• Title/Summary/Keyword: 심실운동

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Prediction of Improvement of Hibernating Myocardium after Coronary Artery Bypass Grafting -The role of dobutamine stress echocardiography- (동면심근을 가진 관상동맥 환자의 수술 후 기능회복의 예측에 대한 임상적 고찰 - Dobutamine 심초음파의 역할 -)

  • 유경종;강면식;이교준;김대준;임세중;정남식
    • Journal of Chest Surgery
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    • v.31 no.8
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    • pp.776-780
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    • 1998
  • Background: In patients with coronary artery disease, dysfunctional hypoperfused myocardium at rest may represent either nonviable or viable hibernating myocardium. Two-dimensional echocardiography can detect regional wall motion abnormalities resulting from myocardial ischemia by dobutamine infusion. The purpose of the present study was to identify the prediction of improvement of regional left ventricular(LV) function after surgical revascularization. Materials and methods: Sixteen patients with chronic regional LV dysfunction underwent dobutamine stress echocardiography(DSE) (dobutamine: baseline, 5, 10, 20$\mu$g/kg/min) before coronary artery bypass grafting(CABG) and underwent echocardiography at least 2 months after CABG. Results: All patients were male with mean age of 58 years ranging from 42 to 73 years. The mean LV ejection fraction was 41.8% with a range from 19% to 55%. During DSE, there were no complications, also, there were no operative morbidities or mortalities. Improvement of wall motion within the dysfunctional myocardium was found in 8(50%) of 16 patients in DSE. Among them, 6 patients(75%) showed functional recovery after CABG. Another 8 patients did not show improvement of wall motion in DSE. But among them, 3 patients(38%) showed functional recovery after CABG. 84 dysfunctional segments were found in 256 segments of 16 patients. Improvement of wall motion was found in 34 of 84 segments in DSE. Among them, 23 segments(74%) showed functional recovery after CABG. Another 53 segments did not show improvement of wall motion in DSE. But among them, 12 segments(23%) showed functional recovery after CABG. The sensitivity and specificity of DSE for the prediction of postoperative improvement of segmental wall motion were 66% and 84%, respectively. The positive and negative predictive value of DSE were 74% and 77%, respectively. In patients with chronic regional LV dysfunction, think that DSE is a good predictor of the improvement of dysfunctional segments after CABG.

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Right Ventricular Myxoma Obstructing Right Ventricular Outflow Tract (점액종에 의한 우심실 유출로 협착)

  • Song Kwang-Jae;Yun Tae-Jin
    • Journal of Chest Surgery
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    • v.39 no.8 s.265
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    • pp.637-639
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    • 2006
  • Cardiac myxoma is the most common primary tumor of the heart, but right ventricular myxoma causing outflow obstruction is relatively rare. A 15 years old girl developed dyspnea on exertion and intermittent syncope caused by a right ventricular mass obstructing the right ventricle outflow tract. Transthoracic echocardiography revealed $3.6{\times}3.0\;cm$ sized pedunculated subpumonic mass originating from the right ventricular anterior free wall. The patient underwent an emergency operation, consisting of the removal of the mass by wide excision of the tumor base and PTFE (polytetrafluoroethylene) patching of the right ventricular anterior free wall defect. Pathological findings of the mass were compatible with myxoma, and the patient was discharged uneventfully 7 days after the operation.

Cardiac MRI (심장 자기공명영상)

  • Lee, Jong-Min
    • Investigative Magnetic Resonance Imaging
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    • v.11 no.1
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    • pp.1-9
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    • 2007
  • The obstacles for cardiac imaging are motion artifacts due to cardiac motion, respiration, and blood flow, and low signal due to small tissue volume of heart. To overcome these obstacles, fast imaging technique with ECG gating is utilized. Cardiac exam using MRI comprises of morphology, ventricular function, myocardial perfusion, metabolism, and coronary artery morphology. During cardiac morphology evaluation, double and triple inversion recovery techniques are used to depict myocardial fluidity and soft tissue structure such as fat tissue, respectively. By checking the first-pass enhancement of myocardium using contrast-enhanced fast gradient echo technique, myocardial blood flow can be evaluated. In addition, delayed imaging in 10 - 15 minutes can inform myocardial destruction such as chronic myocardial infarction. Ventricular function including regional and global wall motion can be checked by fast gradient echo cine imaging in quantitative way. MRI is acknowledged to be practical for integrated cardiac evaluation technique except coronary angiography. Especially delay imaging is the greatest merit of MRI in myocardial viability evaluation.

