Sex differences exist in the relationship between increases in IMT and age. Age, sex and diabetes mellitus represented the main risk factors.

Cardiomyopathic lesions involving the basal portion and mitral complex were frequently induced in rabbits by vagal stimulation. These lesions bear a close similarity in distribution and reversibility to inverted Takotsubo cardiomyopathy.

SUMMARYA 69-year-old male patient with type 1 diabetes mellitus had been under treatment at our outpatient clinic since the age of 65. He had previously undergone surgery for esophageal cancer at the age of 55; the excised portion of the esophagus was replaced by a retrosternal gastric tube. He was admitted to our hospital for suspected pneumonia on April 8, 2004. An electrocardiogram (ECG) on admission showed marked ST depression in leads V 1 and V 2 , and prominent negative T waves in leads I and aVL; however, the T waves unexpectedly flattened after 2 minutes and the ST depression resolved after about 4 hours. On January 7, 2005, we performed a deep breathing test to analyze the effects of movements of the thoracic wall and intrathoracic structures on the ECG. In this test, deep inspiration induced ST depression reaching 0.5 mV in leads V 1 to V 3 ; this resolved on switching to deep expiration. ECG changes together with chest computed tomography images supported the concept that the ST-T abnormalities were induced by cardiac compression caused by expansion of the gastric tube between the sternum and heart. We have reviewed 7 other similar reported cases. (Int Heart J 2006; 47: 475-482) Key words: Electrocardiography, ST-T segment, Esophageal cancer, Deep breathing test, Chest computed tomography, Echocardiography, Diabetes mellitus, Retrosternal reconstruction, Gastric tube, Cardiac compression ELECTROCARDIOGRAPHY (ECG) is a useful tool for detecting ischemic heart disease, particularly in diabetic patients, because they often lack typical symptoms suggesting myocardial ischemia. However, it has been pointed out that ECG abnormalities resembling myocardial ischemia may be induced by extracardiac factors.1,2) Recently, compression of the heart by a retrosternal gastric tube TAKATO, ET AL used for esophageal reconstruction after resection of esophageal tumors has increasingly received attention as a new extracardiac factor that can induce prominent but reversible ECG abnormalities. [3][4][5][6][7][8] Resection of the esophagus followed by retrosternal reconstruction with a gastric tube is the most common surgical treatment for esophageal cancer in Japan. The diabetic patient presented in this report demonstrated marked reversible abnormalities in ECGs recorded 14 years after retrosternal gastric tube reconstruction was performed following resection of an esophageal tumor. CASE REPORTA 69-year-old male patient who had been under treatment for type 1 diabetes mellitus at our outpatient clinic since the age of 65 was admitted for suspected pneumonia on April 8, 2004. He had previously undergone retrosternal esophageal reconstruction using a gastric tube after excision of an esophageal tumor at the age of 55. He had never complained of any pain or discomfort in his chest that suggested ischemic heart disease. On admission, his chief complaints were cough and chills. His height was 166 cm and weight was 46.1 kg. He had a high fever of 39.9°C associated with a sinus tachycardia of 122/min. His blood pressure was...

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We have recently demonstrated that basal cardiomyopathy develops in rabbits with ventricular tachyarrhythmias that have been induced by electrical stimulation of the cervical vagus. This study investigated whether similar basal car-diomyopathy would develop in rabbits with ventricular tachyarrhythmias induced by a single injection of adrenaline. Adrenaline was intravenously infused for 10-360 seconds in anesthetized rabbits. Colloidal carbon was injected after adrenaline infusion. Wall movement velocity of the left ventricular base was assessed by tissue Doppler echocardiogra-phy. Animals were killed either 1 week or 3-4 weeks later. Pathological lesions were identifi ed by deposits of carbon particles. Animals were divided into two groups according to the infused dose of adrenaline. The small-dose group (group S, n = 15) received 1-10 μg and the large-dose group (group L, n = 23) received 15-60 μg of adrenaline. Adrena-line infusion induced premature ventricular contractions followed by monomorphic ventricular tachycardias in 22 of 23 animals in group L, but in only 1 of 15 animals in group S. Wall movement velocity of the left ventricular base decreased just after adrenaline infusion, remained low after 1 week, and recovered to near-baseline levels after 3-4 weeks in group L. Unique cardiac lesions identifi ed by deposits of carbon particles were frequently observed on the left ventricular basal portion, almost always associated with the mitral valve and papillary muscles, but were never observed in the apical area. Lesions involving all areas of the left ventricular basal portion were observed in 22 of 23 animals in group L, but in only 2 of 15 animals in group S. Basal cardiomyopathy developed in rabbits with ventricular tachycardias induced by a single injection of adrenaline. (Int Heart J 2014; 55: 78-83) T he basal portion of the heart had attracted little attention until recent interest in the new disease entity called inverted Takotsubo cardiomyopathy, which is characterized by reversible isolated myocardial lesions in basal segments of the left ventricle. 1-8) We have recently demonstrated that a basal cardiomyopa-thy associated with unique mitral complex lesions develops in rabbits with ventricular tachyarrhythmias that have been induced by repeated electrical stimulations of the intact cervical vagus nerve. The cardiac lesions are similar in distribution to inverted Takotsubo cardiomyopathy. 9) In a previous study, 10) we revealed that a single injection of adrenaline induced ventricu-lar tachyarrhythmias with subsequent development of unique mitral complex lesions quite similar to those observed in rabbits with ventricular tachyarrhythmias induced by electrical stimulation of the intact cervical vagus nerve. 11-13) In these studies, we paid little attention to myocardial lesions in basal segments of the heart. The present study therefore investigated whether similar basal cardiomyopathy developed in rabbits in which ventricular tachyarrhythmias had been induced by a single injection of adrenaline. M...