Ischemic Preconditioning Effect of Prodromal Angina Is Attenuated in Acute Myocardial Infarction Patients With Hypertensive Left Ventricular Hypertrophy (前駆症状である狭心症の虚血性前処置効果は高血圧性左室肥大がある急性心筋梗塞患者では減弱する)

雑誌掲載版動物実験によると、急性心筋梗塞に対する虚血性前処置の保護効果は高血圧動物ではより著明と言われるが、臨床的にこれを検証した報告はない。本研究では再灌流治療に成功した初回前壁急性心筋梗塞(AMI)患者125例を高血圧の有無により2群に分け、更に各群を狭心症の前駆症状の有無により2群に分け、更に各群を狭心症の前駆症状の有無により2群に分けて再灌流治療後の左室形態と左室機能をSPECT、左室造影、心エコー図により評価した。その結果は動物実験とは逆で、高血圧性左室肥大があるAMI患者ではそれがないAMI患者と比較して前駆狭心症による保護効果は減弱していた

APPLICATIONS OF THE HOMOGENIZATION METHOD TO MATERIAL DESIGN

The homogenization method is applied to obtain the preferred mechanical characteristics of materials. Since the homogenization method takes into account the effect of microstructural configuration to characterize thermo-mechanical properties of composite materials based on the asymptotic expansion method, our design methods can reflect the micromechanical responses. Two examples of the design-oriented applications are presented: one is the combination with the so-called voxel digitization method to generate finite element models of microstructures based on image processing technology and the other is the inverse optimization together with the generalized layout design method of a structure. While the former finds the optimal material and material configurations of composites, the latter creates the material with properties not hitherto available in single phase materials. 1. Introduction The global-local approach by the asymptotic homogenization method has altered the conventional ways..

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【学会の動向】第39回日本循環器管理研究協議会総会「日本循環器病予防学会」第69回生活習慣病予防講演会を開催して

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Intraprocedural left ventricular free wall rupture diagnosed by left ventriculogram in a patient with infero-posterior myocardial infarction and severe aortic stenosis

Background: Left ventricular wall rupture remains a major lethal complication of acute myocardial infarction and hypertension is a well-known predisposing factor of cardiac rupture after myocardial infarction. Case presentation: An 87-year-old man was admitted to our hospital, diagnosed as acute myocardial infarction (AMI). The echocardiogram showed 0.67-cm2 aortic valve, consistent with severe aortic stenosis (AS). A coronary angiography showed a chronic occlusion of the proximal left circumflex artery and a 99 % stenosis and thrombus in the mid right coronary artery. During percutaneous angioplasty of the latter, transient hypotension and bradycardia developed at the time of balloon inflation, and low doses of noradrenaline and etilefrine were intravenously administered as needed. The patient suddenly lost consciousness and developed electro-mechanical dissociation. Cardio-pulmonary resuscitation followed by insertion of an intra-aortic balloon pump (IABP) and percutaneous cardiopulmonary support were initiated. The echocardiogram revealed moderate pericardial effusion, though the site of free wall rupture was not distinctly visible. A left ventriculogram clearly showed an infero-posterior apical wall rupture. Surgical treatment was withheld because of the interim development of brain death. Conclusions: In this patient, who presented with severe AS, the administration of catecholamine to stabilize the blood pressure probably increased the intraventricular pressures considerably despite apparently normal measurements of the central aortic pressure. IABP, temporary pacemaker, or both are recommended instead of intravenous catecholamines for patients with AMI complicated with significant AS to stabilize hemodynamic function during angioplasty