JaLCDOI 10.18926/AMO/47263
フルテキストURL 65_6_379.pdf
著者 Shiraki, Teruo| Saito, Daiji|
抄録 The aim of this study was to clarify the prevalence of coronary risk factors in order to characterize the prognostic factors in elderly patients and to also identify any factors beneficial for the prevention of further cardiac events and death. We studied 888 patients with ST-elevation acute myocardial infarction who were admitted within 48h of symptom onset. The patients were divided into 3 groups according to age for comparison of variables:a younger group (n=99) aged<50, a middle-aged group (n=435)>51 years but<70 years and an elderly group (n=354) aged>71 years. The elderly group had higher rates of female gender, pulmonary congestion, in-hospital mortality, and atrial fibrillation and a higher plasma concentration of high-sensitivity CRP (hs-CRP) (p<0.05). Hypertension, diabetes mellitus, and dyslipidemia were more common in the middle-aged group (p<0.05). The prevalence of smokers and the plasma level of total cholesterol, LDL-cholesterol and triglycerides were lower in the elderly group (p<0.05). The grade of collateral circulation was highest in the elderly group, but the success rate of reperfusion therapy was lowest. Multiple regression analysis showed that age, pulmonary congestion, CKD and hs-CRP were predictors of in-hospital mortality.This investigation indicated that elderly patients with acute myocardial infarction have different clinical characteristics than younger patients. A specific algorithm might be needed in elderly patients, and could use hs-CRP, eGFR and atrial fibrillation as factors.
キーワード acute myocardial infarction coronary risk factor elderly
Amo Type Original Article
発行日 2011-12
出版物タイトル Acta Medica Okayama
65巻
6号
出版者 Okayama University Medical School
開始ページ 379
終了ページ 385
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2011 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 22189478
Web of Sience KeyUT 000298516900004
JaLCDOI 10.18926/AMO/47012
フルテキストURL 65_5_307.pdf
著者 Shiraki, Teruo| Saito, Daiji|
抄録 Factors contributing to the sex difference of in-hospital mortality after acute myocardial infarction (MI) are still unknown. We compared the clinical characteristics on admission and in-hospital outcome of consecutive 1,354 patients with acute MI between the 2 sexes. Age on admission was about 7 years older in women than in men. In-hospital death was significantly more frequent in women. Pulmonary congestion and hypertension were more likely in women with higher serum levels of total cholesterol and LDL cholesterol. A higher prevalence of current smoking and inferior wall involvement and lower serum HDL cholesterol level were observed in man. After adjusting for age, adverse in-hospital mortality for women was observed in both younger and older patients. Multivariate logistic regression analysis demonstrated that age, location of infarction, recanalization and serum C-reactive protein (CRP) concentration were independent predictors for in-hospital mortality for overall patients, while age and recanalization were independent predictors for male gender, and pulmonary congestion and serum CRP concentration were independent predictors for female gender. In-hospital outcome after acute MI was worse in women. A multivariate logistic regression model revealed that the sexually different factors affected in-hospital mortality in females.
キーワード sex difference acute myocardial infarction inferior infarction in-hospital mortality age difference
Amo Type Original Article
発行日 2011-10
出版物タイトル Acta Medica Okayama
65巻
5号
出版者 Okayama University Medical School
開始ページ 307
終了ページ 314
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2011 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 22037267
Web of Sience KeyUT 000296116400004
JaLCDOI 10.18926/AMO/32869
フルテキストURL fulltext.pdf
著者 Tanakaya, Machiko| Takahashi, Natsuki| Takeuchi, Kazufumi| Katayama, Yusuke| Yumoto, Akihisa| Kohno, Kunihisa| Shiraki, Teruo| Saito, Daiji|
抄録 Postprandial hypotension is an important hemodynamic abnormality in diabetes mellitus, but few reports are available on the relationship between autonomic dysfunction and postprandial hypotension. Ten diabetic patients and 10 healthy volunteers were recruited for this study. Postural blood pressure and heart rate changes were measured before lunch, and then the hemodynamic responses to a standardized meal were investigated. Holter electrocardiogram (ECG) monitoring was conducted for assessing spectral powers and time-domain parameters of RR variations. Postural changes from the supine to the upright position decreased the systolic blood pressure of the diabetics from 133(+-)16 to 107(+-)20 mmHg (p<0.01), but did not decrease the systolic blood pressure of the controls. The heart rate remained constant in the diabetics but was increased in the controls. Food ingestion decreased systolic blood pressure in the diabetics, with a maximum reduction of 25(+-)5 mmHg. This decrease was not associated with any changes in the ratio of low frequency to high frequency, and yet the heart rate remained almost constant. Indexes involving parasympathetic tone were not affected. Food ingestion did not affect blood pressure in the control group. These findings suggest that lack of compensatory sympathetic activation is a factor contributing to postprandial hypotension in diabetics, and that parasympathetic drive does not make a significant contribution to this condition.
