No abstract available.
Mitral Valve Insufficiency* ; Mitral Valve*

The pressure gradient across the mitral valve and atrioventricular pressure half time were measured by Doppler echocardiography during cardiac catheterization in 15 patients with mitral stenosis. Among these 15 patients with mitral stenosis, 6 patients were combined with aortic insufficiency and 4 patients with mitral insufficiency. Mitral valve area(MVAe) was measured by Doppler echocardiographic pressure half time and mitral valve area(MVAc) was measured by cardiac catheterization data(modified Gorlin's formula). Mean diastolic pressure gradient(MDPG) and peak diastolic pressure gradient(MDPG) measured by Doppler echocaridgraphy were compared with pulmonary wedge pressure. Obtained results were as follows; 1) Thewe was significant correlation between MVAe and MVAc regardless of mitral regurgitation or aortic regurgitation(r=0.09). 2) There was significant correlation between mean diastolic pressure geadient(MDPG) and mean pulmonary wedge pressure(r=0.69). But MDPG were lower than mean pulmonary wedge pressure in patients with mitral regurgitation or aortic regurgitation, which may be due to left ventricular volume overload. 3) The correction coefficiency between peak diastolic pressure gradient(PDPG) measured by Doppler echocardiography and mean pulmonary wedge pressure(r=0.59) was slightly lower than the correlation coefficiency between mean diastolic pressure gradient(MDPG) and mean pulmonary wedge pressure(r=0.69).
Aortic Valve Insufficiency ; Blood Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Echocardiography* ; Echocardiography, Doppler ; Humans ; Mitral Valve Insufficiency ; Mitral Valve Stenosis ; Mitral Valve* ; Pulmonary Wedge Pressure

To stydy the parameters of preload, afterload, and contractility of the heart, we evaluated 10 mitral stenosis, 5 mitral stenoinsufficiency, and 5 mitral stenosis with aortic insufficiency by measuring the external energy potential, external mechaical work, and external energy potential to PVa(Pressure-volume Area) ratio with non-invasive method, echocardiography and carotid pulse tracting. The results are summarized as follows; 1) External energy potential of mitral stenosis was significantly higher than that of MSI or MS with AI. 2) External mechanical work of MSI or MS with AI was significantly higher than that of Ms. 3) External energy potential to PVA ratio was signifiantly higher in the MS, but there was no significantly difference between the MSI and MS with AI. According to the above results, external energy potential to PVA ratio with echocardiogram and carotid pulse tracting was good parameters of preload, afterload, and contractility. And this method may used bed-side monitoring in the clinical area.
Echocardiography ; Heart ; Heart Valve Diseases* ; Mitral Valve Stenosis

Since recognition of coronary arterial clloateral circulation in living patients has been made possible by coronary arteriography, controversy has existed about the functional importance of these vessel and their ability to protect the myocardium against ischemia. The coronary arteriograms and left ventriculograms of 279 consecutive patients were reviewed. All had at least 50% diameter reduction of 1 or more major coronary arteries. In 94 patients(111 arteries), at least 1 major branch was totally occluded. Collateral circulation was seen in 85 of 111(76.6%) totally occlued arteries versus 22 of 107(20.6%) with > or =90% but <100% stenosis(P<0.01). No artery with <90% stenosis(254 arteries) recieved angiographically detectable collateral vessels. An analysis was made of the relation between left ventricular segmental wall motion and the quality of collateral circulation in 68 totally occluded arteries among 60 patients with myocardial infarction(Group 1) and in 43 totally occluded arteries among 34 patients without prior myocardial infarction(Group 2). Good collateral vessels went to 62.8% of Group 2, but 38.8% of Group 1(P<0.05). LV contraction was abnormal in all Group 1 patients with good collateral circulation. Of 27 with good collateral circulation in Group 2, LV contraction was normal in 59.3% and abnormal in 40.7%. But there was no statistically significant difference between the effect of good or poor collateral circulation in LV wall motion in each Group. Also we have studied the frequency of collateral circulation appearance in 34 patients, in whom the date of symptom onset of transmural infarction was definitely documented. The presence of collateral vessels was significantly higher in the patients studied 1-15 day period after symptom onset vs those studied within 1 day(77.8% vs 14.3%, P<0.05). but there was no significant differance in the apperance of collaterals in the patients studied in the 1-15 day vs the 15 day-2 month, and vs the 2-36 month period(77.85, 66.7% and 66.7%, NS). These observation indicate that collateral circulation cannot be seen angiographically unless there is total or near-total occlusion, and that the pressence of good collaterals may play a patrial role in preserving myocardial function and preventing myocardial infarction. The development of collaterals in myocardial infarction seems to be occurred within 15 days after the symptom onset of transmural infarction. But any benefits can not be expected from newly developed collateral circulation after myocardial infarction.
Angiography ; Arteries ; Collateral Circulation* ; Coronary Artery Disease* ; Coronary Vessels* ; Humans ; Infarction ; Ischemia ; Myocardial Infarction ; Myocardium

