• Title/Summary/Keyword: 급성 심근경색

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Changes of the Plasma Atrial Natriuretic Peptide during Myocardial Infarction in Rats (흰쥐 심근경색 모델에서 혈장 Atrial Natriuretic Peptide의 변화)

  • Ahn, Dong-Choon;Kim, In-Shik
    • Journal of Veterinary Clinics
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    • v.29 no.2
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    • pp.148-153
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    • 2012
  • Atrial natriuretic peptide (ANP) is associated with the variety of disorders of myocardial function. The effect, however, of myocardial infarction (MI) on ANP has not been fully described. Thus, this study investigated the effect of experimental MI, induced by left coronary artery ligation, on ANP secretion. Male Sprague-Dawley rats aged 60 d underwent ligation of the left anterior descending coronary artery to induce MI and were compared with a group that underwent a sham operation. Rats of sham operation had a similar procedure without having the suture tightened around the coronary artery. Animals were sacrificed at 1, 3, 6, 12, and 18 h or 1, 3, 5, 7, 14, and 30 d after the procedure. MI size was assessed by planimetry and perimetry, and plasma ANP levels were determined by radioimmunoassay. Mean infarct size was 39.6-44.5% of the left ventricle after coronary occlusion in experimental groups. No significant differences were observed in infarct size among groups. In contrast, the concentration of plasma ANP was significantly higher at 1, 3, 6, 12, 18, and 24 h after left coronary artery ligation than in sham animals. This parameter, however, did not differ significantly at 3, 5, 7, 14, and 30 d after ligation compared with sham-ligated controls. These results demonstrate that plasma ANP levels are markedly increased in the early phase of MI in the male rat and can be a useful biomarker for diagnosis in acute MI.

The Feasibility of the DKUH-75 Left Ventricular Assist Device for Acute Cardiogenic Shock in Pigs (돼지의 급성 심인성 쇼크 모델에서 DKUH-75 좌심실보조키의 유용성에 관한 연구)

  • Park, Seong-Sik
    • Journal of Chest Surgery
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    • v.40 no.3 s.272
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    • pp.168-179
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    • 2007
  • Background: The recent trend of an increasing number of patients with acute cardiogenic shock or chronic congestive heart failure following myocardial infarction, as well as the considerable number who can not be weaned from cardiopulmonary bypass after open heart surgery, call for immediate efforts to develop affordable ventricular assist devices that are suitable for the Korean physique. Recently, a pneumatic pulsatile ventricular assist device (VAD), named DKUH-75, has been developed by the Department of Biomedical Engineering, in collaboration with the Department of Thoracic and Cardiovascular Surgery of Dankook University College of Medicine. The feasibility of the DKUH-75 VAD was evaluated on the bases of common hemodynamic variables and echocardiographic measurements in pigs, which are subjected to an acute cardiogenic shock state following myocardial infarction, using a novel coronary artery ligation method employing the ischemic preconditioning concept. Material and Method: Acute cardiogenic shock was induced in 10 Yorkshire Landrace Duroc strain pigs by ligating the left anterior descending coronary artery via an ischemic preconditioning process. The hemodynamic variables were monitored, with epicardial echocardiographic measurements performed before and one hour after the ligation. The DKUH-75 VAD was implanted into 5 pigs one hour after the onset of the shock. The hemodynamic variables and echocardiographic measurements were taken one hour after installation of the VAD. Result: The systolic, diastolic and mean systemic arterial pressures were significantly decreased in all the experimental animals one hour after the ligation. The systolic, diastolic and mean pulmonary arterial pressures were increased (Eds note: this completely contradicts the preceding statement? However, if you mean the non-experimental animals this should be stated?). The left ventricular end diastolic pressure (LVEDP) was increased, but the cardiac index decreased, An increase in the left ventricular end systolic dimension and decreases in the fractional shortening and ejection fraction were observed all animals one hour after the coronary artery ligation. In all 5 of the VAD implanted pigs, the systolic and mean systemic arterial pressures were increased, and the pulmonary arterial pressures decreased one hour after the implantation; the LVEDP decreased, but the cardiac index was significantly increased, In the echocardiographic measurements, the left ventricular end systolic dimension decreased after the implantation of the VAD, but the fractional shortening and ejection fraction significantly increased. Conclusion: Significant improvements in the hemodynamic variables and echocardiographic measurements were observed in the 5 VAD implanted animals one hour after installation, which had been subjected to an acute cardiogenic shock state by ligation of the coronary artery, indicating that the DKUH-75 VAD could help in the recovery of the myocardial function. This suggests that the DKUH-75 VAD is feasible in the short term in relation to an acute cardiogenic shock state due to myocardial infarction.