キーワード postprandial hypotension sympathetic tone RR variability diabetes mellitus
Amo Type Original Article
発行日 2007-08
出版物タイトル Acta Medica Okayama
61巻
4号
出版者 Okayama University Medical School
開始ページ 191
終了ページ 197
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 17726508
Web of Sience KeyUT 000248957100002
JaLCDOI 10.18926/AMO/32442
フルテキストURL fulltext.pdf
著者 Saito, Daiji| Yasuhara, Koichiro| Takeda, Kou| Hyodo, Tatsuo| Fujii, Akinobu| Uchida, Toshiaki| Abe, Yukihiro| Haraoka, Shoichi| Nagashima, Hideo|
抄録 <p>The effects of intravenous infusion of isoproterenol on stenosis resistance were studied in the anesthetized open-chest dog. The circumflex coronary artery (LCx) was isolated near its origin and an electromagnetic flow transducer was placed around the vessel for measuring coronary flow. A polyethylene catheter was inserted into the small branch of LCx for monitoring distal coronary pressure. LCx was constricted with a thick cotton string to a degree of obstruction that eliminated reactive hyperemia following a 20-second coronary occlusion. The coronary resistance across the stenotic segment (RL) was calculated as the pressure gradient across the stenosis divided by coronary flow. Isoproterenol was infused intravenously in a dose to keep the heart rate at a level 25-30% above the control with and without coronary constriction. For maintaining the ascending aortic pressure at the pre-isoproterenol level, the descending thoracic aorta was constricted with a tape. In the absence of coronary constriction, the vascular resistance of large coronary arteries was not affected by isoproterenol with a significant increase in coronary flow. In the presence of coronary stenosis, isoproterenol markedly increased RI regardless of additional aortic constriction. The magnitude of the increase in RL during aortic constriction varied directly with the percent increase in the pressure gradient across the coronary stenosis. Pacing-tachycardia essentially did not affect RL. These results suggest that isoproterenol increased the vascular resistance of the stenotic segment with fixed caliber.</p>
キーワード coronary cinstriction open-chest dog distal coronary pressure
Amo Type Article
発行日 1983-02
出版物タイトル Acta Medica Okayama
37巻
1号
出版者 Okayama University Medical School
開始ページ 59
終了ページ 66
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 6846053
Web of Sience KeyUT A1983QD83600007
JaLCDOI 10.18926/AMO/32419
フルテキストURL fulltext.pdf
著者 Saito, Daiji| Abe, Yukihiro| Takeda, Koh| Hyodo, Tazuo| Tani, Hideki| Ohnishi, Shigeru| Haraoka, Shoichi| Nagashima, Hideo|
抄録 <p>Stress-induced changes in the resistance due to coronary arterial stenosis of a fixed diameter and in the myocardial blood flow distal to the stenosis were investigated in the open-chest dog. Myocardial blood flow in the inner and outer third of the left ventricular wall was continuously measured with heated cross-thermocouples. The circumflex coronary artery was constricted with a thick string so that myocardial reactive hyperemia was nearly eliminated. Without constriction, a 15-second occlusion of the artery produced no significant changes in the resistance of large coronary arteries. On the contrary, in the presence of coronary constriction, a brief coronary occlusion caused a sustained decrease in distal coronary pressure and subendocardial myocardial flow during reactive hyperemia, while coronary flow returned quickly to the pre-occlusion level with significant reactive hyperemia of subepicardial flow. This change resulted in a long-lasting increase in the stenosis resistance. These results suggest that stenosis resistance changes dynamically, resulting in additional myocardial ischemia especially in the subendocardial myocardial layers.</p>
キーワード stenosis resistance coronary constriction transient myocardial ischemia myocardial flow
Amo Type Article
発行日 1983-10
出版物タイトル Acta Medica Okayama
37巻
5号
出版者 Okayama University Medical School
開始ページ 423
終了ページ 429
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 6650224
Web of Sience KeyUT A1983RN98400006
JaLCDOI 10.18926/AMO/32059
フルテキストURL fulltext.pdf
