Factors Predicting Mortality in Patients after Myocardial Infarction Caused by Left Main Coronary Artery Occlusion : Significance of ST Segment Elevation in Both aVR and aVL Leads
スポンサーリンク
概要
- 論文の詳細を見る
Acute left main coronary artery obstruction is rare and most patients in this clinical setting die of sudden death or cardiogenic shock. During the past 8 years, we encountered 13 patients with acute myocardial infarction caused by total occlusion of the left main coronary artery (LMCA-AMI). Thus, we surveyed these patients, and attempted to elucidate helpful predictors related to the prognosis. Six of 13 patients with LMCA-AMI survived. Successful left coronary artery dilatation was achieved in all survivors (group S), and in 5 (71%) non-survivors (group non-S). The age was not different between the two groups. A past history of angina was confirmed in 83% of group S, while only in 29% of group non-S. Clinical findings such as time of onset of AMI, interval from the AMI onset to admission, elapsed period from the AMI onset to recanalization of LMCA and the value of CK on admission were not different between the two groups. However, cardiogenic shock occurred in only 1 patient (17%) in group S compared with 5 patients (71%) in group non-S. As emphasized in the literature, good collateral circulation to the left anterior descending artery was observed in 5 patients (83%) in group S, while not observed in group non-S. Electro cardiographically, ST elevation in the aVR lead was very characteristic. This finding was confirmed in 69% of the total patients. Noticeably, 5 out of 6 non-survivors (83%) showed ST elevation not only in leads aVR but also in the aVL lead. In addition to the absence of collateral circulation, this electrocardiographic finding, which obviously indicates the presence of extensive myocardial ischemia in the diseased heart, is a simple and important predictor suggesting a poor prognosis in LMCA-AMI patients.
- Japanese Heart Journal Associationの論文
著者
-
KUROSAWA TOSHIRO
Department of Medicine, Kitasato University School of Medicine
-
Izumi Tohru
Department Of Cardio-angiology Kitasato University School Of Medicine
-
Aizawa Yoshifusa
First Department of Internal Medicine, Niigata University School of Medicine
-
Hori Tomoyuki
Department of Internal Medicine, Kitasato University School of Medicine
-
Yoshida Makoto
Department of Internal Medicine, Kitasato University School of Medicine
-
Yamazoe Masaru
First Department of Internal Medicine, Niigata University School of Medicine
-
Yamazoe Masaru
First Department Of Internal Medicine
-
Hori Tomoyuki
Department Of Biotechnology Graduate School Of Agricultural And Life Sciences The University Of Toky
-
Yoshida Makoto
Department Of Biology Faculty Of Science University Of Kochi
-
Kurosawa Toshiro
Department Of Cardio-angiology Kitasato University School Of Medicine
-
Izumi Tohru
Department Of Angio-cardiology Kitasato University School Of Medicine
-
AIZAWA Yoshifusa
First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.
関連論文
- A National Survey on Myocarditis Associated With the 2009 Influenza A (H1N1) Pandemic in Japan
- NO SPECIFIC ORGAN REMOVES ATRIAL NATRIURETIC PEPTIDE FROM THE HUMAN PLASMA
- -445- CLINICAL EVALUATION ON THE RESPONSE OF PLASMA ATRIAL NATRIURETIC PEPTIDE TO EXERCISE IN PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY
- Arrhythmogenic Difference Between the Left and Right Atria During Rapid Atrial Activation in a Canine Model of Atrial Fibrillation
- Rationale and Design of a Study to Examine Lower Targets for Low-Density Lipoprotein-Cholesterol and Blood Pressure in Coronary Artery Disease Patients : The Japanese Coronary Artery Disease Study II (JCADII)
- Factors Predicting Mortality in Patients after Myocardial Infarction Caused by Left Main Coronary Artery Occlusion : Significance of ST Segment Elevation in Both aVR and aVL Leads
- Importance of Morphological Changes in T-U Waves During Bepridil Therapy as a Predictor of Ventricular Arrhythmic Event
- Effects of Phase II Cardiac Rehabilitation on Job Stress and Health-Related Quality of Life After Return to Work in Middle-Aged Patients With Acute Myocardial Infarction
- Vanadate Improves Cardiac Function and Myocardial Energy Metabolism in Diabetic Rat Hearts
- Decreased Expression of Na+/H+ Exchanger Isoform 1 (NHE1) in Non-infarcted Myocardium after Acute Myocardial Infarction
