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

对1993年4月~1995年12月山形地区急性心肌梗死后早期死亡率及其影响因素进行了研究。在41家医院登记的1014名急性心肌梗死患者中，有184名患者在发病后28天内死亡(短期死亡率为18%)，并与存活的患者进行了比较。死亡的患者明显比存活的患者年龄大(76vs68岁，p&lt；0.01)，更有可能是女性(50vs31%)，有高血压、糖尿病、既往心肌梗死或Killip III或IV级疾病。心力衰竭、心脏破裂或心律失常引起的死亡率在发病后呈指数下降。冠状动脉痉挛合并慢性稳定型心绞痛采用DCA导管切除器质性狭窄部位，再通治疗能有效降低早期死亡率。增厚的内膜进行了组织学检查，然而，我们不能确定冠状动脉痉挛部位特有的发现。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。这些数据一直在积累，以确定与脂蛋白组分的水平和大小相关的风险。我们使用60个单极心外膜电图仪研究了麻醉开胸犬再灌流后发生室颤的机制。VF组再灌注后ST段改变随时间延长而延长。在VF出现之前，传导阻滞和位于不协调ST段交替点之间的折返发生在VF出现之前。高甘油三酯血症的兔是由WHHL兔近交的，4代后高甘油三酯血症的渗透率为95%。并对其病理生理特点进行了详细分析。

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.