The pullback pressure from the left renal vein (LRV) to the inferior vena cava was studied in 16 patients with left renal bleeding of unknown origin (group A), 15 patients with hematuria of miscellaneous laterality (group B), and nine control subjects (group C). The mean pressure gradients were 5.0 +/- 2.0 mm Hg (mean +/- SD) in group A, 1.9 +/- 1.0 mm Hg in group B, and 1.1 +/- 0.9 mm Hg in group C. The mean pressure gradient of group A was significantly higher than that of groups B and C (P less than .001). From the results of control studies, we regarded pressure gradients greater than or equal to 3.0 mm Hg as indicative of LRV hypertension. With this criterion, 88% (14 of 16) of the patients in group A had LRV hypertension, which was considered a cause of hematuria. Analysis of the results of renal angiography in the 31 patients revealed that opacification of collateral pathways of the LRV was a significant angiographic finding in LRV hypertension.
In addition to hydration, ANP administration is effective in the prevention of CIN in patients with chronic renal failure, and the effect was maintained for 1 month.
Our results confirm that perfusion defect volume by Tc-99m tetrofosmin scintigraphy is the most pivotal predictor of the future occurrence of lethal arrhythmic events and of sudden cardiac death. Tc-99m tetrofosmin SPECT images may assist in identifying subsets of patients with a greater likelihood of arrhythmic death among patients with LV dysfunction.
SUMMARYA 45-year-old Japanese man with paroxysmal atrial fibrillation (AF) developed acute anteroseptal myocardial infarction (MI). He had used 1 % topical minoxidil (RiUP ® ) once a day for 4 months before the onset of MI for treatment of baldness. Coronary angiography demonstrated severe stenosis at the proximal portion of the left anterior descending coronary artery with a filling defect. Electrocardiographic monitoring revealed paroxysmal AF and sinus bradycardia with sinus arrests, suggestive of sick sinus syndrome. Topical minoxidil is now widely used for the treatment of male pattern baldness. Although it may be difficult to relate topical use of minoxidil to myocardial ischemia, a greater awareness of its toxicity will be necessary, and patients with cardiovascular disorders should be excluded from the therapy. (Jpn Heart J 2000; 41: 519-523)
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