Search

This study was designed to investigate how pacemaeker would influence the myocardial tissue, accessing tissue characterization by ultrasonic integrated backsatter (IBS). Study Group included 30 cases underwent pacemaker implantation from Jan. 1 1988 to Apr. 30 2002. The group was divided into two subgroups; one group included patients implanted DDD mode pacemaker (DDD:16cases) and the other included patients implanted VVI mode pacemaker (VVI:14cases). Parasternal short axis view was shown using SONOS 5500 and recorded with IBS mode. The ROI was set in the interventricular anteroseptum (AS) and the posterior wall (PW) and measured the value of IBS (IB), then was corrected to reduce the IB of left ventricular cavity as standard value from IB (CIB). The amplitude of cyclic variation (CVIB) was defined the difference between enddiastolic IB and endsystolic IB. There was no correlation between CIB and CVIB in AS or PW and the term during pacing but CIB in both AS and PW in VVI was greater than that in DDD (15.3 ± 2.1:12.5 ± 3.4 p

Backgrounds: The aim of this study is to demonstrate HANP administration combined with acute revascularization prevent LV remodeling independent of myocardial salvage. Methods: Consecutive 44 patients with acute anteroseptal myocardial infarction were randomly assigned to either continuous infusion of HANP at a dose of 0.025 microgram/kg/min for 3 days, or control. Myocardial salvage, infarct size, and LV volume was assessed by 99mTc-tetrofosmin imaging. Results: No differences in patients backgrounds were observed. HANP suppressed LVEDVI increase in comparison with placebo (HANP:3.2 ± 16.8 control:16.0 ± 23.4 p < 0.05) with no difference in salvage index(HANP:55.6 ± 24.9% control:55.5 ± 34.1%). The relationship between the infarct size and delta-LVEDVI were shown in the figure.Conclusion: This study clearly demonstrate that HANP can suppress LV volume expansion despite no difference of infarct size. Download high-res image (96KB) Download full-size image

Background: Early resolution of ST-segment elevation is an indicator of final infarct size and clinical outcomes. However, the relationship between the degree of ST resolution and the indexes derived from perfusion scintigraphy such as area at risk(AAR), infarct size(IR), and salvaged myocardium(SI) is unclear.Methods: Consecutive 65 patients with anteroseptal myocardial infarction with successful mechanical reperfusion, whose AAR, IS, and SI could be assessed by myocardial perfusion imaging, were studied. Serial 12 leads electrocardiograms were performed at baseline, 90 minutes after reperfusion. ST resolution was defined as complete (>70%, n = 16), partial (

Functional risk area assessed by 99mTc tetrofosmin (TF) measured on arrival is most powerful determinant of infarct size. However, the impact of AAR on LV dilatation and heart failure is not known. We studied 51 patients with anterior AMI who were recanalized by PTCA. Pts were divided into 3 groups according to the size of AAR (small AAR(n = 17), moderate AAR(n = 17), large AAR(n = 17)). LVG and TF imaging were performed on arrival and 6 months after onset. The LVEDVI increased in large AAR than small and moderate AAR (deltaLVEDVI small:.−4.7 ± 10.5, moderate: 13.1 ± 17.8, large 24.6 ± 25.7 p < 0.05). There were 2 deaths in-hospital, 2 out-hospital death and 4 admission due to HF during mean F/U of 3 years. These data suggest strong impact of the severity of AAR on the patients long term prognosis. Download high-res image (295KB) Download full-size image

Background: PTSMA is a effective non-surgical technique for achieving the reduction of the pressure gradients of LV outflow and patients symptoms dramatically. However, the effect of this approach to the sympathetic activity is not well known.Purpose and Methods: To investigate the time course of the sympathetic nerve activity, we evaluate the sympathetic activity by MIBG scintigraphy performed just before, 1week after, and 3 months after the procedure in 6 patients with severe HOCM. H/M ratio in early and delayed images and washout rate was used as the indexes showing sympathetic function.Results: The procedures were all successful without severe complications. CPK release ranged from 976 to 3642 IU. LV outflow PG decreased markedly from 110 ± 16mmHg to 45 ± 31mmHg and concomitant improvement of NYHA classification was evident ( pre-PTSMA:2.5 ± 0.8 post-PTSMA:1.2 ± 0.4). MIBG demonstrates the transient increase of washout (pre:34 ± 5% post:44 ± 6%) and decrease of H/M ratio of delayed images (pre:1.9 ± 0.8, post:1.7 ± 0.2) at 1week after procedures. 3 months after procedure, significant decrease of washout(3M:30 ± 8%) and increase of H/M ratio(3M:2.0 ± 0.3) was observed.Conclusion: Transient overactivation of sympathetic nerve probably associated with iatrogenic infarction was observed early after PTSMA. However, sympathetic activity was gradually reduced at chronic phase suggesting the favorable effect of this therapy on loading conditions of the hypertrophied heart.