- Subarachnoid Hemorrhage and Myocardial Damage Clinical and Experimental Studies
- Patient Selection and Therapeutic Strategy for Emergency Percutaneous Cardiopulmonary System in Cardiopulmonary Arrest Patients
- OE-075 Suppression of Insulin Signaling Attenuates Cardiac Aging in Mice(Heart failure, basic(01)(M),Oral Presentation(English),The 72nd Annual Scientific Meeting of the Japanese Circulation Society)
- Rapamycin Ameliorates Experimental Autoimmune Myocarditis
- Clinical Usefulness of Electrophysiologic Study (EPS)-Guided Risk Stratification for Life-Threatening Arrhythmia in Patients With Heart Failure
- Predictive Impact of the Inducibility of Ventricular Fibrillation in Patients With Brugada-Type ECG
- Primary Cardiac Osteosarcoma in a Young Man with Severe Congestive Heart Failure
- 5 Clinical Effect of Tolvaptan, an Oral Vasopressin V_2 Receptor Antagonist, in Patients with Chronic Heart Failure (CHF) and Peripheral Edema : Result from a Double-Blind, Randomized Trial(Late Breaking Clinical Trials II,The 73rd Annual Scientific Meeti
- Inhomogenic Effect of Bepridil on Atrial Electrical Remodeling in a Canine Rapid Atrial Stimulation Model
- Atrial Natriuretic Peptide (ANP) Suppresses Atrial Electrical Remodeling in Canine Rapid Atrial Stimulation Model
- Bepridil Was More Effective Than Class I Antiarrhythmic Drugs toPrevent the Atrial Fibrillation in "Hybrid-Therapy" of Atrial Flutter-Fibrillation
- Monitoring the Progression of the Atrial Electrical Remodeling in Patients With Paroxysmal Atrial Fibrillation : Analysis of the f-f Interval During Ambulatory ECG Monitoring
- Evaluation of the Effect of Bepridil on Paroxysmal Atrial Fibrillation : Relationship Between Efficacy and the f-f Interval in Surface ECG Recordings
- The Importance of The Monitoring of The F-F Interval in Surface ECG in Patients with Paroxysmal Atrial Fibrillation
- Effect of verapamil and pilsicainide on the atrial electrical remodeling in canine rapid atrial stimulation model
- Examination of the intraatrial heterogeneity of the electric remodeling by atrial rapid stimulation Comparison of right and left atrial stimulation
- Bepridil prevents the paroxysmal atrial fibrillation by class III antiarrhythmic drug effect
- Cardioprotective Effect of Mexiletine in Acute Myocardial Ischemia : Studies in the Rabbit Closed Chest Ischemia Model
- Electrical Remodeling of the Ventricular Myocardium in Myocarditis : Studies of Rat Experimental Autoimmune Myocarditis
- Inhomogeneity in the Appearance of Electrical Remodeling During Chronic Rapid Atrial Pacing : Evaluation of the Dispersion of Atrial Effective Refractoriness
- Two Cases of Brugada Syndrome Associated With Spontaneous Clinical Episodes of Coronary Vasospasm
- Advantage of Recombinant Technology for the Identification of Cardiac Myosin Epitope of Severe Autoimmune Myocarditis in Lewis Rats
- PJ-146 Incidence and Characteristics of T-wave Changes along the Time Course of Bepridil Therapy for Atrial Fibrillation(PJ025,Arrhythmia, Others (Clinical/Diagnosis/Treatment) 2 (A),Poster Session (Japanese),The 73rd Annual Scientific Meeting of The Japa
- Clinical Significance of the Electrophysiologic Study (EPS)-Guided Therapy for the Secondary Prevention of Ventricular Tachycardia
- Bepridil Inhibits Sub-Acute Phase of Atrial Electrical Remodeling in Canine Rapid Atrial Stimulation Model
- Long-Term Follow-up of Changes in Fibrillation Waves in Patients With Persistent Atrial Fibrillation : Spectral Analysis of Surface ECG
- Changes in clinical arrhythmia in patients with heart failure due to dilated cardiomyopathy
- A National Survey on Myocarditis Associated With the 2009 Influenza A (H1N1) Pandemic in Japan
- Surveillance study for creating the national clinical database relating to ECG-gated myocardial perfusion SPECT of asymptomatic ischemic heart disease in patients with type-2 diabetes mellitus : J-ACCESS 2 study design
- Risk Factors and Triggers of Sudden Death in the Working Generation : An Autopsy Proven Case-Control Study
- Activity Immediately Before the Onset of Non-Fatal Myocardial Infarction and Sudden Cardiac Death
- N-Acetylcysteine Suppresses the Progression of Ventricular Remodeling in Acute Myocarditis : – Studies in an Experimental Autoimmune Myocarditis (EAM) Model –
- Changes in perfusion and fatty acid metabolism of rat heart with autoimmune myocarditis
