Kyoung Sig Chang

Non-invasive recognition of generalized coronary arteriosystemic fistulae by contrast echocardiography and multidetector CT

Coronary artery fistulae, including generalized coronary arteriosystemic fistulae, are usually identified incidentally during invasive coronary angiographies. Generalized or multiple coronary arteriosystemic fistulae arise from all three major coronary arteries draining into the left ventricular chamber. In a patient with generalized coronary arteriosystemic fistulae, myocardial ischemia and diastolic volume overload of the left ventricle can be caused by a left-to-left shunt; however, the clinical and hemodynamic consequences are incompletely understood. We report the case of generalized coronary arteriosystemic fistulae in a 73-year-old female who presented with mild exertional dyspnea as an anginal equivalent. This case report represents the complementary, non-invasive role of transthoracic contrast echocardiography and multidetector computed tomography (MDCT) coronary angiography in the early recognition of generalized coronary arteriosystemic fistulae by demonstrating a plexus of multiple small vessels emptying exclusively into the left ventricle.

Influence of Amineptine on Changes of Blood Pressure Evoked by Norepinephrine and Dopamine

The influence of amineptine, an antidepressant currently employed having mainly selective dopaminergic neurochemical activity, on the pressor responses evoked by norepinephrine (NE) and dopamine (DA) was studied in anesthetized whole rats. Amineptine at doses of 0.5, 1.5, and 5.0 mg/kg/30 min infused into the femoral vein of the rat caused a dose-related inhibition of the pressor responses of NE and DA. The hypertensive responses of NE and DA augmented by pretreatment with reserpine, a catecholamine depletor, were also clearly depressed following the infusion of amineptine with a rate of 1.5 mg/kg/30 min. Furthermore, the pressor responses of NE and DA potentiated by pretreatment with debrisoquin, a sympathetic neuron blocker, were markedly diminished after pretreatment with the infusion of amineptine at the above same rate (1.5 mg/kg/30 min). These experimental results demonstrate that amineptine causes an inhibitory effect on the pressor responses evoked by NE and DA. It is thought that the amineptine effect may be due to the blockade of the peripheral adrenergic alpha-receptors in addition to the previously described uptake inhibition of dopamine.