著者 Nakagawa, Masahiro| Saito, Daiji| Ueda, Minoru| Yoshida, Hidenori| Mae, Ritsuo| Ioriya, Kazuo| Haraoka, Shoichi|
抄録 <p>Vectorcardiogram (VCG) recorded by both the Frank and Kimura systems were examined in 45 patients with complete right bundle branch block (RBBB) and left axis deviation (LAD) to investigate the relationship seen on electrocardiogram (ECG) between RBBB with LAD and bilateral bundle. The sample included: 13 cases of type SI, SII, SIII, SaVF; 21 cases of type SI, SII, SIII, aVF; and 11 cases of types SI, SII, SIII. VCG recorded by the Frank system were classified into seven types according to the QRS loop pattern on the frontal plane and into three types according to the horizontal plane. The main findings were: (a) In the Frank system the QRS loop in the frontal plane showed a variety of patterns in RBBB with LAD. (b) On VCG of complete RBBB judged complicated by a left anterior hemiblock by the Frank system, the main portion of the QRS loop extended to the left superior or merely to the left in the frontal plane. The direction of rotation and position on the horizontal plane were not consistent. (c) The results of this study suggest the usefulness of the Kimura system as an auxiliary diagnostic technique.</p>
キーワード right bundle branch block left axis deviation bilateral bundle branch block vectorcardiography Frank system Kimura system
Amo Type Article
発行日 1979-10
出版物タイトル Acta Medica Okayama
33巻
5号
出版者 Okayama University Medical School
開始ページ 395
終了ページ 404
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 160186
JaLCDOI 10.18926/AMO/31857
フルテキストURL fulltext.pdf
著者 Iwasaki, Jun| Kono, Kunihisa| Katayama, Yusuke| Takahashi, Natsuki| Takeuchi, Kazufumi| Tanakaya, Machiko| Osawa, Kazuhiro| Shiraki, Teruo| Saito, Daiji|
抄録 <p>There is little information available concerning the influence of right bundle branch block (RBBB) on the prognosis of patients with inferior myocardial infarction (MI). In this study we evaluated the influence of RBBB on the short-term prognosis of patients with inferior MI. Our study subjects were 1,265 hospitalized patients with Q wave MI. Patients were divided into 4 groups based on the presence or absence of RBBB and on the location of the infarction. RBBB was classified into 4 categories according to the timing of its appearance and its duration as new permanent, transient, old and age indeterminate. In-hospital death and pulmonary congestion were observed more frequently in patients with RBBB than in those without RBBB. Moreover, in inferior MI as in anterior MI, in-hospital death and pulmonary congestion occurred more frequently in new permanent RBBB patients than in patients with other types of RBBB. Multivariate regression analysis reveals that new permanent RBBB was a strong independent predictor for an adverse short-term prognosis in patients with inferior MI, as well as in patients with anterior MI. New permanent RBBB during inferior MI is a strong independent predictor for increased in-hospital mortality, regardless of the infarction location.</p>
キーワード right bundle branch block inferior infarction in-hospital death new permanent RBBB
Amo Type Original Article
発行日 2009-02
出版物タイトル Acta Medica Okayama
63巻
1号
出版者 Okayama University Medical School
開始ページ 25
終了ページ 33
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 19247420
Web of Sience KeyUT 000263730300004
JaLCDOI 10.18926/AMO/31107
フルテキストURL fulltext.pdf
著者 Maekawa, Kiyoaki| Saito, Daiji| Kobayashi, Hiroo| Mizuo, Kouzo| Obayashi, Naotsugu| Uchida, Shinji| Haraoka, Shoichi|
抄録 <p>Nipradilol is a newly synthesized beta-blocker which has a propranolol-like structure and contains a nitrate moiety. To examine the effect of nipradilol on venous blood flow, a single oral dose of nipradilol (6 mg) and propranolol (20 mg) was administered in the same 15 normal volunteers on separate days. Peak flow velocities, flow velocity integrals, and the diameter of the right brachiocephalic vein were measured before and 2 h after drug administration using Doppler echocardiography. These two beta-blockers significantly decreased systolic blood pressure to the same extent as they did heart rate. Nipradilol dilated the venous diameter by 8% and decreased peak flow velocity by 8% during systole and 9% during diastole. The flow velocity integral in one cardiac cycle also decreased significantly by 14%. Propranolol, however, failed to modify these parameters. These results suggest that nipradilol decreased venous return through its nitroglycerin-like direct vasodilating action.</p>