- Effect of Hypothermia Therapy After Outpatient Cardiac Arrest Due to Ventricular Fibrillation
- Predicting the Efficacy of Antiarrhythmic Agents for Interrupting Persistent Atrial Fibrillation According to Spectral Analysis of the Fibrillation Waves on the Surface ECG
- Role of Electrophysiologic Study (EPS)-Guided Preventive Therapy for the Management of Ventricular Tachyarrhythmias in Patients With Heart Failure
- The Anti-Atherosclerotic Effects of Lipid Lowering with Atorvastatin in Patients with Hypercholesterolemia
- Event Rates of Acute Myocardial Infarction and Coronary Deaths in Niigata and Nagaoka Cities in Japan
- 8 Coming Paradigm for Patient with Refractory Heart Failure(Therapeutic Strategy for Severe Heart Failure-From LVAD to Heart Transplantation-,Symposium 11 (SY-11) (H),The 73rd Annual Scientific Meeting of The Japanese Circulation Society)
- Prognostic Significance of Increased Serum Bilirubin Levels Coincident With Cardiac Decompensation in Chronic Heart Failure
- Early and Long-Term Mortality of the Clinical Subtypes of Myocarditis
- Improvement of Quality of Life With Nocturnal Oxygen Therapy in Heart Failure Patients With Central Sleep Apnea
- Tumor Necrosis Factor-α Downregulates the Voltage Gated Outward K^+ Current in Cultured Neonatal Rat Cardiomyocytes : A Possible Cause of Electrical Remodeling in Diseased Hearts(EXPERIMENTAL INVESTIGATION)
- 4 Usefulness of One-leg Standing Time as a Disability Measure in Elderly Patients Undergoing a Phase I Cardiac Rehabilitation(How to Manage the Very Elderly Patient with Heart Failure, The 71st Annual Scientific Meeting of the Japanese Circulation Society
- PE-554 Circulating Interleukin-18 is a Specific Biomarker to Distinguish Metabolic Syndrome (MetS) Patients from Pre-MetS Conditions(Preventive medicine/Epidemiology/Education-4, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- Immunomodulatory Effect of Pentoxifylline in Suppressing Experimental Autoimmune Myocarditis
- Circulating Levels of Interleukin-18 Reflect Etiologies of Heart Failure : Th1/Th2 Cytokine Imbalance Exaggerates the Pathophysiology of Advanced Heart Failure
- Resuscitation From Fulminant Myocarditis Associated With Refractory Ventricular Fibrillation
- Myocarditogenic Epitopes and Autoimmune Myocarditis
- Adaptation to Low-Intensity Exercise on a Cycle Ergometer by Patients With Acute Myocardial Infarction Undergoing Phase I Cardiac Rehabilitation
- PE-382 Association of depression with abnormal heart rate recovery in patients with coronary artery disease(Exercise Test/Cardiac Rehabilitation 7 (IHD) : PE65)(Poster Session (English))
- Recurrent Fulminant Viral Myocarditis With a Short Clinical Course
- Electrophysiologic Parameters to Predict Clinical Recurrence of Ventricular Tachycardia in Patients Under Electrophysiologic Study-Guided Effective Pharmacological Therapy
- PJ-324 The Role of Phosphoinositide 3-Kinase, Akt and Target of Rapamycin Pathway in Thyroid Hormone Induced Cardiac Hypertrophy(Cardiac hypertrophy, basic/clinical-4, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- Angiotensin II Receptor Antagonist Attenuates Expression of Aging Markers in Diabetic Mouse Heart
- Cardiac Aging-Angiotensin II Receptor Antagonist Suppressed the Expression of Senescence Markers in Diabetic Mouse Heart(Heart Failure, Basic 5 (M), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- 2 Clinical Efficacy and Cost-Benefit-Analysis of Nocturnal Home Oxygen Therapy in Patients with Chronic Heart Failure and Sleep-Disordered Breathing(ESC/JCS Joint Symposium (ESC) (M) : Physical Therapy for Heart Failure)(Special Program)
- Recovery From Complete Atrioventricular Block Caused by Idiopathic Giant Cell Myocarditis After Corticosteroid Therapy
- 4 A Proposal of Heart Failure Management for Senile Patients Based on Their Distinctive Clinical Characteristics-Importance of Comprehensive Disease Management(Characteristics and Management Strategies of Chronic Heart Failure in the Japanese,Symposium 12
- Paroxysmal Atrial Fibrillation Coincident With Cardiac Decompensation is a Predictor of Poor Prognosis in Chronic Heart Failure
