持続を延一長し,さらに収縮張力の増強をもたらすという2重の変力機構があることが結論された.