Tomohiko Kamata

Antiischemic effects of nicorandil during coronary angioplasty in humans

SummaryThe present study was undertaken on 10 patients with angina undergoing percutaneous transluminal coronary angioplasty. The angioplasty procedure consisted of two successive 30-second balloon inflations at 5 minute intervals. After the first inflation, nicorandil (0.1 mg/kg) was given intravenously over a 2-minute period. The second inflation was then performed 3 minutes after the completion of drug administration. Myocardial ischemia was measured as the magnitude of ST-segment elevation on the intracoronary electrocardiogram (intracoronary ECG) recorded from the guidewire. Nicorandil significantly reduced the magnitude of ST-segment elevation. Nicorandil did not change the heart rate-blood pressure product, nor the oxygen saturation of the blood sampled from the great cardiac vein, nor the velocity of coronary blood flow in those patients with no evidence of collaterals. These results favor the conclusion that nicorandil prolongs the intrinsic ability of cardiac myocyte to withstand oxygen deprivation. This salutary effect is possibly due to a direct cellular mechanism because nicorandil did not modify the peripheral and coronary hemodynamic parameters that govern myocardial oxygen consumption.

Sudden Appearance of Coronary Thrombus Observed by Angiography—A Case Report:

A sudden coronary thrombus formation was documented by chance during cardiac catheterization in a patient with postinfarction angina. The thrombus was successfully treated with intravenous urokinase and heparin infusions, and there after, coronary angioplasty was performed without any complication.

Contrast echocardiography in a patient with right atrial myxoma

Contrast echocardiography employing intracoronary injection of Albunex was performed in a patient with right atrial myxoma. An echolucent area within the tumor mass was observed on 2-dimensional echocardiography and Albunex injection caused an appreciable opacification of this echolucent area suggesting the presence of a vascular-like structure. This finding was subsequently confirmed by coronary arteriography and from a pathologic specimen.