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Shape and Motion Visualization of the Left Ventricle using a Dynamic Gaussian Blob Model (동적 가우시안 블럽 모델을 이용한 좌심실의 형태 및 운동 가시화)

  • Choi, Soo-Mi;Kim, Myoung-Hee
    • Journal of KIISE:Computer Systems and Theory
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    • v.27 no.9
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    • pp.768-776
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    • 2000
  • 본 논문에서는 심혈관 조영영상으로부터 좌심실의 형태 및 운동을 가시화하기 위해 기하학적 정보와 물리적 정보를 통합한 동적 가우시안 블럽(dynamic gaussian blob)모델을 개발하였다. 동적 가우시안 블럽 모델은 superellipsoid에 3차원 가우시안 형태함수를 갖는 단일 유한요소를 통합한 것으로, 좌심실에 작용되는 가상적인 힘에 의해 형태를 적하하고, 심박동 전 주기에서의 운동을 추적한다. 또한 벽 운동 정도에 따라 다른 색을 지정하여 볼 수 있도록 함으로써 벽 운동에 이상이 있는 부위를 육안으로 쉽게 판별할 수 있도록 하였다. 이와 같은 좌심실의 동적.색체 가시화는 형태가 변황되는 심장질환이나 허혈이나 심근경색증처럼 심실벽 운동에 이상이 있는 질환의 진단을 도울 수 있다.

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Unidirectional Valve Patch Closure for Ventricular Septal Defect with Severe Pulmonary Hypertension -A case Report - (심한 폐동맥고혈압을 동반한 심실중격결손 환자에서 일방성 판막 팻취를 이용한 교정술 -1례 보고-)

  • 문석환;조건현;장윤희;박성룡;왕영필;김세화;곽문섭;강재걸
    • Journal of Chest Surgery
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    • v.31 no.7
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    • pp.718-721
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    • 1998
  • The surgical closure of VSD in patient with severe pulmonary hypertension has been considered a difficult problem for surgeons, because sudden hemodynamic change after closure of the defect could bring on high perioperative mortality. Recently, it was reported that UVP(unidirectional valve patch), which allows some blood to flow from right to left in case of acute right heart failure, is effective in improving the postoperative hemodynamics after closing septal defects. This 42-year old woman had suffered from VSD for 20 years and recently complained of worsening exertional dyspnea for three months, and was diagnosed of a large VSD(2.0 cm in diameter) with severe pulmonary hypertension(116/38 mm Hg), equal to systemic arterial pressure. We could successfully close VSD with severe pulmonary hypertension using one UVP and the other UVP for the creative ASD to be prepared against possible acute right heart failure. She was discharged on the fourteenth postoperative day and has been well for twelve months with spontanenous closure of UVP patch at the ninth postopeative month.

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Myocardial Hamartoma Involving the Interventricular Septum (심실중격을 침범한 심근이형종)

  • 이정렬;황호영;배은정;김종재
    • Journal of Chest Surgery
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    • v.36 no.4
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    • pp.277-279
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    • 2003
  • A 15 year-old boy was referred to us because of mild dyspnea on exertion and incidentally found heart murmur. On echocardiography, a mass involving mainly interventricular septum and causing left ventricular outflow tract obstruction was detected. Cardiac catheterization demonstrated a transaortic pressure gradient of 20 mmHg. Partial excision of the septal mass was performed via aortotomy under cardiopulmonary bypass. The pathologic diagnosis revealed myocardial hamartoma. The lesion was mainly composed of mature, severely hypertrophic myocytes and intervening fibrosis. During the 5 year of follow-up after the surgery, no evidence of arrhythmia or tumor recurrence was documented.

