Project/Area Number |
08457200
|
Research Category |
Grant-in-Aid for Scientific Research (B)
|
Allocation Type | Single-year Grants |
Section | 一般 |
Research Field |
Circulatory organs internal medicine
|
Research Institution | Yamagata University |
Principal Investigator |
TOMOIKE Hitonobu Yamagata University ; Professor, 医学部, 教授 (90112333)
|
Co-Investigator(Kenkyū-buntansha) |
MIYAWAKI Hiroshi Yamagata University ; Instructor, 医学部, 助手 (30261704)
TAKEISHI Yasuchika Yamagata University ; Instructor, 医学部, 助手 (40272067)
SHIRAKABE Masanori Yamagata University ; Instructor, 医学部, 助手 (10241697)
YAMAGUCHI Seiji Yamagata University ; Assistant Professor, 医学部, 講師 (30239892)
KUBOTA Isao Yamagata University ; Associate Professor, 医学部, 助教授 (30161673)
|
Project Period (FY) |
1996 – 1997
|
Project Status |
Completed (Fiscal Year 1997)
|
Budget Amount *help |
¥7,800,000 (Direct Cost: ¥7,800,000)
Fiscal Year 1997: ¥3,600,000 (Direct Cost: ¥3,600,000)
Fiscal Year 1996: ¥4,200,000 (Direct Cost: ¥4,200,000)
|
Keywords | acut myocardiol infarction / mortality / reperfusion therapy / lipoprotein / hypertriglyceridemia / ST alternans / ventricular fibrillation / ディファレンシャル・デイスプレイ / 急性期死亡 / 冠攣縮 / 内膜肥厚 / 不安定狭心症 / 冠動脈硬化 / 粥腫 / 血清コレステロール / 血清トリプリセライド / リポ蛋白質 / 血小板 |
Research Abstract |
Early mortality and factors influencing it after acute myocardial infarction (AMI) were studied in Yamagata area from April 1993 to December 1995. Among 1014 patients with AMI,enrolled from 41 hospitals, 184 patients died within 28 days after the onset (short-term mortality ; 18%) and were compared with with those of patients that survived. Patients who died were significantly older than survivers (76 vs 68 years, p<0.01), were more likely to be women (50 vs 31%), to have had hypertension, diabetes mellitus, prior MI,or Killip class III or IV disease. Mortality as a result of heart failure, cardiac rupture, or arrhythmia fell exponentially after the onset. Reperfusion therapy was efficacious to reduce the early mortality. The site of organic coronary stenosis was resected by DCA catheter in patients with coronary artery spasm and chronic stable angina pectoris. The thickened intima was histologically examined, however, we were not able to define findings peculiar to the site of coronary spasm. Lipoprotein analysis was performed using an HPLC method in patients with ischemic heart disease. The data has been accumulating to define risks relating to the levels and size of lipoprotein fractions. Mechanism of the occurrence of ventricular fibrillation after reperfusion was studied in anesthetized open-chest dogs using 60 unipolar epicardial electrograms. In VF group, ST alternans progressed with time after reperfusion. Conduction block and reentry located between sites of discordant ST alternans ensued just before the appearance of VF. Rabbits showing hypertriglyceridemia were inbred from WHHL rabbits and the penetration rate of hypertriglyceridemia was 95% after 4 generations. Their pathophysiological features were analyzed in detail.
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