Journal of cardiography
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Journal of cardiography · Mar 1985
Case Reports[Cardiac involvement in systemic amyloidosis: myocardial scintigraphic evaluation].
To assess the clinical significance of technetium-99m-pyrophosphate (Tc-99m-PYP), -methylene diphosphonate (Tc-99m-MDP) and thallium-201 (Tl-201) myocardial scintigraphy in the diagnosis of cardiac amyloidosis and in the differential diagnosis of cardiac diseases, 12 patients with biopsy-proved systemic amyloidosis (seven with familial amyloid polyneuropathy (FAP) and five with primary amyloidosis) were investigated. The results obtained were as follows: In 10 patients (six with FAP and four with primary amyloidosis) studied by Tc-99m-PYP scintigraphy, two (FAP one, primary amyloidosis one) had diffusely positive myocardial uptake, which was of greater intensity than that of the sternum. Six (four FAP; two primary amyloidosis) also had diffusely positive myocardial uptakes, but the intensity was less than that of the sternum. ⋯ Left ventricular hypertrophy was found in six patients and right ventricular visualization in five. Although electrocardiograms in seven of 10 patients showed QS patterns in the right to mid precordial leads, similar to that seen in antero-septal and extensive anterior myocardial infarctions, neither myocardial perfusion defect nor low uptake on Tl-201 images was detected in nine of them. The scintigrams in another one, which showed low uptake at the apical portion of the left ventricle, were considered normal.(ABSTRACT TRUNCATED AT 400 WORDS)
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Journal of cardiography · Jun 1984
Comparative Study[Noninvasive determination of the ratio of pulmonary to systemic blood flow with two-dimensional Doppler echocardiography: efficacy and limitation].
Noninvasive determination of the ratio of the pulmonary to systemic blood flow (Qp/Qs) was attempted in 31 cases with intracardiac shunt using two-dimensional pulsed Doppler echocardiography. The Qp/Qs of these cases was ranged from 0.99 to 4.55 with an average of 2.63 by cardiac catheterization. Technical problems in the measurement were also studied. ⋯ In 17 cases, pulmonary and systemic flow volumes measured by the direct Fick method were compared with those by the Doppler method, respectively. Considerable differences were observed between them. There was a tendency that both pulmonary and systemic flow volumes were under-estimated by the Doppler method in cases with a large shunt.(ABSTRACT TRUNCATED AT 400 WORDS)
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Journal of cardiography · Jun 1984
[Diagnosis of myocardial ischemia in Kawasaki disease: thallium-201 myocardial imagings at rest, with exercise and with dipyridamole administration].
Thallium-201 myocardial imaging was performed at rest in 131 children with coronary arterial lesions due to Kawasaki disease. The coronary arterial lesions were assessed by selective coronary angiography within a few days of the isotope study. Twenty-one children had occlusive lesions, and segmental stenotic lesions were seen in 16 children. ⋯ Thus the dilated coronary lesions seemed to give a perfusion defect. In some of the patients whose perfusion defects disappeared at rest on a follow-up study, the defects were disclosed by exercise and/or dipyridamole administration. Thus, thallium-201 myocardial imagings combining resting and exercise or dipyridamole studies were valuable for the detection and assessment of coronary arterial lesions of Kawasaki disease.
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Journal of cardiography · Sep 1983
[Pulsed Doppler echocardiographic observation of right and left ventricular inflow velocity patterns in various types of arrhythmia, with special reference to the mechanism of atrioventricular regurgitation].
To investigate the possibility for detection of atrio-ventricular (A-V) regurgitation in arrhythmias non-invasively, we recorded velocity patterns of blood flow at the inflow tract of the right (RVI) and left ventricles (LVI), and at the outflow tract of the left ventricle (LVO) by pulsed Doppler echocardiography in 32 patients with various types of arrhythmia. They were six cases with supraventricular premature contraction (SVPC), 13 with ventricular premature contraction (VPC), two with second degree A-V block, five with complete A-V block and six with artificial right ventricular pacemaker. The following results were obtained. ⋯ Velocity pattern of a blood flow at RVI and LVI showed two types of reverse flow patterns in all cases with complete A-V block or with artificial right ventricular pacemaker; a) systolic reverse flow in beats with P wave superimposed on QRS complex or ST segment, and b) diastolic reverse flow in beats with markedly prolonged P-R intervals. Diastolic tricuspid regurgitation was demonstrated by contrast echography at the level of the tricuspid valve orifice, and diastolic mitral regurgitation by left cineventriculography. The clinical implication of pulsed Doppler echocardiography to detect A-V regurgitation during systole and diastole was discussed in various types of arrhythmia.
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Journal of cardiography · Sep 1983
[Pulsatile flow dynamics of the ductus arteriosus, thoracic aorta and pulmonary artery in patients with patent ductus arteriosus].
In 20 infants or children with an isolated or complicated patent ductus arteriosus (PDA), we qualitatively and quantitatively studied pulsatile flow dynamics of the ductus, descending thoracic aorta and pulmonary artery by means of a catheter-tip electromagnetic flow velocity probe. They were divided into four groups according to ductal shunt states as follows: 14 patients with a continuous left-to-right (L-R) shunt (Group I), three patients with a bidirectional but a dominant L-R shunt (Group IIA), two patients with a bidirectional but dominant right-to-left (R-L) shunt (Group IIB), and one patient without a significant ductal flow (Group III). In Group I, the ductal flow was pulsatile and showed continuous L-R shunting. ⋯ The peak flow velocity of the thoracic aorta was correlated with the ductal L-R shunt ratio determined by the Fick method (r = 0.46), and the diastolic regurgitant flow fraction of the thoracic aorta was increased in patients with a larger L-R shunt or with a reversed shunt. Therefore, it was suggested that a net forward flow of the thoracic aorta is reduced in these patients. On the other hand, the quantitative evaluation of a pulmonary flow during systole was found unreliable and expected to be underestimated because of the occurrence of turbulence at the site of the main pulmonary artery by the confluence of ejection stream from the right ventricle and a shunted flow from the aorta.(ABSTRACT TRUNCATED AT 400 WORDS)