Weighting of Acute Myocardial Infarction Quality Indicators using Delphi Method (델파이기법을 이용한 급성심근경색증 질 평가지표 가중치 부여)

  • Kim, Hyung Seon;Cho, Yeon Hee
    • Journal of Korean Public Health Nursing
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    • v.28 no.3
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    • pp.565-573
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    • 2014
  • Purpose: Health Insurance Review & Assessment Service (HIRA) launched an Acute Myocardial Infarction(AMI) assessment for the Payment For Performance(Quality Incentives) Pilot Project from July 2007. Assessment measures of AMI were composed of five process measures and one outcome measure, and each measure was incorporated into one composite quality score to Pay for Performance. Method: For calculation of composite quality score, we considered weighting for the measures using the Delphi method. The questionnaire was composed of three measure groups, 'Reperfusion rate'(Fibrolytic therapy received within 60 minutes of hospital arrival, Primary Percutaneous Coronary Intervention within 120 minutes of hospital arrival), 'Medication prescription rate'(Aspirin at arrival, Aspirin prescribed at discharge, Beta-blocker prescribed at discharge) and 'Survival Index'(30-day mortality rate). Result: A panel composed of 18 and completed a questionnaire by allocation of 10 scores to the three above mentioned measure groups. The Delphi was carried out until three rounds of surveys. In conclusion, each measure group was weighted differently and the 10 scores were allocated as 4.5 to 'Reperfusion rate', 2.5 to 'Medication prescription rate', and 3.0 to 'Survival Index'. Conclusion: The results of this study proposed the calculation method for weighting of Acute Myocardial Infarction quality indicators.

Assessment of Viability in Regional Myocardium with Reversed Redistribution by Thallium Reinjection in Patients with Acute Myocardial Infarction (급성심근경색 환자에서 역재분포를 보인 심근의 Thallium 재주사에 의한 생존능의 평가)

  • Yoon, Seok-Nam;Park, Chan-H.;Pai, Moon-Sun
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.6
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    • pp.509-515
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    • 1998
  • Purpose: The aim of this study was to evaluate whether T1-201 reinjection distinguishes viable from non-viable myocardium in patients with reverse redistribution after acute myocardial infarction. Materials and Methods: We studied 42 patients with acute myocardial infarction (age, $55{\pm}12$ years). Eighteen (43%) out of 42 showed reverse redistribution on dipyridamole stress-4 hour redistribution T1-201 single photon emission computed tomography (SPECT). T1-201 reinjection was performed at 24 hours. Reverse redistribution was defined as worsening of perfusion defect at 4 hour delayed scan. All patients underwent follow-up echocardiography in 4 months to assess regional wall motion improvement. T1-201 uptake on reinjection images were analyzed for the prediction of myocardial wall motion improvement. Results: Of 36 segments with reverse redistribution, 17 segments showed normal wall motion on echocardiography, while 19 segments showed wall motion abnormalities. Of 19 the segments with reverse redistribution, 11 (58%) showed enhanced uptake after 24 hour reinjection. Myocardial wall motion was improved in 10 of 11 segments (90%) with enhanced uptake on reinjection. Wall motion improvement was not seen in 5 of 8 segments (63%) without enhanced thallium uptake. When myocardial viability was assessed by the uptake on reinjection image, nine of 10 segments (90%) with normal or mildly decreased uptake showed improved wall motion. Wall motion was not improved in 5 of 9 segments (16%) with severely decreased uptake. Conclusion: In patients with acute myocardial infarction, T1-201 reinjection imaging on myocardial segments with reverse redistribution has a high positive predictive value in the assessment of myocardial viability.

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