Double Outlet Right Ventricle in a Maltese Dog (말티스견에서 발생한 양대혈관 우심실기시)

  • Lee, Jong-Sung;Choi, Ran;Han, Suk-Hee;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.27 no.6
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    • pp.735-739
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    • 2010
  • An 8 month old female Maltese (body weight 3.6 kg) was referred with primary complaints of dyspnea and exercise intolerance. Diagnostic imaging studies revealed marked cardiomegaly and prominent main pulmonary trunk dilation on thoracic radiography, abnormally arisen aortic roots (toward right ventricle) with left-to right shunted perimembraneous ventricular septal defect located underneath of aortic root, aortic root was located to predominantly to the right ventricle and pulmonary regurgitation (peak velocity 4.7 m/s, pressure gradient ~88 mmHg) from pulmonary over-circulation and hypertension on echocardiography, indicating double outlet right ventricle (DORV). The dog was treated with furosemide (1 mg/kg, BID) for reducing volume overload at right ventricle, spironolatcone (1 mg/kg) and enalapril (0.5 mg/kg) for minimizing deleterious cardiac remodeling, and sildenafil (1 mg/kg) for lessening pulmonary over-circulation and hypertension. The clinical condition of this dog was improved after 1 week of medical treatment. The dog is currently survived and regularly monitored.

Electrocardiographic and Echocardiographic Characterisitics of Wolff-Parkinson-White Syndrome in Preschool Children (학동전 아동에서 Wolff-Parkinson-White 증후군의 심전도 소견에 따른 유형 및 심초음파 소견)

  • Chu, Jeoung Min;Sim, Hyun Sup;Cho, Soo Chul;Joo, Chan Uhng
    • Clinical and Experimental Pediatrics
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    • v.45 no.9
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    • pp.1097-1105
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    • 2002
  • Purpose : This study was conducted to estabilish the prevalence, clinical features and relationship between ECG findings and echocardiographic findings of Wolff-Parkinsion-White(WPW) syndrome in asymptomatic preschool children. Methods : An electrocardiographic screening study was performed on 77,824 preschool children in Jeonbuk province from April, 1999 to August, 2001. Patients with WPW syndrome underwent echocardiographic study. Results : Twenty three patients with WPW syndrome were discovered by electrocardiographic screening of preschool children. The prevalence rate was 2.9 per 10,000 preschool children and there was no significant sexual difference. Two patients had a history of symptoms related to tachyarrythmia. According to the ECG classification of Rosenbaum et al., five patients were type A and 18 were type B. Utilizing the criteria of Gallagher et al, right anterior, 12 patients; right anteiror paraseptal, four patients; left anteiror, three patients. Nineteen of 23 patients underwent echocardiographic study. Four of five patients with type A WPW syndrome had abnormal early systolic anterior motion of left ventricular posterior wall. Twelve of 14 patients with type B had abnormal interventricular septal motion characterized by early sytolic posterior motion immediately after inscription of the delta wave. Conclusion : The prevalence rate of preschool children in Jeonbuk province was 2.9/10,000. By the classification according to the electrocardiographic findings, the accessory pathway location was dominant right side than left side. In the echocardiographic study, type A WPW syndrome showed abnormal left ventricular posterior wall motion and type B WPW showed abnormal interventricular septal motion.

Interaction of Blood Flow and Leaflet Behavior in a Bileaflet Mechanical Heart Valve (기계식 인공심장판막(MHV)에서의 혈액유동과 판막운동의 상호작용)

  • 최청렬;김창녕;권영주
    • Journal of Biomedical Engineering Research
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    • v.21 no.5
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    • pp.505-512
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    • 2000
  • 기계식 인공심장판막을 통한 혈액의 유동과 이 유동에 관련된 판첨의 거동특성을 수치해석기법을 이용하여 연구하였다. 혈액은 맥동류, 층류, 비압축성 유동으로 가정하였으며 유체-고체의 상호작용을 고려하기 위하여 혈액의 유동방정식과 고체의 운동방정식이 동시에 계산되었다. 심실과 대동맥에서의 압력파형을 경계조건으로 사용하였다. 연구의 결과로서 혈액유동과 판첨의 거동이 예측되었으며, 판막을 통한 3개의 제트가 발견되었으며 vortex가 판첨의 끝단에서 발생하여 하부로 흘러가는 것이 관찰되었다. 판첨의 닫힘 거동은 열림 거동에 비하여 2배정도 빠르게 진행되었으며 sinus에서 2개의 큰 vortex가 관찰되었다. 유체-고체 상호작용을 고려하는 본 연구방법은 향후 판막의 연구와 개발에 매우 유용할 것으로 판단된다.

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