Interrelationship between blood constituents and vessel wall during exacerbation and quiescence of myocardial ischemia.

1993年4月至1995年12月对山形地区急性心肌梗死（AMI）患者的早期死亡率及其影响因素进行了研究。在来自41家医院的1014例AMI患者中，184例患者在发病后28天内死亡（短期死亡率；18%），并与存活患者进行比较。死亡患者明显大于存活患者（76岁vs 68岁，p<0.01），女性患者（50岁vs 31%）较多，有高血压、糖尿病、既往心肌梗死或Killip III级或IV级疾病。心力衰竭、心脏破裂或心律失常导致的死亡率在发病后呈指数级下降。再灌注治疗可有效降低早期死亡率。对冠状动脉痉挛合并慢性稳定型心绞痛患者，采用DCA导管切除器质性冠状动脉狭窄部位。对增厚的内膜进行了组织学检查，然而，我们无法确定冠状动脉痉挛部位的特殊表现。采用高效液相色谱法对缺血性心脏病患者进行脂蛋白分析。不断积累的数据定义了与脂蛋白含量和大小有关的风险。应用60张单极心外膜电图对麻醉开胸犬再灌注后心室颤动的发生机制进行了研究。VF组随再灌注时间延长，ST房变进展明显。传导阻滞和再入位于不一致的ST交替部位之间，紧接着出现VF。高甘油三酯血症家兔与WHHL家兔自交系，4代后高甘油三酯血症渗透率达95%。详细分析了其病理生理特征。

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.