キーワード Doppler echocardiography venous return nipradilol
Amo Type Article
発行日 1994-04
出版物タイトル Acta Medica Okayama
48巻
2号
出版者 Okayama University Medical School
開始ページ 87
終了ページ 91
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 8042538
Web of Sience KeyUT A1994NJ77500004
著者 Haraoka, Shoichi| Saito, Daiji| Ueda, Minoru| Yoshida, Hidenori| Ogino, Yasuhiro| Kusuhara, Shunichi| Yoshioka, Nobuhiko| Miyasaka, Minoru|
発行日 1978-04
出版物タイトル Acta Medica Okayama
32巻
1号
資料タイプ 学術雑誌論文
著者 Haraoka, Shoichi| Saito, Daiji| Tawara, Ritsuya| Ueda, Minoru| Yoshida, Hidenori| Ogino, Yasuhiro| Yoshioka, Nobuhiko| Ikenaga, Toyotake|
発行日 1978-07
出版物タイトル Acta Medica Okayama
32巻
3号
資料タイプ 学術雑誌論文
著者 Haraoka, Shoichi| Saito, Daiji| Miyasaka, Minoru| Kawasaki, Tomoko| Yoshioka, Nobuhiko| Ikenaga, Toyotake| Okazaki, Satoru|
発行日 1978-10
出版物タイトル Acta Medica Okayama
32巻
5号
資料タイプ 学術雑誌論文
著者 Haraoka, Shoichi| Saito, Daiji| Ueda, Minoru| Ogino, Yasuhiro| Yoshida, Hidenori| Kusuhara, Shunichi| Yoshioka, Nobuhiko| Kawasaki, Tomoko|
発行日 1978-06
出版物タイトル Acta Medica Okayama
32巻
2号
資料タイプ 学術雑誌論文
JaLCDOI 10.18926/AMO/31008
フルテキストURL fulltext.pdf
著者 Saito, Daiji| Ueeda, Masayuki| Hina, Kazuyoshi| Watanabe, Hirofumi| Mima, Tsutomu| Hasui, Masahiro| Yamada, Nobuyuki| Haraoka, Shoichi| Tsuji, Takao|
抄録 <p>The effect of the heart rate and myocardial contractile force on the extravascular resistance to blood flow of the left anterior descending coronary artery (LAD) was evaluated in 15 mongrel dogs anesthetized with sodium pentobarbital. The LAD was maximally dilated by intracoronary infusion of adenosine, which precluded the influence of vasomotor tone. Increases in the heart rate and myocardial contractile force decreased coronary blood flow in the absence of a change in coronary perfusion pressure. The changes in mean coronary resistance showed a significant linear relationship to changes in developed tension. The changes in coronary resistance caused by varying the heart rate and contractile force were so small that a normal coronary vascular tree could easily compensate for the increase in resistance. However, it is supposed that with critical stenosis of the vascular tree even a small increase in resistance might cause deleterious effects on coronary blood flow.</p>
キーワード contractile force tachycardia extravascular resistance coronary flow adenosine
Amo Type Article
発行日 1988-12
出版物タイトル Acta Medica Okayama
42巻
6号
出版者 Okayama University Medical School
開始ページ 335
終了ページ 342
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 3239438
Web of Sience KeyUT A1988R743300005
JaLCDOI 10.18926/AMO/30893
フルテキストURL fulltext.pdf
著者 Kusachi, Shozo| Iwasaki, Kohichirou| Nishiyama, Osamu| Ueda, Minoru| Kita, Toshimasa| Hata, Takato| Taniguchi, Gyou| Watanabe, Hirofumi| Hina, Kazuyoshi| Saito, Daiji| Tsuji, Takao| Haraoka, Shoichi|
抄録 <p>We studied the factors which may induce acute high grade restenosis in emergency percutaneous transluminal coronary angioplasty (PTCA). PTCA was attempted in 50 patients with acute myocardial infarction, and the balloon catheter passed successfully across the occlusion site in 47 (94%) of the patients. These 47 patients were analyzed. &#34;Acute restenosis&#34; was defined as a lesion which was revascularized to less than 50% luminal reduction narrowed again to more than 75% luminal reduction 5 min after the balloon inflation. Univariate and multivariate analyses were used for determining factors which significantly influenced acute restenosis. The incidence of at least one restenosis episode was 45%. Multiple regression analysis selected 5 factors associated significantly with an increased rate of acute restenosis: 1) angiographic evidence of dissection, 2) lesion in the right coronary artery (RCA), 3) lack of or insufficient administration