- Clinical Characteristics of Heart Disease Patients with a Good Prognosis in spite of Markedly Increased of BNP(Cardiomyopathy, Clinical 6 (M), The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- Immunomodulatory Effects of β-Adrenergic Stimulation Through G-Protein Signaling Pathway on the Development of Myocarditis(Inflammatory Heart Disease-Update and Future Perspective-, The 69th Annual Scientific Meeting of the Japanese Circulation Society)
- Clinical Characteristics of Heart Disease Patients With a Good Prognosis in Spite of Markedly Increased Plasma Levels of Type-B Natriuretic Peptide (BNP) : Anomalous Behavior of Plasma BNP in Hypertrophic Cardiomyopathy
- PJ-314 Clinical significance of BNP-guided management in senile patients with chronic heart failure(Heart Failure, Clinical 7 (M) : PJ53)(Poster Session (Japanese))
- OJ-053 Experimental Model of Chronic Autoimmune Myocarditis Induced by Autoreactive Myocarditogenic T Cells(Myocarditis, Basic/Clinical (M) : OJ7)(Oral Presentation (Japanese))
- G Protein Modulates Autoimmune Myocarditis
- Retropharyngeal Abscess due to Methicillin-resistant Staphylococcus aureus in a Case of Acute Myeloid Leukemia
- All-trans-Retinoic Acid Treatment for Chemotherapy-Resistant Acute Adult T-Cell Leukemia
- Leakage of Energy to the Body Surface During Defibrillation Shock by an Implantable Cardioverter-Defibrillator (ICD) System : Experimental Evaluation During Defibrillation Shocks Through the Right Ventricular Lead and the Subcutaneous Active-Can in Canine
- Evaluation of Post-Repolarization Refractoriness for Conduction Block in Cardiac Muscle : Studies in an Artificial Isthmus in the Canine Right Atrium
- Quantitative Evaluation of a Directly Depolarized Area Induced by High-Output Pacing on the Cardiac Muscle
- PE-216 Impact of Weight Loss on Atherogenic Systemic Inflammation : Circulating Interleukin-18 in Patients with Metabolic Syndrome(PE037,Obesity/SAS 1 (H),Poster Session (English),The 73rd Annual Scientific Meeting of The Japanese Circulation Society)
- Resveratrol Ameliorates Experimental Autoimmune Myocarditis
- PJ-371 Appropriate Indication and Management for the Use of Percutaneous Cardiopulmonary Support (PCPS) in Acute Myocardial Infarction (AMI) Patients(Emergency care-3, The 71st Annual Scientific Meeting of the Japanese Circulation Society)
- 5 Appropriate Indication and Therapeutic Strategy for the Use of Percutaneous Cardiopulmonary Support (POPS) in Cardiopulmonary Arrest (CPA) Patients(Symposium 6 (SY6) (IHD) : Treatment for CPA : Improving the Current Status?)(Special Program)
- -501-SEASONAL AND CIRCADIAN VARIATIONS OF SUDDEN DEATH DUE TO ISCHEMIC HEART DISEASE : Myocardial Infarction : FREE COMMUNICATIONS(II) : PROCEEDINGS OF THE 53th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY
- Influence of nifedipine coat-core and amlodipine on systemic arterial stiffness modulated by sympathetic and parasympathetic activity in hypertensive patients
- A New Scoring System to Predict the Efficacy of Steroid Therapy for Patients With Active Myocarditis : A Retrospective Study
- Effect of nifekalant on life-threatening ventricular arrhythmias in patients with cardiopulmonary resuscitation or during the perioperative state
- Cardiac Dendritic Cells and Acute Myocarditis in the Human Heart
- 0300 CLINICO-PATHOLOGICAL STUDY OF THE MECHANISMS WITH MECHANICAL COMPLICATION FOLLOWING ACUTE MYOCARDIAL INFARCTION
- Sudden Cardiac Death in Japanese People Aged 20-60 Years : An Autopsy Study of 133 Cases
- National Survey of Fulminant Myocarditis in Japan : Therapeutic Guidelines and Long-Term Prognosis of Using Percutaneous Cardiopulmonary Support for Fulminant Myocarditis (Special Report From a Scientific Committee)
- Left Ventricular Filling Profile in Diastolic Dysfunction on the Basis of Filling Velocity and Volume Relationship
- C-Reactive Protein Is a Predictor of Prognosis in Heart Failure with Ischemic Heart Disease, but not with Non-Ischemic Heart Disease
- Cost Effectiveness of Beta Blockade for Heart Failure in Japan
- Cardiac function estimated by stroke volume starts to recover just after reperfusion therapy with special reference to stunning of acute myocardial infarction
- Effect of Mexiletine on Ischemic Heart : Studies in the Closed Chest Rabbit Acute Ischemia Model
- Studies on Reactivity of T Lymphocytes Derived from Lewis Rats Undergoing Experimental Autoimmune Myocarditis (EAM)
- A Long Course of Leukocytopenia and Splenomegaly with Extramedullary Hematopoiesis in the Absence of Clinically Manifested Rheumatoid Arthritis