The analysis of regional myocardial function is important for the evaluation of myocardial performance. We evaluated whether the motion images of the coronary bifurcation points can be used for computation of the regional deformation and the regional wall stress. In 5 mongrel dogs, 4 to 7 lead markers were implanted adjacent to the bifurcarion points of coronary artery. Left ventricular pressure curve was obtained, and left ventriculography was performed to measure the major and minor axes of the left ventricle. Afterthen, biplane coronary arteriography was performed. The motion images of the lead markers and the corresponding coronary bifurcation points were used as landmarkers for the kinetic analysis of the regional wall deformation and wall stress. The results of the analysis using two kinds of landmarkers were well correlated(P<0.001). Analysis of the diagnosis biplane coronary cineangiograms of each patient group demonstrated that quite difference wave forms between the normally perfused segment and the underperfused segments. In group I there was no coronary arterial narrowings and no regional wall motion abnormalities. Their mean and peak wall thicking were 10.10+/-9.28% and 47.99+/-20.70%. And their peak and mean values of circumferential and longitudinal wall stresses are as follows; 2.70+/-0.74x10(5)dyn/cm2, 2.34+/-0.71x10(5)dyn/cm2, 0.84+/-0.21x10(5)dyn/cm2, 2.34+/-0.71x10(5)dyn/cm2, 0.84+/-0.21x10(5)dyn/cm2 and 0.64+/-0.13x10(5)dyn/cm2. Of 5 male patients having coronary arterial disease with regional wall motion abnotmalities(Group III), 2patients have single vessel disease, 2 paitents have 2 vessel disease. In subgroup b of group III, there was a significant decrease of regional wall thickening(mean and peak value; 0.54+/-9.91%.14.87+/-12.055; P<0.001 vs. group I), and increasing tendency of regional wall stresses. Using biplane coronary cineangiogram, which is routine diagnostic procedure in coronary artery disease, this method can valuate regional myocardial function. And this method can evaluate regional myocardial function. And this method will be especially useful, when serial coronary cineangiograms are needed for serial evaluation of patients, such as before and after percutaneous transluminal coronary angioplasty, coronary arterial bypass graft surgery, etc.
Angiography ; Angioplasty, Balloon, Coronary ; Animals ; Coronary Artery Disease ; Coronary Vessels ; Diagnosis ; Dogs ; Heart Ventricles ; Humans ; Male ; Transplants ; Ventricular Pressure

No abstract available.