of thrombolytic agent preceding PTCA, 4) curved lesion and 5) relatively small balloon/artery diameter ratio. Acute restenosis correlated significantly with late reocclusion. This study indicates that it is important to administer a thrombolytic agent prior to emergency PTCA, and to use an adequately sized balloon to the artery when the acute restenosis occurs by using relatively smaller sized balloon. The present data also demonstrated that patients with RCA and a curved lesion have a relatively high risk of acute restenosis. This study indicates how patients with relatively high risk of acute restenosis may be identified.</p>
キーワード emergency coronary angioplasty restenosis acute myocardial infarction multivariate analysis
Amo Type Article
発行日 1989-02
出版物タイトル Acta Medica Okayama
43巻
1号
出版者 Okayama University Medical School
開始ページ 55
終了ページ 63
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 2524153
Web of Sience KeyUT A1989T938500007
JaLCDOI 10.18926/AMO/30698
フルテキストURL fulltext.pdf
著者 Saito, Daiji| Yasuhara, Koichiro| Takeda, Hikaru| Hyodo, Tatuo| Yamada, Nobuyuki| Uchida, Toshiaki| Haraoka, Shoichi| Nagashima, Hideo|
抄録 <p>Changes in the stenotic resistance of a coronary artery following brief coronary occlusion were studied in the anesthetized open-chest dog. A critical coronary stenosis was constructed by tying a thick string around the circumflex coronary artery (LCx) near its origin. The LCx was occluded for 5, 10, 15, 20 and 30 seconds with and without coronary stenosis then the reactive hyperemia was observed. In the absence of the stenosis, resistance of the segment of the large coronary artery remained unchanged during the reactive hyperemia independent of the duration of occlusion. In the presence of the stenosis, however, stenotic resistance increased for a certain time after the release of occlusion. This increased resistance lasted longer with more severe stenosis and with longer duration of coronary occlusion. These results suggest that stenotic resistance can increase dynamically, and that the duration of increased resistance may reflect the severity of the stenosis.</p>
キーワード stenotic resistance reactive hyperemia distal coronary pressure
Amo Type Article
発行日 1982-06
出版物タイトル Acta Medica Okayama
36巻
3号
出版者 Okayama University Medical School
開始ページ 199
終了ページ 205
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 7113744
Web of Sience KeyUT A1982NV62100004
JaLCDOI 10.18926/AMO/30538
フルテキストURL fulltext.pdf
著者 Saito, Daiji| Kusachi, Shozo| Nishiyama, Osamu| Yasuhara, koichiro| Yoshida, Hidenori| Haraoka, Shoichi|
抄録 <p>The effects of changes in distal resistance on stenotic resistance were studied in vitro. Physiological saline was passed through the left carotid artery obtained from the dog, flexible rubber tubing, or through solid polyethylene tubing with a constant perfusion pressure or with a constant flow rate. Various stenotic resistances were established using a screw type constrictor and the distal resistance was varied by allowing physiological saline to pass through either a 23 gauge hypodermic needle (high peripheral resistance) or 23 and 20 gauge needles (low peripheral resistance ). For arteries with anatomically fixed stenosis, the calculated resistance was increased in association with reduction of the distal resistance. The stenotic resistance in the flexible rubber tubing changed in the same manner as that of the carotid artery, while the solid polyethylene tubing showed no significant stenotic resistance changes due to altering the distal resistance. These findings suggest that the stenotic resistance change of the artery correlates with the elasticity of the vessel wall and also indicate that resistance values were of little usefulness for evaluating the effects of vasodilating stimuli on the vessel segment with a significant stenosis.</p>
キーワード stenotic resistance constant perfusion pressure constant flow rate.
Amo Type Article
発行日 1980-04
出版物タイトル Acta Medica Okayama
34巻
2号
出版者 Okayama University Medical School
開始ページ 109
終了ページ 115
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 6450512
Web of Sience KeyUT A1980JY15600004