Kita Y

Coronary angiographic characteristics in Japanese patients with heterozygous familial hypercholesterolemia

Coronary angiographic findings were analyzed in 51 consecutive patients (36 males and 15 females) with heterozygous familial hypercholesterolemia (FH) and 279 consecutive patients (216 males and 63 females) without FH (non-FH). The coronary stenosis index and over 75% stenosis vessel subset were almost three times as high in the FH group. The incidence of myocardial infarction was almost twice as high in the FH group. Levels of total cholesterol and its lipoprotein fractions, except HDL-cholesterol, were almost twice as high in the FH group. In the FH group aged under 50 years, the two parameters of coronary angiogram and the incidence of myocardial infarction were significantly higher in males than in females. However, in the group aged over 50 years, all three parameters were not significantly different between those in males and females. The level of HDL-cholesterol was significantly lower in males than in females. A significantly higher incidence (18%) of coronary ectasia was observed in the FH group compared with the incidence (2%) in non-FH. All patients with coronary ectasia were males, except one female with FH. On comparison of the males among the FH patients with those among the non-FH patients matched for total cholesterol, age and other risk factors, the FH patients were associated with a significantly higher degree of coronary atherosclerosis and lower level of HDL-cholesterol. Seven FH patients with a normal coronary angiogram were observed. However, any factors as regards age, total cholesterol, HDL-cholesterol and Achilles tendon thickness failed to distinguish between the FH patients with a normal coronary angiogram and those without.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of preload reduction on left atrial pump pump function in hypertrophic cardiomyopathy and myocardial infarction

To characterize the preload dependence of augmented left-atrial pump function in left-ventricular dysfunction, the changes in the transmitral flow velocity pattern induced by a lower-body negative pressure (LBNP) of −20 and −40 mm Hg were investigated in 19 ,patients with hypertrophic cardiomyopathy, 17 patients with myocardial infarction and 19 control subjects. The maximal early diastolic flow velocity and early diastolic flow velocity integral decreased with −20 mm Hg LBNP, with even greater decreases occuring with −40 mm Hg LBNP in all groups

Early Diastolic Dysfunction of Left Ventricle and its Relation to Pathologic Finding in Patients with Diabetes Mellitus

In diabetes mellitus, the development of myocardial injury secondary to hypertension and coronary arteriosclerosis poses a major clinical problem. In addition, this issue has been the focus of great interest and it has been demonstrated that the existence of myocardial injury is not attributable to hypertension or coronary arteriosclerosis. It has also been reported in various pathological studies that even in the diabetic heart without hypertension and coronary artery lesions, various histological changes such as myocyte hypertrophy, perivascular fibrosis, and interstitial fibrosis are present (1–3). On the other hand, the existence of functional abnormalities such as left ventricular systolic and diastolic dysfunction has also been reported (4–12). It is, however, not yet clear which pathological changes account for these functional disturbances in the diabetic heart. To clarify this point we investigated the relation between systolic and diastolic function and the myocardial histological findings in diabetic patients.