The present study was undertaken to evaluate the effect on PVC with IV disopyramide injection in 23 patients with PVC. There were 6 male and 17 female patients with age from 16 to 71 years. Three patients of hypertension, two patients of atherosclerotic heart disease, one patient of myocardial infarction, one patient of mitral stenosis, one patient of cardiomyopathy, one patient of uremic heart, fourteen patients of fuctional PVC were studied. The dose of 100mg of disopyramide was given with IV injection repeatedly until PVC disappeared.(Total: 40 Times) EKG monitering was performed in all cases to reveal the following results while the patients were on the regimen. 1. PVC disappearance rate in 23 patients was 78.2%. Average disappearance time and average dose is 7 minutes, 70.5mg respectively. 2. EKG revealed no change in P-R interval and pulse rate but slight prolongation of QRS and QTc interval. 3. When repeated injection was performed, the effect against PVC was decreased. 4. Acute heart failure as complication of disopyramide was not developed in all patients. As a result of present study, we recommended IV disopyramide injection, when disappearance of PVC was required immediately and safely.
Cardiomyopathies ; Disopyramide* ; Electrocardiography ; Female ; Heart ; Heart Diseases ; Heart Failure ; Heart Rate ; Humans ; Hypertension ; Male ; Mitral Valve Stenosis ; Myocardial Infarction

The antihypertensive effects of once-daily 50mg dose of atenolol(Tenormin(R)) were observed in 28 cases of essential hypertension, and the results were as follows. 1. Mean drop in systolic and diastolic pressure were 19mmHg and 16mmHg respectively. 2. In 85.7% of the cases good or fair control of blood pressure was resulted. 3. Transient indigestion and fatigue were complained by 3 patients, but subsided spontaneously with continuous treament.
Blood Pressure ; Dyspepsia ; Fatigue ; Humans ; Hypertension

Antihypertensive and untoward effects of atenolol were studied in 20 cases of essential hypertension with their average pre-treatment systolic and diastolic blood pressures of approximately 160mmhg and 100mmhg, respectively. All patients were assigned to a single dose of 50mg atenolol once daily for a period of four weeks, and a weekly complete history and physical examination. Besides routine blood counts and urinalysis, blood chemistry relating to hepatic and renal functions, and electrolytes balance as well as fasting blood sugar levels were checked before and at the end of medication. In addition, in 10 cases, pulmonary function was studied before and after one week of treatment. With the therapy, the diastolic blood pressure fell to 90mmHg or below in 17 out of 20 cases(85%), and the pre-treatment diastolic blood pressure in the remaining three cases who responded poorly was 108mmHg or above. However two cases of the 17, who responded well and whose blood pressure became normal, had an initial diastolic pressure of 110mmHg each. The hypotensive effect of atenolol on both systolic and diastolic blood pressures was essentially similar, and the effect appeared during the first week with its peak effect occurring during the third week. There was no significant difference during treatment between recumbent and sitting blood pressures, both systolic and diastolic; thus no postural hypotension was observed. The comparison of the results of post-treatment laboratory tests with pre-treatment data revealed no significant changes. These suggest that atenolol can be used in patients with diabetes mellitus, chronic obstructive pulmonary disease or cerebral sclerosis, which are frquently associated with essential hypertension. Also a once-daily dose with satisfactory hypotensive response is one of very practical advantages of atenolol, particularly from the patient's point of view, in the treatment of hypertension, in which a life-long therapy is needed in most cases. Thus atenolol seems to be one of the most attractive choices of drugs for the treatment of mild to moderate hypertension.
Atenolol* ; Blood Glucose ; Blood Pressure ; Chemistry ; Diabetes Mellitus ; Electrolytes ; Fasting ; Humans ; Hypertension* ; Hypotension, Orthostatic ; Physical Examination ; Pulmonary Disease, Chronic Obstructive ; Tuberous Sclerosis ; Urinalysis

Twenty four hyperlipidemic patients, consist of 13 males and 11 females, were administration a new hypolipidemic agents, Pantethine, and blood lipid level were checked sereally for 16 weeks. The following results are obtained. 1. The serum high density lipoprotein-cholesterol are markedly increased by 11.8%. 2. The serum cholesterol level are reduced mildly by 4.8% & it seems to be insignificant. 3. The serum triglyceride level are moderately reduced by 10.7%. 4. In 11 female patients, pantethine are more than effect on male patients. 5. Pantethine has been well tolerated in most patients. With a consideration of remakable safety, it is promising that pantethine are effective in reducing cholesterol, Triglyceride and increasing high density lipoprotein-cholesterol level.
Cholesterol ; Female ; Humans ; Hypolipidemic Agents ; Male ; Triglycerides