(7) Clinical and Pathological Studies on Coronary Angiography in Patients of Angina Pectoris and Myocardial Infarction

To evaluate the diagnostic usefulness of coronary angiography is the purpose of this presentation.Coronary angiography was performed both on pathological materials and clinical cases and compared with histopathological and other clinical findings.Method: Forty-nine hearts were studied by the method described by Schlesinger, and stereographic method was adopted.Frontal sections of 15cm.thickness were once more photographed by ultrasoft X ray.Other 169 hearts were studied by the method of Schonmacker.The contrastmedium was injected at first only into the left coronary arteries.Postero-anterior and left-anterior-oblique X-ray films were taken.Thereafter right coronary arteries were filled by contrast medium and photographed in the same positions.These experiments were made by Dr. K. Aoki under the supervision of prof.G.A. Neuhaus of the Free University Berlin, and sent to us by his kind permission to use for our investigation.Clinical coronary angiographies were performed by Seldinger's method on 28 cases and 50 exposures were made.By using electronically controled X-ray apparatus, the injection was made at the end of systole under the pressure of 14kg./cm2., and exposure was made just before the systole of the second beat from the injection.We used 80% Angioconray as contrast medium.Eighty-five preliminary experiments on dogs using same method showed no serious complication.We experienced no direct serious complication on clinical trials of 50 times except for one case of femoral thrombosis.Results; 1. Grade of coronary sclerosis evaluated from the angiographic films of autopsy materials showed good correlations with histological findings of the coronary arteries of the respective parts, and with grade of histopathological changes in respective myocardium.2. Almost all the hearts which showed fine appearance of small arteries in the left ventricular myocardium on the ultrasoft X ray films corresponded to the ECG findings of left ventricular hypertrophy.3.About a half of cases whose angiograms revealed moderate grade of sclerosis showed normal ECG.Almost all the cases of normal angiographic appearance had normal ECG.All the cases of myocardial infarction showed severe sclerosis on